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They would often say to me, “Doctor. You’ve always said that weight loss is the key to reversing diabetes. Yet you prescribed me a drug that made me gain 25 pounds. How is that good?” I never had a good answer, because none existed. It was not good. The key was weight loss, whereupon the diabetes often goes away or at least gets significantly better. So, logically, insulin does not help reverse the disease, but actually worsens it.
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.
Over a period of years, you went from pre-diabetes, to diabetes, to taking one medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse! Even if your blood sugars get better, your diabetes is getting worse. This is unfortunately what happens to virtually every patient. The body is already overflowing with sugar.
If your mood, sleep, blood sugar, and energy are being affected, limiting intake may be advised. The most important thing when choosing coffee for people with diabetes or those managing their weight is to pay attention to the carbohydrate content from milk and added sweeteners. Cutting back or eliminating artificial sweeteners is advised as these have shown to disrupt gut bacteria, cause cravings and overeating, and negatively impact weight and blood sugar management.

Aside from managing your diabetes, a diabetes diet offers other benefits, too. Because a diabetes diet recommends generous amounts of fruits, vegetables and fiber, following it is likely to reduce your risk of cardiovascular diseases and certain types of cancer. And consuming low-fat dairy products can reduce your risk of low bone mass in the future.
In addition to the millions of adults with diabetes, another 57 million adults have “pre-diabetes.” (7) This early warning sign is characterized by high blood sugar levels on a glucose tolerance test or a fasting glucose test. Whether pre-diabetes expands into full-blown type 2 diabetes is largely up to the individual. Making changes in weight, exercise, and diet can not only prevent pre-diabetes from becoming diabetes, but can also return blood glucose levels to the normal range.
DM can be controlled through improvement in patient’s dietary knowledge, attitudes, and practices. These factors are considered as an integral part of comprehensive diabetes care.51 Although the prevalence of DM is high in gulf countries, patients are still deficient in understanding the importance of diet in diabetes management.52 Studies have shown that assessing patients’ dietary attitude may have a considerable benefit toward treatment compliance and decrease the occurrence rate of complications as well.52 A study conducted in Egypt reported that the attitude of the patients toward food, compliance to treatment, food control with and without drug use and foot care was inadequate.53 Another study presented that one-third of the diabetic patients were aware about the importance of diet planning, and limiting cholesterol intake to prevent CVD. Various studies have documented increased prevalence of eating disorders and eating disorder symptoms in T2DM patients. Most of these studies have discussed about the binge eating disorder, due to its strong correlation with obesity, a condition that leads to T2DM.53 Furthermore, a study revealed that the weight gain among diabetic patients was associated with the eating disorder due to psychological distress.54 In another study that examined eating disorder-related symptoms in T2DM patients, suggested that the dieting-bingeing sequence can be applied to diabetics, especially obese diabetic patients.55 Unhealthy eating habits and physical inactivity are the leading causes of diabetes. Failure to follow a strict diet plan and workout, along with prescribed medication are leading causes of complications among patients of T2DM.56 Previous studies57 conducted in Saudi Arabia have reported that diabetic patients do not regard the advice given by their physicians regularly regarding diet planning, diet modification and exercise.
Acarbose (Precose), a drug designed to reduce small intestinal absorption of carbohydrates has been used with some success as well and is licensed for diabetes prevention in some countries. The STOP NIDDM trial showed that in about 1400 patients with impaired glucose tolerance, acarbose significantly reduced progression to diabetes compared to placebo. However, the occurrence of gastrointestinal side effects have limited the use of this drug for some people.
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.")
Among 85,000 married female nurses, 3,300 developed type 2 diabetes over a 16-year period. Women in the low-risk group were 90 percent less likely to have developed diabetes than the rest of the women. Low-risk meant a healthy weight (body mass index less than 25), a healthy diet, 30 minutes or more of exercise daily, no smoking, and having about three alcoholic drinks per week.
Eat a Source of Protein with Breakfast: As the first meal of the day, breakfast can set the tone for your body’s blood sugar balance and overall mindset on eating well (which, of course is also affected by a steady blood sugar!). Many typical breakfast foods tend to be rich in carbohydrates (fruit, cereal, oatmeal, toast, etc.) which may lead to spikes in blood sugar if eaten in large quantities alone.Add in sources of protein, fiber and/or healthy fats to create a blood-sugar steadying breakfast: pair fruit with yogurt or cottage cheese, oatmeal with a spoonful of peanut or almond butter, or a slice or two of whole grain toast with a couple of eggs or hummus.

The prediabetes diet plans below are designed to help you lose weight, improve your blood sugar control and overall health, and be easy to follow. Each plan has about 1,200 to 1,400 calories per day. If you need more, you can add in one or more of the healthy snack options listed below the menus. There is are one-week menus for a low-carb ketogenic diet and for a balanced, DPP-based prediabetes diet, and snacks listed for both types of diets.
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.
A growing body of evidence links moderate alcohol consumption with reduced risk of heart disease. The same may be true for type 2 diabetes. Moderate amounts of alcohol—up to a drink a day for women, up to two drinks a day for men—increases the efficiency of insulin at getting glucose inside cells. And some studies indicate that moderate alcohol consumption decreases the risk of type 2 diabetes. (8, 46–51) If you already drink alcohol, the key is to keep your consumption in the moderate range, as higher amounts of alcohol could increase diabetes risk. (52) If you don’t drink alcohol, there’s no need to start—you can get the same benefits by losing weight, exercising more, and changing your eating patterns.
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.

Although the genes you inherit may influence the development of type 2 diabetes, they take a back seat to behavioral and lifestyle factors. Data from the Nurses’ Health Study suggest that 90 percent of type 2 diabetes in women can be attributed to five such factors: excess weight, lack of exercise, a less-than-healthy diet, smoking, and abstaining from alcohol. (8)
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!
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
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.
Designed to support positive behaviour change, the program helps eligible participants plan and action small lifestyle changes that have long term health benefits. The program involves six sessions overs six months and is delivered by qualified health professionals. Participants have the choice of group sessions or phone coaching options. Group sessions in local areas work well for people who enjoy social interaction and learning from others’ experiences while phone coaching appeals to those whose work or life situation make it difficult for them to commit to set days and times.
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!

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."
Charlene Crawford has spent more than half of her life with diabetes. At 14, she was diagnosed with prediabetes. By 18, she had type 2. She was prescribed medication, which she barely took, and advised to make lifestyle changes, which she didn't do. But when she got pregnant, her priorities shifted. "Having a child makes you see things differently," says Crawford, a mother of two. "I wanted to be there for him and not be so tired and be active when he needed me."

Food can be powerful in preventing and reversing diabetes. However, dietary approaches have changed as we have learned more about the disease. The traditional approach to diabetes focuses on limiting refined sugars and foods that release sugars during digestion-starches, breads, fruits, etc. With carbohydrates reduced, the diet may contain an unhealthful amount of fat and protein. Therefore, diabetes experts have taken care to limit fats- especially saturated fats that can raise cholesterol levels, and to limit protein for people with impaired kidney function. The new approach focuses more attention on fat. Fat is a problem for people with diabetes. The more fat there is in the diet, the harder time insulin has in getting glucose into the cells. Conversely, minimizing fat intake and reducing body fat help insulin do its job much better. Newer treatment programs drastically reduce meats, high-fat dairy products, and oils.[46,47,48,49,50] At the same time, they increase grains, legumes, fruits, and vegetables. The study found that patients on oral medications and patients on insulin were able to get off of their medications after some days on a near-vegetarian diet and exercise program. During 2 and 3-year follow-ups, most people with diabetes treated with this regimen have retained their gains. The dietary changes are simple, but profound, and they work.[51,52,53]
#1. LEGUMES—Diets rich in legumes—soybeans, black beans, kidney beans, lentils, pinto beans—are good for your blood sugar levels both short-term and long-term. The secret? "Resistant starches," which resist digestion in the small intestine and go straight to the colon, feeding the bacteria in your gut and in the process improve your body's response to insulin.  (These resistant starches are also in green bananas, uncooked oats, and potatoes that have been cooked and cooled. Rejoice, potato salad lovers who can control their portions.)
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