Metformin is likely effective for as long as 10 years, based on long-term follow-up of patients in the Diabetes Prevention Program (DPP). In this trial, investigators randomized 3234 at-risk patients to 3 groups: metformin 850 mg twice daily; lifestyle modification (7% weight loss, 150 minutes of physical activity per week, and a one-to-one 16-lesson curriculum covering diet, exercise, and behavior modification); or placebo.4 At a mean 2.8-year follow-up, the incidence of diabetes was 31% lower in the metformin group (95% confidence interval [CI], 17%-43%) and 58% lower in the lifestyle modification group than in the placebo group (95% CI, 48%-66%; P<.001 for both comparisons).


Rather than following a specific diabetes prevention diet, the greatest impact in prevention has occurred with weight reduction. Consequently, there is no single recommended diabetes prevention diet. The American Diabetes Association recommends goals of modest weight loss (5%-10% of body weight) and moderate exercise as primary interventions for preventing type 2 diabetes.

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More than half of the dialysis patients I see are type 2 diabetic – a few are type 1 (maybe 5 in a hundred) – it’s scary because when I see overweight people I think to myself if they don’t die first of heart disease they will be on dialysis. My advice now is to get our children outside playing and exercising – and watching their diets. Often fat kids grow up to be fat adults – AMEN – Peggy Harum RD, LD renal dietitian for more than 40 years
Jitahadi bought books on diabetes, nutrition, the glycemic index, and diabetes-friendly meals. Instead of slightly modifying her diet, Jitahadi decided to completely overhaul it. "I started realizing that what ['watch what you eat'] really meant was I needed to eat healthier, more balanced meals," she says. She wrote down everything she ate. And instead of dining out, she cooked meals from scratch. Jitahadi swapped white sugar for lower-glycemic sweeteners, traded in white rice for brown, lowered the amount of sodium she consumed, cut a lot of carbs, and made veggies the mainstay of each meal. (Her favorite: grated cauliflower sautéed with veggies and chicken or egg for low-carb fried "rice.")

To avoid fast food, a convenient temptation, he prepped meals in advance. "A lot of it, especially as I lost a lot of weight, had to do with saying, 'I just walked x miles and burned x calories, do I really want to ruin it by popping in and having a burger?' " he says. "After a while, it got a little easier. Now I drive by [fast-food restaurants] and I don't even give them a second thought."
Food sources of carbohydrates including breads, cereals, crackers, pasta, starchy vegetables (peas, corn, potatoes), fruit and sweets/desserts need to be eaten consistently throughout the day by focusing on small and frequent meals every 3-4 hours. Patients with type 2 diabetes should work with a dietitian who can prescribe a goal number of carbohydrate servings (or grams) at each meal and snack and teach appropriate portion size for each carbohydrate food. Daily carbohydrate needs will vary based on the individual.
Carry a Rescue Snack: Going too long without eating can lead to dips in blood sugar, sometimes called “lows”, which create unpleasant symptoms, including ravenous hunger. This often leads to poor food choices, since we’re more focused on eating anything in sight, even if it’s not healthy. Rather than getting to this point, keep a healthy snack with you throughout the day in case you get stuck somewhere you didn’t plan at a mealtime. A balanced snack will combine a nutritious carb or veggie + source of protein or healthy fat.The chart below provides portable options you can mix and match to your tastes:
Most people with diabetes find that it is quite helpful to sit down with a dietitian or nutritionist for a consult about what is the best diet for them and how many daily calories they need. It is quite important for diabetics to understand the principles of carbohydrate counting and how to help control blood sugar levels through proper diet. Below are some general principles about the diabetic diet.

Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team (including your primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator, and pharmacist), family, and other important people in your life. Managing diabetes can be challenging, but everything you do to improve your health is worth it!

More than 86 million American adults—approximately one-third of those over age 18 and half of those over 65—have prediabetes, and most of them don’t even know it. If you have prediabetes, it means your blood sugar levels are consistently higher than normal, but not yet high enough to be diagnosed as diabetes. Prediabetes puts you at higher-than-normal risk of developing type 2 diabetes, heart disease, and stroke. According to U.S. Centers for Disease Control, up to 30% of overweight men and women with prediabetes will develop type 2 diabetes within five years of diagnosis. You don’t have to be one of them! Here are five steps you can take to reduce your diabetes risk.


Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.


Veggies, first: Research suggests that eating vegetables and lean proteins before carbohydrates may result in a lower rise in blood sugar levels over the next few hours (as compared to eating the same foods in the opposite order). While more research is needed on this topic, it’s possible that eating protein and veggies first is delaying how fast the carbohydrates get absorbed.

The American Diabetes Association (ADA) advocates for a healthy diet with an emphasis on balancing energy intake with exercise. Historically, they have advocated for the majority of calories coming from complex carbohydrates from whole grains such as whole-grain bread and other whole-grain cereal products and a decreased intake of total fat with most of it coming from unsaturated fat.
The COACH Program® provided by Diabetes Tasmania, is a free telephone coaching service for people at risk of or diagnosed with type 2 diabetes. It provides people with the opportunity to work with a coach (health professional) to understand, manage and improve their health in particular around the risk factors associated with diabetes and its complications.
Sit Less, Move More. Aim for some daily physical activity. Exercise is important to help prevent type 2 diabetes and has so many other benefits. It can help you keep lost weight off, and improve your heart health, and if you’re insulin resistant, it can help increase your body's response to insulin (exercise so you will have better blood glucose control. Plus, exercise promotes better sleep, and can even reduce the symptoms of depression, helping put you in a better mood. 
If you fall into the second camp, there is plenty you can do to minimize the risk of the prediabetes progressing to diabetes. What's needed is a ''lifestyle reset," says Jill Wiesenberger, MD, RDN, CDE, FAND, a certified health and wellness coach and certified diabetes educator in Newport News, Virginia, and author of Prediabetes: A Complete Guide.2  The new book is published in collaboration with the American Diabetes Association.
Veggies, first: Research suggests that eating vegetables and lean proteins before carbohydrates may result in a lower rise in blood sugar levels over the next few hours (as compared to eating the same foods in the opposite order). While more research is needed on this topic, it’s possible that eating protein and veggies first is delaying how fast the carbohydrates get absorbed.

If you have found that your fasting blood glucose is rising over time, even if it is normal, and certainly if you "officially" have impaired glucose intolerance (pre-diabetes), strongly consider getting a home glucose meter and testing your own blood to see if you can determine which lifestyle changes help lower and stabilize your blood glucose. The only problem is that many insurance companies will not pay for this preventative step, and the test strips are admittedly expensive. Still, you might be able to afford to monitor yourself at least occasionally or find a diabetic friend who sometimes has extra strips. Tracking your blood glucose response to meals and over time can be a big help in preventing the progression of diabetes.


If you choose to drink alcohol, remember: To drink with your meal or snack (not on an empty stomach!), to drink slowly or dilute with water or diet soda, that liqueurs, sweet wines and dessert wines have a lot of sugar, to wear your Medic Alert (Alcohol can cause hypoglycemia/low blood glucose), reducing alcohol can promote weight loss and help you lower your blood pressure.
This is the advice that diabetics received a hundred years ago. Even in Sweden, with the high fat-Petrén diet that included fatty pork cuts, butter and green cabbage. And when diabetics start eating this way today the same thing happens as it did in the past. Their blood sugar levels improve dramatically from day one. This makes sense, as they avoid eating what raises blood sugar.
Although we cannot change your genetic risk for developing type 2 diabetes, we do know that even modest exercise and weight loss can delay or prevent the development of type 2 diabetes. A landmark research study in the United States, the Diabetes Prevention Program (DPP) was completed in 2002 and showed that when people modified their risk factors for type 2 diabetes, they reduced their chance of developing the condition. Similar results have been shown in Finland.
Well I do eat meat vegetable sometimes I like some sweet and I make eat something sweet. But the first that is a lye is the FDA, Doctors used u as a pig for their better money make it. What happen a family eat the same since they are related and group together so they will do the same. Doctors are not a person to really believe on them we are the machine for them to have a luxury home car and money to place in an Bank Account.
A vegetarian or vegan diet can be a good choice for people with diabetes. Vegetarian and vegan diets are typically high in carbohydrates - about 13% higher than a diet with that includes both plant and animal products (omnivorous) – which we generally think is bad for diabetes. However, a vegetarian or vegan diet is typically higher in fiber and lower in calories and saturated fat, so the inflammatory risks associated with high meat consumption are avoided. Research studies that have tested vegetarian and vegan diets for people with diabetes; have found them to be beneficial at reducing blood sugar.12
Consider signing up for a virtual coach.  Trying to make these changes on your own, at your own pace, and in your own time is very hard. So consider joining a support group like Overeaters Anonymous so you don't have to go it alone. Another way to gain insights and get some help as you attempt to make some changes is to find an app that offers personalized tips and ideas. Having a virtual coach is both convenient has been shown effective in improving diabetes care.
There is convincing evidence that diets rich in whole grains protect against diabetes, whereas diets rich in refined carbohydrates lead to increased risk (53). In the Nurses’ Health Studies I and II, for example, researchers looked at the whole grain consumption of more than 160,000 women whose health and dietary habits were followed for up to 18 years. Women who averaged two to three servings of whole grains a day were 30 percent less likely to have developed type 2 diabetes than those who rarely ate whole grains. (21) When the researchers combined these results with those of several other large studies, they found that eating an extra 2 servings of whole grains a day decreased the risk of type 2 diabetes by 21 percent.
The Centers for Disease Control and Prevention (CDC) and the American Medical Association (AMA) are sounding an alarm about prediabetes because a national effort—by everyone from physicians to employers to patients to community organizations—is required to prevent type 2 diabetes in the United States. In addition to focusing on the person with prediabetes or diabetes, we also must engage the systems and communities where people live, work and play. We can all Act – Today.

Low-carb diets, the glycemic index diet or other fad diets may help you lose weight at first. But their effectiveness at preventing diabetes isn't known, nor are their long-term effects. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients. Instead, make variety and portion control part of your healthy-eating plan.
The first thing to understand when it comes to treating diabetes is your blood glucose level, which is just what it sounds like — the amount of glucose in the blood. Glucose is a sugar that comes from the foods we eat and also is formed and stored inside the body. It's the main source of energy for the cells of the body, and is carried to them through the blood. Glucose gets into the cells with the help of the hormone insulin.

Some easy-to-follow examples I often provide are adding chopped mixed vegetables to scrambled eggs and including fresh fruit on the side; preparing a green smoothie with low-fat milk, low-fat yogurt, chopped fresh kale, and frozen fruit; preparing vegetarian jambalaya with brown rice; or choosing a hearty salad with mixed greens, nuts, beans, and light salad dressing from a salad bar. Food can be medicine and it can also be enjoyable!
It’s best to get fiber from food. But if you can’t get enough, then taking fiber supplements can help. Examples include psyllium, methylcellulose, wheat dextrin, and calcium polycarbophil. If you take a fiber supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fiber intake.
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.
Balancing carbohydrates is integral to a diabetes-friendly diet. Processed and refined carbs aren’t the best options, but including whole grains and dietary fiber can be beneficial in many ways. Whole grains are rich in fiber and beneficial vitamins and minerals. Dietary fiber helps with digestive health, and helps you feel more satisfied after eating.
While some people attempt to manage their type 2 diabetes with diet and exercise alone, this may not work for everyone. In fact, though the Centers for Disease Control and Prevention estimates 16 percent of people with diabetes don't take medication, the majority of people with diabetes require insulin or oral meds at some point, often at diagnosis.
As a bonus, stress relief may help you sleep better, which is important because studies show that not getting enough sleep can worsen type 2 diabetes. Sleeping less than six hours a night has also been found to contribute to impaired glucose tolerance, a condition that often precedes type 2 diabetes. In fact, a review published in 2015 in Diabetes Care analyzed 10 studies that involved more than 18,000 participants combined and found the lowest risk of type 2 diabetes in the group of participants that slept seven to eight hours per day. That’s the minimum recommended amount of sleep for most adults, according to the National Sleep Foundation.
Jitahadi bought books on diabetes, nutrition, the glycemic index, and diabetes-friendly meals. Instead of slightly modifying her diet, Jitahadi decided to completely overhaul it. "I started realizing that what ['watch what you eat'] really meant was I needed to eat healthier, more balanced meals," she says. She wrote down everything she ate. And instead of dining out, she cooked meals from scratch. Jitahadi swapped white sugar for lower-glycemic sweeteners, traded in white rice for brown, lowered the amount of sodium she consumed, cut a lot of carbs, and made veggies the mainstay of each meal. (Her favorite: grated cauliflower sautéed with veggies and chicken or egg for low-carb fried "rice.")
If you’ve recently been diagnosed with type 2 diabetes, pay special attention.  Research on newly diagnosed type 2 diabetics coming to the Pritikin Longevity Center illustrate how profoundly beneficial early intervention can be.  Scientists from UCLA followed 243 people in the early stages of diabetes (not yet on medications).  Within three weeks of coming to Pritikin, their fasting blood sugar (glucose) plummeted on average from 160 to 124.  Research has also found that the Pritikin Program reduces fasting insulin by 25 to 40%.

This is the advice that diabetics received a hundred years ago. Even in Sweden, with the high fat-Petrén diet that included fatty pork cuts, butter and green cabbage. And when diabetics start eating this way today the same thing happens as it did in the past. Their blood sugar levels improve dramatically from day one. This makes sense, as they avoid eating what raises blood sugar.

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.
If you have found that your fasting blood glucose is rising over time, even if it is normal, and certainly if you "officially" have impaired glucose intolerance (pre-diabetes), strongly consider getting a home glucose meter and testing your own blood to see if you can determine which lifestyle changes help lower and stabilize your blood glucose. The only problem is that many insurance companies will not pay for this preventative step, and the test strips are admittedly expensive. Still, you might be able to afford to monitor yourself at least occasionally or find a diabetic friend who sometimes has extra strips. Tracking your blood glucose response to meals and over time can be a big help in preventing the progression of diabetes.
Fresh vegetables are a great option, and usually the tastiest option. Studies show that frozen veggies have just as many vitamins and nutrients because they are often frozen within hours of harvesting. Just check to make sure there aren't added fats or sweeteners in the sauces that are on some frozen veggies. If you don't like vegetables on their own, try preparing them with fresh or dried herbs, olive oil, or a vinaigrette dressing. Aiming to consume a rainbow of colors through your vegetables is a good way to get all of your nutrients.
Bacterial infections under the skin of the genitals and areas around them. Rare but serious infections that cause severe tissue damage under the skin of the genitals and areas around them have happened with FARXIGA. This infection has happened in women and men and may lead to hospitalization, surgeries and death. Seek medical attention immediately if you have fever or you are feeling very weak, tired or uncomfortable and you also develop any pain or tenderness, swelling, or redness of the skin in the genitals and areas around them
Gestational diabetes is a condition that is first recognized during pregnancy and is characterized by high blood sugar. Approximately 4% of all pregnancies are diagnosed with gestational diabetes. Low blood sugar is prevented by hormones produced by the placenta during a woman's pregnancy. The actions of insulin are stopped by these hormones. Gestational diabetes is the result of the pancreas' inability to produce enough insulin to overcome the effect of the increase hormones during pregnancy.

Instead, opt for using honey as a sweetener, and pair with an unsweetened milk option over creamer. This will decrease saturated fat and carbohydrate intake while still providing flavor. Stick to 1 tablespoon of honey or less, which contains 15 grams of carbohydrates. Traditional coffee drinks can contain up to 75 grams of carbohydrates from added sugar, so this cuts it down significantly.
“High glycemic index foods are going to be primarily processed foods,” says Lori Chong, RD, CDE, at The Ohio State University Wexner Medical Center in Columbus. Those processed foods tend to have more white sugar and flour in them, which are higher on the GI, she says. Foods lower on the GI include vegetables, especially non-starchy vegetables, like broccoli, cauliflower, and leafy greens and whole-grain products, such as brown rice (as opposed to white rice), Chong says. She notes that even many fruits are low on the GI, with pineapple and dried fruit being some of the highest (Berries, apples, and pears tend to be fairly low.)
The plate method. The American Diabetes Association offers a simple seven-step method of meal planning. In essence, it focuses on eating more vegetables. When preparing your plate, fill one-half of it with nonstarchy vegetables, such as spinach, carrots and tomatoes. Fill one-quarter with a protein, such as tuna or lean pork. Fill the last quarter with a whole-grain item or starchy food. Add a serving of fruit or dairy and a drink of water or unsweetened tea or coffee.
A large number of cross-sectional as well as prospective and retrospective studies have found significant association between physical inactivity and T2DM.12 A prospective study was carried out among more than thousand nondiabetic individuals from the high-risk population of Pima Indians. During an average follow-up period of 6-year, it was found that the diabetes incidence rate remained higher in less active men and women from all BMI groups.13 The existing evidence suggests a number of possible biological pathways for the protective effect of physical activity on the development of T2DM. First, it has been suggested that physical activity increases sensitivity to insulin. In a comprehensive report published by Health and Human Services, USA, 2015 reported that physical activity enormously improved abnormal glucose tolerance when caused by insulin resistance primarily than when it was caused by deficient amounts of circulating insulin.14 Second, physical activity is likely to be most beneficial in preventing the progression of T2DM during the initial stages, before insulin therapy is required. The protective mechanism of physical activity appears to have a synergistic effect with insulin. During a single prolonged session of physical activity, contracting skeletal muscle enhances glucose uptake into the cells. This effect increases blood flow in the muscle and enhances glucose transport into the muscle cell.15 Third, physical activity has also been found to reduce intra-abdominal fat, which is a known risk factor for insulin resistance. In certain other studies, physical activity has been inversely associated with intra-abdominal fat distribution and can reduce body fat stores.16 Lifestyle and environmental factors are reported to be the main causes of extreme increase in the incidence of T2DM.17

When incorporating fiber rich foods in your diet, which helps with blood sugar control – remember to stay hydrated with enough daily water intake.  Drink water with meals and snacks and keep a water bottle with you to take sips throughout the day.  Staying well hydrated helps with regularity and promotes blood sugar control.  Aim for 60-100 fluid ounces per day.


One of the biggest tips I discuss with my clients who are trying to manage their Diabetes is to focus on adding more fiber to their diet. We first start by adding fruits and veggies to the meals that they are already consuming. I find adding to the diet is usually an easier approach for most. Another tip is to focus on adding more whole foods, like apples with the skin versus juices or baked sweet potatoes versus the instant varieties. Along with more fruits and veggies, clients can also add fiber in the forms of nuts and seeds to meals or snacks to help with satiety and blood sugar control. One of the key points I stress to any client is to focus the balance and take it one step at a time. I don’t expect anyone to do a complete 360 on their food intake since it takes time to build new (and healthy) habits that will last long-term.
The process of type 2 diabetes begins years or even decades before the diagnosis of diabetes, with insulin resistance. Insulin resistance is the beginning of the body not dealing well with sugar, which is the breakdown product of all carbohydrates. Insulin tells certain body cells to open up and store glucose as fat. When the cells stop responding your blood sugar rises, which triggers the release of more insulin in a vicious cycle. Insulin resistance is associated with abdominal obesity, high blood pressure, high triglycerides, and low HDL ("good cholesterol"). When these occur together, it is known as metabolic syndrome or pre-diabetes. It is a risk factor for heart disease and type 2 diabetes. 

The process of type 2 diabetes begins years or even decades before the diagnosis of diabetes, with insulin resistance. Insulin resistance is the beginning of the body not dealing well with sugar, which is the breakdown product of all carbohydrates. Insulin tells certain body cells to open up and store glucose as fat. When the cells stop responding your blood sugar rises, which triggers the release of more insulin in a vicious cycle. Insulin resistance is associated with abdominal obesity, high blood pressure, high triglycerides, and low HDL ("good cholesterol"). When these occur together, it is known as metabolic syndrome or pre-diabetes. It is a risk factor for heart disease and type 2 diabetes.
Chong points to previous research in Circulation that describes the underlying mechanisms of sleep apnea. In people with sleep apnea, activation of the sympathetic nervous system — including increased heart rate, increased blood pressure, and constriction of blood vessels — all led to a higher risk of heart attack and stroke, which can be compounded in people who have type 2 diabetes (and thus already have a higher risk of heart disease).
Fruit often gets a bad rap due to its carb content, but this food group can actually be great in a diabetes diet when chosen wisely and eaten in moderation. In particular, fruit can be a great replacement for unhealthy processed sweets, such as pastries, cakes, and cookies, while providing disease-fighting antioxidants, vitamins, minerals, and satiating fiber to boot.

Meanwhile, processed or packaged foods should be avoided or limited in your diabetes diet because, in addition to added sugars and processed carbohydrates, these foods are often high in sodium and therefore may increase your blood pressure and, in turn, the risk of heart disease or stroke — two common complications of diabetes. It’s important to keep your blood pressure in check when managing diabetes.


The desert’s scorching heat and torrential rainfalls stress the Hintonia latiflora tree and provide the keys to a powerful defense mechanism inherent in the plant and an essential part of its medicinal value. The natural environmental stresses to the tree enhance its ability to survive and thrive in such a harsh environment and are key to hintonia’s traditional use to treat Type 2 diabetes and gastrointestinal problems.
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