A healthy diet for prediabetes does not necessarily need to be low in carbohydrates. According to U.S. News and World Report rankings, the two types of diet for prediabetes and high cholesterol in 2018 are moderate diet patterns. A Mediterranean diet pattern is ranked first, followed closely by the Dietary Approaches to Stop Hypertension, or DASH, diet.
Sometimes pills for diabetes — even when combined with diet and exercise — aren't enough to keep blood sugar levels under control. Some people with type 2 diabetes also have to take insulin. The only way to get insulin into the body now is by injection with a needle or with an insulin pump. If someone tried to take insulin as a pill, the acids and digestive juices in the stomach and intestines would break down the medicine, and it wouldn't work.
The evidence is growing stronger that eating red meat (beef, pork, lamb) and processed red meat (bacon, hot dogs, deli meats) increases the risk of diabetes, even among people who consume only small amounts. The latest support comes from a “meta analysis,” or statistical summary, that combined findings from the long-running Nurses’ Health Study I and II and the Health Professionals Follow-Up Study with those of six other long-term studies. The researchers looked at data from roughly 440,000 people, about 28,000 of whom developed diabetes during the course of the study. (43) They found that eating just one daily 3-ounce serving of red meat—say, a steak that’s about the size of a deck of cards—increased the risk of type 2 diabetes by 20 percent. Eating even smaller amounts of processed red meat each day—just two slices of bacon, one hot dog, or the like—increased diabetes risk by 51 percent.
The role of inflammation is an area of extreme interest in regard to disease development. For example, we have begun to understand the importance of inflammation and heart disease. We now know that inflammation may play an important role in the development of diabetes as well. An inflammation marker known as C-reactive protein (CRP) has been shown to be increased in women at risk for developing the metabolic syndrome, and in both men and women at risk for developing type 2 diabetes. Recent studies have shown shifts in the blood levels of a number of markers for inflammation during the progression from no disease, to prediabetes, and then to full-blown diabetes. This research highlights the importance of inflammation as part of the mechanism of diabetes development.
According to American Diabetes Association (ADA) recommendations, it may be appropriate for people with type 2 diabetes whose A1Cs are close to target to manage diabetes with lifestyle changes alone for three to six months—provided their doctor deems them "highly motivated." If that doesn't work, metformin is typically the first in a long list of type 2 blood glucose–lowering medications to add to the diet and exercise plan.
To hit your blood sugar level target, eat a variety of foods but monitor portions for foods with a high carbohydrate content, says Alison Massey, RD, CDE, the director of diabetes education at Mercy Medical Center in Baltimore. “[Foods high in carbohydrates] have the most impact on blood sugar level. This is why some people with diabetes count their carbohydrates at meals and snacks,” she says.
Dr. Erica Oberg, ND, MPH, received a BA in anthropology from the University of Colorado, her doctorate of naturopathic medicine (ND) from Bastyr University, and a masters of public health (MPH) in health services research from the University of Washington. She completed her residency at the Bastyr Center for Natural Health in ambulatory primary care and fellowship training at the Health Promotion Research Center at the University of Washington.
Losing weight and keeping it off. Weight control is an important part of diabetes prevention. You may be able to prevent or delay diabetes by losing 5 to 10 percent of your current weight. For example, if you weigh 200 pounds, your goal would be to lose between 10 to 20 pounds. And once you lose the weight, it is important that you don't gain it back.
When the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs – the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.
The oral glucose tolerance test (OGTT), or glucose tolerance test is a blood test used (not routinely however) to diagnose diabetes, and gestational diabetes. Information in regard to reliability of the oral glucose tolerance test is important, as some conditions (common cold), or food (caffeine), or lifestyle habits (smoking) may alter the results of the oral glucose tolerance test.
As a renal dietitian my focus can’t be solely on diabetes. Although a very large percentage of our patients with chronic kidney disease are here due to unmanaged blood sugar control, that is just one of our problems. I have to prioritize my counseling in other ways – the most important being control of potassium, then sodium (fluid), protein and phosphorus.
Controlling Type II Diabetes by diet is an absolute must. Eating low glycemic foods and staying away from highly processed foods that contain hidden toxins as well as hidden sugars is important. You cannot always trust food labels so I suggest eating as many foods that DO NOT have labels – fresh vegetables, lean proteins and nutrient rich complex carbohydrates. Some examples include, spinach, kale, asparagus, broccoli, brussel sprouts, sweet potatoes, quinoa, brown rice or bean pastas – and of course lots of lean proteins from chicken, turkey and fish. Eliminate high sugar vegetables such as peas, carrots and corn and stay away from white foods such as white flour, bread, pastries, cakes, dairy and milk products (eggs are ok).
Phelps also made significant changes to his exercise routine, which went from 1/3-mile walks around his neighborhood (it took him 40 minutes and three rest stops the first time) to walking a half marathon a little under a year later. As he lost weight and became fitter, Phelps got addicted to triathlons. At 64, he's now set his sights on Ironman races, which he hopes to compete in next year.
One serving in a category is called a "choice." A food choice has about the same amount of carbohydrates, protein, fat and calories — and the same effect on your blood glucose — as a serving of every other food in that same category. So, for example, you could choose to eat half of a large ear of corn or 1/3 cup of cooked pasta for one starch choice.
Some people with type 2 diabetes are treated with insulin. Insulin is either injected with a syringe several times per day, or delivered via an insulin pump. The goal of insulin therapy is to mimic the way the pancreas would produce and distribute its own insulin, if it were able to manufacture it. Taking insulin does not mean you have done a bad job of trying to control your blood glucose—instead it simply means that your body doesn’t produce or use enough of it on its own to cover the foods you eat.
Two large studies - one in Finland and the other one U.S. (the Diabetes Prevention Program- DPP) have shown the benefit of weight loss in diabetes prevention. In the Finnish study, more than 500 men and women with impaired glucose tolerance were assigned to a control group or an exercise/weight loss group. By the end of the study, the weight loss group had lost about 8 pounds, and the control group about 2 pounds. The weight loss group had significantly less participants develop diabetes than the control group.
She still plans to lose more weight, but she knows that slow and steady beats the quick loss (and equally quick regain) she experienced on countless fad diets in her past. Because she's not trying to drop a dress size—she wants to change her life. "My goal is to be as healthy as I can," she says. "If something happens and one day I'm back on medication, my goal is still to be healthy."
Eat every two to three hours. Spreading your energy needs throughout the day allows for healthier choices to be made and your blood sugar to stabilize. Work towards achieving a healthy meal pattern of breakfast (the first meal), followed by a small snack, then lunch (mid-day meal), another snack, dinner (last-meal of the day) and sometimes a small end of the day snack. 

In this country, we tend to over- do it on those. Most people do not enjoy measuring their foods or counting carbs. My favorite way to estimate portion sizes is to use the “Create Your Plate” method created by the America Diabetes Association. Simply use a disposable plate divided into three sections (one half-plate section and two quarter plate sections). The large, half plate section should be used for non-starchy vegetables, things like carrots, broccoli, or cauliflower. Place your lean meat or protein in one quarter-plate section, and your carbohydrate in the other quarter-plate section. You can practice designing your meal using this method on their website: http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/


Regular physical activity helps the body cells take up glucose and thus lower blood glucose levels. Regular physical activity also helps with weight loss as well as controlling blood cholesterol and blood pressure. You need to let your doctor and dietitian know about the kinds of physical activities you do regularly. Your doctor and dietitian will help you balance your physical activity with your medication and diabetic meal plan. If you are not physically active now, your doctor may recommend that you increase physical activity. Important benefits of a regular aerobic exercise program in diabetes management include decreased need for insulin, decreased risk of obesity, and decreased risk for heart disease. Exercise decreases total cholesterol, improves the ratio of low-density lipoprotein (LDL) to high-density lipoprotein cholesterol (HDL), and reduces blood triglycerides. It may also decrease blood pressure and lower stress levels. Walking is one of the easiest and healthiest ways to exercise. This is one activity that anyone can do for a lifetime without special equipment and with little risk of injury. Talk to your doctor about exercise. Supervised activity is best because of the risk of an insulin imbalance. Use the buddy system when you exercise.[71,72,73,74,75,76,77]
Each person needs individualized treatment. Type-1 diabetes always requires insulin, diet, and exercise. Type-2 diabetics require insulin or oral hypoglycemic agents (medication that helps lower blood sugar), if diet and exercise alone fail to lower blood glucose. If you have diabetes, you need to have a medical team (doctor, nutritionist, and health educator or nurse) working with you. Whichever type of diabetes you have, the key to proper control is balancing the glucose and the insulin in the blood. This means adjusting your diet, activity, and sometimes taking medication.[29,30]
Childhood obesity rates are rising, and so are the rates of type 2 diabetes in youth. More than 75% of children with type 2 diabetes have a close relative who has it, too. But it’s not always because family members are related; it can also be because they share certain habits that can increase their risk. Parents can help prevent or delay type 2 diabetes by developing a plan for the whole family:
Dr. Erica Oberg, ND, MPH, received a BA in anthropology from the University of Colorado, her doctorate of naturopathic medicine (ND) from Bastyr University, and a masters of public health (MPH) in health services research from the University of Washington. She completed her residency at the Bastyr Center for Natural Health in ambulatory primary care and fellowship training at the Health Promotion Research Center at the University of Washington.
Reduce portions and eat healthier: First, build your meals around vegetables rather than meat, and cut back on your starches. Avoiding added sugar and sugar substitutes, as well as processed grains. Instead, substitute with heart-healthy fats, high protein-whole grains (eg, pasta made from chickpea flour, quinoa, sprouted wheat bread), fruit to add sweetness even to salads or as a snack, and lean meats and dairy products. Seek out new, appetizing recipes; there are many cookbooks that offer lower-fat and healthier recipes.

Find safe ways to exercise at home. If you have trouble leaving the house because of your health or lack of transportation, you can still find safe ways to stay active from home. Find workout videos online, or make even ordinary household chores a little more fun by turning on some music. If it’s safe for you to do so, you might try doing strengthening exercises from home.
Food sources of carbohydrates should always be eaten WITH a source of protein and or unsaturated (“healthy”) fat. Fat and protein digest more slowly which helps prevent blood sugar spikes. Examples of balanced snacks that combine carbohydrate foods with protein/fat include, apple with peanut butter; berries with plain Greek yogurt; whole wheat toast with almond butter; baked potato with cottage cheese.

Low-carbohydrate diets have gotten a lot of attention recently as strategies for reversing prediabetes. The carbohydrates in your diet that provide calories include sugars and starches. Starches are in grains and flour, beans, and starchy vegetables. Added sugars include sugars in sweets, sweetened foods such as flavored oatmeal and ketchup, and sugar-sweetened beverages such as soda. There are also natural sugars, which are found in nutritious foods such as dairy products and fruit.


Fasting is the simplest and fastest method to force your body to burn sugar for energy. Glucose in the blood is the most easily accessible source of energy for the body. Fasting is merely the flip side of eating – if you are not eating you are fasting. When you eat, your body stores food energy. When you fast, your body burns food energy. If you simply lengthen out your periods of fasting, you can burn off the stored sugar.

So you go to your doctor. What does he do? Instead of getting rid of the toxic sugar load, he doubles the dose of the medication. If the luggage doesn’t close, the solution is to empty it out, not use more force to . The higher dose of medication helps, for a time. Blood sugars go down as you force your body to gag down even more sugar. But eventually, this dose fails as well. So then your doctor gives you a second medication, then a third one and then eventually insulin injections.

Often, people with type 2 diabetes start using insulin with one long-acting shot at night, such as insulin glargine (Lantus) or insulin detemir (Levemir). Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health.
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