Your Free Guide to Living Well with Diabetes

Your Free Guide to Living Well with Diabetes

Introduction

If you have or are concerned about getting diabetes, the first step is to learn about the condition. This guide provides an overview of diabetes including what it is, its causes, the different types of diabetes and how to treat it so you can live your best life.

By thoroughly understanding your condition, you can take immediate steps to eat healthy and get more active, and you will be able to ask your doctor informed questions so that you can get the best care.

Diabetes terms can be confusing. If you are not familiar with them, see our Glossary on Diabetic Terms in this guide.

What Is Diabetes?

Diabetes is a condition in which the body does not properly process food for use as energy. Most of the food we eat is turned into glucose, or sugar, for our bodies to use as energy. In a healthy person, a hormone called insulin is secreted into your bloodstream to help process this sugar. The insulin enables the sugar from food to enter and nourish the cells in your brain, muscles and tissues. When you have diabetes, either there is not enough insulin, or the cells in the body become resistant to insulin.   As a result, your body is deprived of vital nutrients, causing a variety of health problems. As of 2021, 10.5% of Americans, accounting for 34.2 million people, have some form of diabetes.

There are four different types of diabetes:

• Prediabetes
• Gestational diabetes
• Type 1 diabetes
• Type 2 diabetes

Prediabetes is when you are showing signs of nearing the disease state.  It occurs when blood sugar levels are higher than usual but not high enough to be considered diabetes. If your doctor tells you that you have prediabetes, it is not too late. You can often reverse the symptoms by adopting a healthy lifestyle. A number of studies have shown that regular physical activity can significantly reduce the risk of developing Type 2 diabetes. 

Gestational diabetes is a temporary condition that can happen when a woman is pregnant. While it usually resolves after the baby is born, if ignored, it can cause dangerous conditions for both baby and mother.

Type 1 diabetes and type 2 diabetes are chronic conditions, generally lasting throughout the patient’s life and are the most concerning forms of the disease. If not managed properly, type 1 and type 2 diabetes can lead to serious complications, including cardiovascular disease, nerve damage, kidney damage, blindness, amputation and dementia.

In all forms of diabetes, it is important to monitor your blood sugar. Both high blood sugar and low blood sugar can cause distressing and sometimes dangerous symptoms.

High Blood Sugar

High blood sugar, also called hyperglycemia, is when there is too much glucose in your blood. It is caused by eating certain foods, eating too much food, being sick or skipping medication. Extreme hyperglycemia can cause diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS) and is life-threatening. Signs of hyperglycemia include:

• Frequent urination
• Increased thirst
• Dry mouth
• Blurred vision
• Fatigue
• Headache
• Nausea and Vomiting
• Confusion

If you have these symptoms, seek emergency medical attention:

• Dry mouth
• Extreme thirst
• Drowsiness
• Confusion
• Dark urine
• Seizures

Low Blood Sugar

Low blood sugar, or hypoglycemia, is when there is too little glucose in the blood. It can be caused by skipping a meal, taking more medication than required or exercising more than usual. If you have low blood sugar, eating or drinking something with sugar can quickly correct the problem. If the problem is extreme, you may lose consciousness and need an emergency injection of glucagon, which will stimulate the release of sugar into the blood.

Signs of hypoglycemia include:

• Sweating
• Shakiness
• Weakness
• Hunger
• Irritability
• Dizziness
• Headache
• Blurred vision
• Heart palpitations
• Slurred speech
• Drowsiness
• Confusion

What Causes Diabetes?

The cause of Type 1 diabetes is not completely understood.  It is believed that genetics and environmental factors play a part. Type 2 diabetes is most commonly caused by being overweight or obese, causing more than 90-95% of diabetes in the United States.

Risk factors are based on the type of diabetes and include:

• Gestational diabetes:
• Being over 25 years old
• Having prediabetes
• Having a parent or sibling who has type 2 diabetes
• Being overweight

Being of certain races or ethnicities including Black, Hispanic, Native American and Asian

Type 1 diabetes:

• Having a parent or sibling who has type 1 diabetes
• Having been exposed to a viral illness
• Having immune system cells called autoantibodies present
• Being from certain countries, including Finland and Sweden
• Prediabetes and Type 2 diabetes:
• Having a parent or sibling who has type 1 diabetes
• Being overweight
• Being of certain races or ethnicities including Black, Hispanic, Native American and Asian
• Leading a sedentary lifestyle
• Being older than 45
• Having gestational diabetes during pregnancy
• Having prediabetes (for type 2)
• Having polycystic ovary syndrome (PCOS)
• Having high blood pressure
• Having abnormal cholesterol and triglyceride levels

Types of Diabetes

There are more than 34 million Americans with some form of diabetes, which if left untreated, can have serious health consequences. Your family doctor, general practitioner or internist can determine if you have diabetes, but if you are diagnosed with the disease, an endocrinologist can treat you, monitor your blood sugar, address any complications and advise you about making lifestyle changes.

Prediabetes

An estimated 88 million people in the United States, about a quarter of the population, have prediabetes. However, the vast majority are unaware of the condition because there are no symptoms.

Diagnosis

Since there may be no symptoms in the initial stages, it is important to get annual well-checkups where your doctor can order a blood test. Blood testing can diagnose prediabetes, giving you the chance to reverse it before it develops into full-fledged diabetes. Your doctor will order one or more of three recommended blood tests to identify or diagnose prediabetes:

Test	Result That Shows Presence of Prediabetes
A1C	AIC is 5.7% to 6.4%
Fasting plasma glucose	Fasting plasma glucose is 100-125 milligrams per deciliter (mg/dL), showing impaired fasting glucose
2-hour post 75 g oral glucose challenge	2-hour post 75 g oral glucose challenge is 140-199 mg/dL (showing impaired glucose tolerance)

The A1C (glycated hemoglobin) measures your average blood sugar for the past 2-3 months. You do not need to fast before having this test.  Diabetes is diagnosed at an a1C greater than or equal to 6.55.  A CDC report found that 9% to 25% of people with an A1C between 5.5 and 6% went on to develop type 2 diabetes within five years, as did 25% to 50% of those with an A1C between 6% and 6.5%.

This study was based on middle-aged people; those in their 70s and 80s may not have as much to worry about since their risk of developing diabetes was actually lower, 8% to 9%.

Treatment

If your doctor tells you that you have prediabetes, they will recommend lifestyle changes including losing a modest amount of weight (5% to 7% of total body weight) and getting at least 150 minutes a week of physical activity such as brisk walking.

If you have risk factors for diabetes and a blood test shows that you are prediabetic, talk to your doctor about getting a referral to a local NDPP provider. Medicare Part B, many private health insurance plans and Medicaid in some states cover the cost of participation in the program.

If you are diagnosed with prediabetes with certain risk factors such as:

• An HbA1c greater than 6%
• Hypertension
• Elevated triglycerides
• Family history of diabetes in a first-degree relative
• Obesity
• And you are younger than 60 years

Your doctor may prescribe a medication called metformin. Metformin may also be prescribed if you are unable to implement the recommended lifestyle changes, or if after having made the changes, symptoms have not improved in a meaningful way.

Type 1 Diabetes

Type 1 diabetes, which used to be called juvenile diabetes, accounts for 5%-10% of people with diabetes. In type 1 diabetes, the immune system attacks the cells in the pancreas that are responsible for producing insulin. As a result, little to no insulin is produced. Without insulin circulating in the bloodstream, the sugar from your food cannot be used by your cells.

Scientists still do not understand exactly why this happens. Having a close relative with type 1 diabetes is a risk factor.  Researchers believe that certain environmental triggers or infections can activate the gene, resulting in a manifestation of the disease. Some evidence points to the possibility that having certain viruses may act as a trigger.

If a man has type 1 diabetes, his child has a 1 in 17 chance of developing it. For a woman with the condition, her child has a 1 in 25 chance if she gives birth before age 25. After age 25, her chances of having a child with type 1 diabetes are reduced to 1 in 100. While having a parent with the disease is a risk factor, 80% of those with type 1 diabetes have no family history of it.

Type 1 diabetes is frequently diagnosed in children, teens and young adults. However, it can develop at any age and is a lifelong condition. While there is no cure for type 1 diabetes, healthy lifestyle choices can help mitigate its symptoms and negative effects.

Type 1 Diabetes Symptoms

Symptoms can develop suddenly, but once they do, they can be severe. If you or your child develop any of these symptoms, it is important to get to your doctor as soon as possible to get a blood test. Untreated type 1 diabetes can lead to serious consequences, including death, within a short period of time.

Look for these symptoms:

• Abnormal thirst and dry mouth
• Frequent urination
• Lack of energy, tiredness
• Constant hunger
• Blurred vision
• Bedwetting
• Sudden weight loss

Weight can drop rapidly, with as much as 22 pounds lost within two weeks.

Type 1 diabetes symptoms are difficult to identify in very young children. If you have a family history of type 1 diabetes and you notice very wet or heavy diapers, bring your child to the pediatrician or emergency room to rule out type 1 diabetes with a blood test.

People with type 1 diabetes are also at risk of developing diabetic ketoacidosis (DKA), a life-threatening complication that occurs when the body produces high levels of blood acids, known as ketones. If you notice these symptoms, seek immediate medical attention:

• Rapid breathing
• Dry skin and mouth
• Flushed face
• Fruity breath odor
• Nausea
• Vomiting or stomach pain

Type 1 Diabetes Diagnosis

Type 1 diabetes symptoms can develop and show themselves quickly. Also, they are usually obvious. However, the initial symptoms can be mistaken for the flu or cold. If you or your child experiences more than one of the type 1 symptoms listed in the previous section, you may want to schedule a visit with your doctor.

To test for type 1 diabetes, doctors give patients a series of examinations to determine a diagnosis. The fastest test for type 1 diabetes is a random plasma glucose test, which can be done whether you have eaten recently or not. It checks to see if your blood sugar is too high. A result higher than 200 mg/dL means that you are positive for diabetes.

The most comprehensive type 1 test is the glycated hemoglobin (HbA1C) test, which shows the average blood sugar level over the course of the previous three months. This test also does not require fasting beforehand. An A1C result of 6.5 or higher indicates diabetes.

Another blood test is a fasting plasma blood glucose test. For this test, you abstain from eating the night before the test so that doctors can see how the body is naturally managing blood sugar levels without food intake. A reading of 126 mg/dL indicates diabetes.

In addition, your doctor may order an autoantibody panel to find out if your body is producing autoantibodies that attack insulin or insulin-producing cells in the pancreas, a c-peptide test or an insulin assay test to measure insulin production.

Type 1 Diabetes Treatment

Careful, daily management of blood sugar levels and treatment can significantly impact overall health and lengthen life expectancy.

Insulin

People who have type 1 diabetes are dependent on insulin produced outside the body and usually have to give themselves daily insulin injections. There are two different types of insulin:

• Basal insulin – This is a daily shot that is slowly released into the body
• Bolus or mealtime insulin – This is administered before a meal to help your body absorb the food’s nutrients. The amount used depends on the size of the meal.

You can administer insulin through syringes, pre-filled injector pens, inhalers, pumps, or an artificial pancreas system, which is a tool that tracks blood glucose levels all day with a continuous glucose monitor and administers the insulin hormone through an insulin pump when needed.

Glucose Monitoring

In order to avoid dangerous blood sugar spikes, those diagnosed with type 1 diabetes must test their blood sugar levels multiple times a day.

There are two ways to self-check your blood sugar:

• Glucose meter or glucometer – Glucometers work by analyzing small blood samples, usually taken via a finger prick. You would place the blood drop on a disposable test strip and put it into the meter for a reading.
• Continuous glucose monitor (CGM) – This is a device that you wear all the time. A tiny sensor that is inserted under the skin to measure glucose levels sends data to a receiver or smart device app.

Your doctor will let you know your appropriate blood sugar range after considering a number of variables, including the severity of diabetes, age, number of years with diabetes, pregnancy status, diabetes complications, and overall health.

Healthy Lifestyle

To keep blood sugar levels under control, doctors recommend maintaining a healthy lifestyle. This includes a balanced, healthy diet and regular exercise. See the “Tips for Living Well with Diabetes” section of this guide for details.

Future Treatments

A monoclonal antibody drug called teplizumab has shown some promise in slowing the onset of type 1 diabetes in clinical trials. In the trial, treatment with the drug delayed the onset of type 1 diabetes by an average of two years in people with a family history of the disease. Additional research and FDA approval are necessary before this will be available as a preventive treatment for those at risk of developing type 1 diabetes.

Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes, accounting for more than 90% of all diabetes cases.  In cases of type 2 diabetes, the body does not efficiently use insulin either by not producing enough insulin or resisting its effects, known as insulin resistance.

Although both type 1 and type 2 diabetes result from the body’s inability to metabolize sugar properly, they have different causes. Unlike type 1, most medical professionals generally believe that type 2 results from lifestyle factors, like a poor diet and lack of exercise and obesity. However, one thing both types have in common is that you have a greater risk of developing the disease if a parent or sibling has it.

Obesity, which is often a genetic predisposition, is the highest risk factor for the disease, and most people with type 2 diabetes are obese.  The incidence of type 2 diabetes has gone up as obesity has increased, and it is a concerning trend.

The risk of developing diabetes also increases with age, especially for those older than 45 years of age. Women who suffer from polycystic ovarian syndrome (PCOS) and those who experienced gestational diabetes also face an increased risk of developing type 2 diabetes.

The good news about type 2 diabetes is that it can be manageable and can even be reversed or go into remission. The best ways to manage type 2 diabetes are by making informed choices about diet and physical activity. A healthy diet and regular exercise are two primary methods of gaining control of this disease, but a holistic lifestyle approach may prove effective as well.

To learn more about healthy lifestyle tips to manage your type 2 diabetes, see “Tips for Living Well with Diabetes.”

Type 2 Diabetes Symptoms

In the early stages of the disease, you may not experience any symptoms at all. However, once your blood sugar level starts to rise, you may notice one or more of the following symptoms:

• Excessive thirst and dry mouth
• Frequent urination
• Lack of energy and tiredness, even when sleeping normally
• Inflamed or red gums
• Slow-healing wounds
• Recurrent skin infections
• Blurred vision
• Tingling or numbness in hands and feet
• Dark patches in the folds of skin at the armpit and neck
• Confused thinking
• Irritability

In addition to these general symptoms, there are some symptoms that are gender-specific. Symptoms specific to men are:

• Erectile dysfunction (ED), especially if occurring at a younger age
• Retrograde ejaculation, as evidenced by reduced or no ejaculation

Symptoms specific to women are:

• Low sexual desire
• Vaginal dryness
• Painful sex
• More frequent yeast infections
• Reduced fertility
• Higher incidence of miscarriage within the first trimester of pregnancy

Type 2 Diabetes Diagnosis

Type 2 diabetes is common in adults over 45, but due to rising rates of childhood obesity, it is becoming more common in young people.

If you are experiencing one or more of the symptoms listed in the above section, you can schedule an appointment with your doctor to test for diabetes.

Diagnostic testing for type 2 diabetes includes:

• The fasting blood glucose test
• The HbA1c test
• The oral glucose tolerance test

These are the same tests done to determine type 1 diabetes (see “Type 1 Diabetes Diagnosis” section of this guide for details), and the same results determine whether or not you have type 2 diabetes.

Type 2 Diabetes Treatment

Healthy Lifestyle

Most individuals can manage type 2 diabetes by losing a modest amount of weight (as little as 5%), stopping smoking and making changes like eating healthy food and exercising, which we will discuss in more detail in the “Tips for Living Well with Diabetes” section of this guide.

Glucose Monitoring

Like those with type 1 diabetes, people with type 2 diabetes also need to keep track of their glucose levels by checking them several times daily. You can do this with a blood glucose meter or continuous glucose monitoring, as outlined in the “Glucose Monitoring” section of this guide in the type 1 diabetes portion.

Diabetes Medications

If the lifestyle changes do not result in lowering your blood sugar to acceptable levels, your doctor may prescribe one of the following medications:

• Metformin (Fortamet, Glumetza and other brands) – This is the go-to medication that is typically prescribed for type 2 diabetes. It works by reducing glucose production in the liver and increasing the body’s sensitivity to insulin. This medication is often the first choice because it does not increase the risk of hypoglycemia (low blood sugar).  Possible side effects include:
  • Vitamin B-12 deficiency
  • Nausea
  • Abdominal pain
  • Bloating
  • Diarrhea
• Sulfonylureas (DiaBeta, Glynase, Glucotrol, Amaryl and other brands) – This medication helps the body produce more insulin. Possible side effects include:
  • Low blood sugar
  • Weight gain
• Glinides (repaglinide, nateglinide) – This medication also helps the body secrete more insulin. It acts faster than sulfonylureas but lasts a shorter amount of time. Possible side effects include:
  • Low blood sugar
  • Weight gain
• Thiazolidinediones (Avandia, Actos and other brands) – This classification of medicine makes the body’s tissues more sensitive to insulin. Possible side effects include: 
  • Risk of congestive heart failure
  • Risk of bladder cancer
  • Risk of bone fractures
  • High cholesterol
  • Weight gain
• DPP-4 inhibitors (Januvia, Onglyza, Tradjenta and other brands) – These have a moderate effect on reducing blood sugar levels. Possible side effects include:
  • Risk of pancreatitis
  • Joint pain
• SGLT2 inhibitors (Invokana, Farxiga, Jardiance and other brands) – This type of medication eliminates excess glucose by flushing it through the kidneys. It may reduce the risk of cardiovascular events like heart attack and stroke in those at risk. Possible side effects include:
  • Risk of amputation
  • Risk of bone fractures
  • Risk of gangrene
  • Vaginal yeast infections
  • Urinary tract infections
  • Low blood pressure
  • High cholesterol

Insulin Therapy

Your doctor may prescribe insulin if your blood sugar cannot be controlled with either lifestyle changes or medication. Depending on how stable your blood sugar levels are, your doctor may put you on either long-acting or short-acting insulin. See the “Insulin”’ section of this guide for more details on the types of insulin and how it can be administered.

Weight Loss Surgery

Weight loss surgery limits the amount of food you can eat and is combined with diet and nutritional supplement recommendations, exercise and mental health care in an overall treatment plan. Research suggests that this kind of surgery may reverse type 2 diabetes altogether.

You may be a candidate for weight loss surgery if you have a diagnosis of type 2 diabetes and a body mass index (BMI) of 35 or higher. BMI estimates your body fat percentage using a formula with your height and weight.

You can calculate your BMI using the National Institute of Health’s online calculator here: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm 

Possible long-term side effects of weight loss surgery include nutritional deficiencies and osteoporosis.

Gestational Diabetes

Gestational diabetes is the third most common type of diabetes and occurs when pregnant women develop high blood sugar levels during pregnancy. The condition occurs in 2% to 10% of pregnancies in the U.S.

Gestational diabetes is usually detected midway through pregnancy and can be managed with frequent glucose monitoring, healthy exercise and diet. Its exact cause is unknown, but scientists believe that hormones may play a part.

As certain hormones increase during pregnancy, they might make the body more resistant to insulin, which can cause abnormal blood glucose levels that result in gestational diabetes. Pregnant women are at a higher risk of developing the condition if they meet the following criteria:

• Are older than 25
• Have high blood pressure
• Have a family history of diabetes
• Were overweight before becoming pregnant
• Gained a larger than normal amount of weight while pregnant
• Are expecting multiple babies
• Have previously given birth to a baby weighing more than 9 pounds
• Have had gestational diabetes in the past
• Have had an unexplained miscarriage or stillbirth
• Have been on glucocorticoids
• Have polycystic ovary syndrome (PCOS), acanthosis nigricans or other conditions that are associated with insulin resistance

Gestational Diabetes Symptoms

It is rare to experience any signs or symptoms of gestational diabetes. This is because it is an incremental problem. When a woman is pregnant, the body goes through hormonal changes and weight gain, leading to insulin resistance. All pregnant women have some level of insulin resistance. Normally, the body is able to adjust by producing additional insulin. When this does not happen, the pregnant woman develops gestational diabetes.

When there are symptoms, they tend to be mild and may include:

• Fatigue
• Blurred vision
• Excessive thirst
• Excessive need to urinate
• Snoring

Complications for the Baby

• Excessive birth weight – Babies who weigh 9 pounds, or more are more likely to experience distress during birth and require a C-section.
• Early birth – High blood sugar increases the risk of preterm birth, which can lead to long-lasting health problems.
• Serious breathing problems
• Low blood sugar – Having severe hypoglycemia at birth can cause seizures.
• Obesity and type 2 diabetes later in life
• Stillbirth

Complications for the Mother

• High blood pressure and preeclampsia – High blood pressure and preeclampsia, which involves damage to organs like the liver and kidneys, is potentially deadly to both mother and baby.
• Increased risk for a C-section – In addition to having a slower recovery, C-sections involve the risk of surgery complications, including death.
• Higher risk for getting type 2 diabetes in the future

Gestational Diabetes Diagnosis

If you are pregnant, the American Diabetes Association (ADA) recommends that your doctor should do routine screening for gestational diabetes. If you do not have a history of diabetes and your blood glucose levels are within the normal range during your first trimester, then your doctor will probably screen you for gestational diabetes when you are between 24 to 28 weeks of pregnancy.

Doctors may use a one- or two-step glucose tolerance test for the screening. During the one-step test, your doctor will start by testing your blood glucose levels after you have fasted. Next, they will give you a solution to drink that contains 75 grams of carbohydrate sugar. Lastly, they will test your blood glucose levels again after one and two hours.

For two-step testing, you will not need to fast. First, you will drink a solution that contains 50 grams of sugar. Then, they will test your blood glucose level after one hour. If your blood glucose level is higher than the normal range, they will conduct an additional test on a different day.

Gestational Diabetes Treatment

Treatment plans for gestational diabetes vary depending on blood glucose levels.

Doctors usually advise patients with the condition to use a glucometer to test their blood glucose before and after meals. A regular healthy diet and fitness routine are usually the main methods to treat gestational diabetes. However, in some instances (about 10% to 20% of cases), a doctor will recommend insulin injections.

In most women with gestational diabetes, the condition goes away once the baby is born. After delivery and again in six to twelve weeks, your doctor will check your blood sugar to make sure that it has returned to normal. Because having gestational diabetes is a risk factor for developing type 2 diabetes in the future, it is important for your doctor to monitor blood sugar levels periodically going forward.

Tips for Living Well with Diabetes

It is possible for people with diabetes to lead rich and fulfilling lives by leading a healthy lifestyle, monitoring blood sugars, taking insulin or medication as prescribed and having regular medical checkups.

Eating healthy food, managing stress and getting enough exercise and sleep are universal recommendations for people with diabetes, and advice that health professionals give often. But they are particularly important for diabetics since they can make a huge impact on how you feel in the moment and your long-term health.

By making healthy choices related to the elements below, you can substantially decrease the frequency and severity of diabetes symptoms and prevent or lessen serious complications.

• Food – The type, quantity, mix and timing of the food you eat all have an effect on your blood sugar levels, causing them to spike, drop or stay stable.
• Managing stress – When you are under a high level of stress over time, your body reacts by producing hormones. These hormones increase your blood sugar levels as a “fight or flight” response. Stress can also cause you to be less diligent about eating right or exercising regularly.
• Exercise – When you exercise, your body uses glucose for energy, reducing your blood sugar levels. It also helps your body utilize insulin more efficiently.
• Sleep – Getting too few hours of sleep and not enough restorative deep sleep can elevate blood sugar levels. 

By learning healthy lifestyle practices and what works for your body and consistently doing them, you can substantially improve your quality of life. If you or someone you love has diabetes, there are several ways and tips that can make living with diabetes better.

Healthcare

Doctors’ Visits

In order to monitor your condition and prevent potential problems, it is important to see your doctor regularly. Generally speaking, you should see your doctor for a well-checkup every three to four months if you use insulin, or every four to six months if you are managing the condition through diet or medication.

Your doctor might suggest more frequent checkups if your blood sugar becomes difficult to manage or you experience complications from diabetes. It is a good idea to keep your doctor well informed of any changes in your health or habits. For instance, you should probably let them know if you decide to start a new diet or exercise routine. It is not recommended that you make any changes to medications without a doctor’s advice, but if you are experiencing unpleasant or severe side effects from the medication, this should be discussed with your doctor.

Make sure to communicate with your doctor if new conditions appear or if your diabetes side effects get worse. Diabetes can affect your eyes, nerves, kidneys, and the cardiovascular system. It is time for a doctor’s appointment if you have experienced:

• Blurred vision
• Chest pain
• Cramping or pain in your legs
• Numbness or tingling in your feet
• Numbness or weakness on a side of your body
• Persistent hand, feet, face or leg swelling
• Unusual weight gain

Your doctor may run diagnostic tests during your visits. For example, a urine test will show if you are developing symptoms of kidney disease. A blood test will check your blood sugar, cholesterol and several other factors.

Medical professionals will also take your blood pressure to check for high blood pressure, which is known as hypertension. This condition can increase your risk for heart attacks, strokes and kidney disease, so it is important to monitor it.

You should see an eye doctor (ophthalmologist) every year if you have type 2 diabetes or every three to five years if you have type 1 diabetes. If you have an eye condition or are pregnant, your ophthalmologist might suggest more frequent visits.

If you are diabetic and are pregnant or planning to get pregnant, inform your regular doctor as well as your obstetrician. Women with pre-existing diabetes generally require additional prenatal visits, and your regular doctor may want to adjust your insulin or medications because of the additional insulin resistance that comes with pregnancy.

Self-Monitoring

Blood Sugar

In addition to visiting your doctors regularly, you should continue to self-monitor your blood sugar and the development and progression of any related complications. Check your blood glucose level regularly according to your doctor’s recommendations with a diabetic management device, such as a blood glucose meter.

If you have type 1 diabetes, your doctor may recommend checking your levels four to 10 times a day. You might need to check your levels more often when you change medication, alter your routine, or become sick.

Times when you might need to check include:

• Before snacks and meals
• Before and after exercise
• Before bed, during the night and just after waking

If you have type 2 diabetes, your doctor will tell you when to monitor your blood sugar based on the type and amount of insulin you use. Ask your doctor if you are unsure.

Your blood sugar range will depend on your age and health as well as the type and severity of your diabetes. The American Diabetes Association recommends a reading of between 80 and 130 mg/dL before meals and less than 180 mg/dL two hours after eating. 

General Health and Wellbeing

You should also monitor your health and wellbeing. Diabetes can take a toll on different parts of your body and can create additional health problems. The earlier you notice a problem, the quicker you and your doctor can take steps to address it. Early detection and intervention can reverse some complications completely and prevent others from becoming severe.

Diabetes can cause harm to your eyes over time when your blood glucose is too high. If you change medications, you may develop blurry vision for a few days to weeks while your body adjusts. However, consistently high glucose can cause your eyes’ tissue to swell and alter fluid level. Damage from swollen, weakened, or leaking blood vessels in the back of your eyes can be permanent without treatment.

Common eye conditions that diabetics experience include:

• Retinopathy – Retinopathy can occur when blood vessels damage your retina, which is the eye’s inner lining. Diabetic retinopathy affects your eyesight and can look like black spots blocking portions of your vision.
• Macular edema – You can also develop partial vision loss from macular edema. Your macular is the part of the eye you need for driving, reading, and identifying faces. Diabetic macular edema is when there is swelling in your macular.
• Cataracts – Cataracts occur when your eyes’ lenses become cloudy. It can occur naturally with age, but diabetics can develop the condition earlier than those without diabetes when high glucose levels can cause a buildup of deposits.
• Glaucoma – When you damage the optic nerve that connects your eyes to your brain, you can develop glaucoma. You can slowly lose your vision and become blind. You have double the chance of developing glaucoma if you have diabetes.

Other potentially serious diabetes complications are nerve damage and reduced circulation in the legs and feet. If you experience numbness or tingling or if your feet feel cold and cannot get warm, make a note of it and inform your doctor.

Food and Exercise Logs

To keep you on track with your nutritional plan, it is helpful to keep a food diary or food log. This will keep you aware of what and how much you are eating and the nutrients in your food, particularly carbohydrates. Likewise, logging your physical activity will serve as a reminder and allow you to track your progress.

There are numerous mobile apps available to help you manage your diabetes. The top all-in-one diabetes tracking apps are:

• Glucose Buddy
  • Apple download: https://itunes.apple.com/us/app/glucose-buddy-diabetes-tracker/id294754639?mt=8
  • Android download: https://play.google.com/store/apps/details?id=com.skyhealth.glucosebuddyfree

• MyNetDiary Diabetes Tracker
  • Apple download: https://itunes.apple.com/us/app/diabetes-tracker-by-mynetdiary/id541478695?mt=8
  • Android download: https://play.google.com/store/apps/details?id=com.fourtechnologies.mynetdiary.diabetes

• Diabetes:M
  • Apple download: https://itunes.apple.com/us/app/diabetes-m/id1196733537?mt=8
  • Android download: https://play.google.com/store/apps/details?id=com.mydiabetes

• One Drop
  • Apple download: https://apps.apple.com/us/app/one-drop-transform-your-life/id972238816
  • Android download: https://play.google.com/store/apps/details?id=today.onedrop.android&hl=en_US&gl=US

Nutrition

Nutrition is essential for everyone’s health, but individuals with diabetes can benefit greatly by eating food tailored to their health needs. Some diabetics even use a healthy diet as the main way they control their blood glucose. Certain foods help manage sugar levels, while others can worsen diabetic symptoms.

What you eat and drink, how much you consume, and when you have meals and snacks greatly affect your general wellbeing. Eating and drinking healthy foods, as well as staying active, can help you:

• Keep your blood sugar level, cholesterol and blood pressure within the target ranges
• Prevent or delay problems and conditions related to diabetes
• Maintain a healthy weight or help you lose weight
• Have more energy and feel healthier   

Having diabetes does not mean giving up the foods you love. Diabetic-focused low carbohydrate meals can be delicious and include a variety of flavors. Your meal plans should include ingredients from all the food groups:

• Vegetables give you vitamins, minerals, fiber and antioxidants.
• Fruits provide nutrients like dietary fiber, vitamin C, folic acid and potassium. They have no cholesterol and are low in calories, fat and sodium.
• Grains have complex carbohydrates, B vitamins and minerals.
• Fish, dairy, poultry, legumes and meat have protein.
• Dairy has calcium, potassium and vitamin D.
• Fat helps you absorb nutrients.

Learn more about what to consider with each food group below.

What You Need to Know About Carbs

For people with diabetes, the most problematic and confusing nutrient is carbohydrates. Carbohydrates, or carbs for short, provide your body with fuel by delivering sugar (glucose) that your cells use for energy. There are three types of carbs in food. They are:

1. Starches
2. Sugars
3. Fiber

Starches are in starchy vegetables like corn and potatoes as well as in whole grains. Sugars may be natural, such as those in fruit and dairy, or added like in honey, granulated sugar or corn syrup (see “Checking Labels” of this guide for a list of sugar names). Fiber is present in plant foods like fruit, vegetables, nuts, seeds and legumes.

Of these, added sugars are the simplest to digest and therefore immediately go into your bloodstream when you eat, with the potential of rapidly elevating your blood sugar. Natural sugars in fruit break down more slowly because fruit also contains fiber.

Starchy vegetables also have fiber and are the next slowest to digest.

Fiber takes the longest to digest and some insoluble fiber does not get digested at all but acts as a broom to sweep undigested food in your intestines to be eliminated. Fiber actually lowers your blood sugar.

If you take insulin or diabetes medication, you will need to count the carbs in each meal. How many grams of carbs you should eat in a meal depends on your body size, activity level and appetite. Talk to your doctor and/or nutritionist about how many carbs you should be eating to put together a meal plan.

Fruits and Vegetables

The fiber in fruits and vegetables keeps you feeling full longer and stops blood sugar spikes. Vegetables are either starchy or non-starchy.

Starchy vegetables have complex carbs that are linked to sugar molecules, which can spike your glucose level. Complex carbs are also more difficult to burn when trying to lose weight. While you can still eat these vegetables, you might want to limit the amount if you are on a low-carb diet. Starchy vegetables include potatoes, sweet potatoes, legumes (dried beans and lentils), winter squash and corn.

Despite the label, non-starchy vegetables do have a very low amount of starch. Non-starchy vegetables include broccoli, carrots, greens, peppers and tomatoes.

The fiber in fruits slows digestion, which helps maintain glucose levels. Fruits lower your risk of cancer, heart disease and stroke. Fruits include oranges, melons, berries, apples, bananas and grapes. Exercise moderation with bananas and their cousin plantains, since they are the only kinds of starchy fruit.

Whole Grains and Protein

Whole grains have fiber that helps with insulin sensitivity. However, you need to avoid processed grain products that contain white flour and sugar. Whole grains include whole wheat, brown rice, oats, cornmeal, popcorn, barley, and quinoa.

Protein makes you feel fuller longer and maintain vital body functions. About 10% to 35% of your daily calories should come from protein. Although most people associate protein with meat, other non-meat ingredients have protein, including nuts and peanuts, dairy such as Greek yogurt, dried beans and certain peas, and soy products like tofu. Meats also include chicken, turkey, fish and eggs. Eating protein at the same time as carbohydrates slows digestion and helps prevent a blood sugar spike.

Dairy

Dairy contains potassium, magnesium and calcium, which reduces blood pressure. Dairy products include milk, yogurt and cheese. If you have lactose intolerance, you can find lactose-free milk products.

Fats

Fat stores energy and supports cell growth. Unsaturated fats are better for your body than saturated fats. Unsaturated fats lower your bad cholesterol and include nuts, oil, olives, oily fish and tofu, while saturated fats include fat from meat, butter and other full-fat dairies.

Beverages

Your body is made up of 60% water. Water helps your body filter, process and eliminate. Drinking water is essential for your body to function by:

• Lubricating and cushioning joints
• Perspiration, urination, and bowel movements
• Protecting your spinal cord and other sensitive tissues
• Regulating body temperature

A spike in your blood glucose level can cause dehydration, so it is important to drink the recommended daily amount of water. Depending on your size and gender, you should drink between 9 and 13 cups of water a day.

Water is the best beverage option, as it will not raise your blood sugar levels. But, if you are not a fan of the bland taste, you can add flavor by adding:

• Slices of lime, lemon or orange
• Sprigs of basil, lemon balm, or mint
• Fresh or frozen strawberries, blackberries and raspberries

Water is the healthiest choice, but there are other beverages that are beneficial to your health and wellness.

Other healthy beverages include:

• Unsweetened tea, like green, black, oolong, herbal, hibiscus, cinnamon, turmeric, lemon balm and chamomile 
  • Enjoy your tea with or without a slice of lemon.
  • Some teas have caffeine, and some do not so that you can have a cup no matter the time of day.
  • Researchers have associated tea with several health benefits, including reducing inflammation, repairing cellular damage and maintaining glucose levels.
• Unsweetened coffee
  • Have your morning cup of joe black or with added low-fat milk and a sugar substitute.
  • Research has shown a correlation between long-term coffee drinking and lower chances of developing diabetes.
  • Studies have also shown that people with diabetes who drink more coffee had higher insulin levels in their blood.
• Tomato or vegetable juice
  • Try making your own blend with a standup mixer at home by using your favorite vegetables.
  • Vegetables have vitamins and other nutrients, without much sugar compared to fruit juices.
• Low-fat milk
  • Incorporate unsweetened, skim or low-fat dairy into your diet for protein and vitamins.
  • Make sure the beverage is fortified with vitamin D.
• Alcohol
  • Drinks that contain alcohol typically have a lot of carbs and sugar, so drink in moderation, if at all.
  • Choose light beer, small amounts of wine or non-fruity mixed drinks when selecting an alcoholic beverage.

Things to Avoid

While carbohydrates and fat are essential to a diet, it is important to eat them in moderation. You should avoid the following.

Food to Avoid

• Foods high in fat, particularly saturated fat and trans fat
• Fried foods and food prepared with lard
• Foods high in sodium (salt)
• Foods with a lot of sugar
• Excessive alcohol
• Foods with “partially hydrogenated” on the label

When it comes to starches, avoid processed grains like white rice, white flour and potatoes. You should also avoid high fat meats, and limit starchy vegetables and fruits.

Drinks to Avoid

• Coffee loaded with sugar and cream
• Energy drinks
• Flavored coffees and chocolate drinks
• Regular beer, fruity mixed drinks and dessert wines
• Regular sodas and soft drinks
• Sweetened tea

Checking Labels

Check labels for ingredients and nutritional information. On labels, the ingredients are listed in order, with those with the highest quantity in the product listed first. If sugar is listed toward the beginning, this should be a red flag. Sometimes, food companies use different names for sugar. Here are some to look out for:

• Anything with the word sugar in it like palm sugar, raw sugar, date sugar, etc.
• Anything ending with -ose like fructose, dextrose, maltose, saccharose and high fructose corn syrup (HFCS)
• Anything with the word syrup in it like maple syrup, refiner’s syrup, rice syrup, sorghum syrup, etc.
• Honey
• Fruit juice or fruit juice concentrate
• Evaporated cane juice or cane juice crystals
• Anything ending in -trin like dextrin or maltodextrin
• Corn sweetener
• Molasses or treacle

To determine if a grain product has whole grains or white flour, first look at the front of the package. If it says, “whole wheat,” then by law it must contain 100% whole wheat flour with no white flour.

However, some products use a mix of whole grain and white flour or look like they are whole grain when the majority of it is white flour. Turn the product over and look for the nutrition facts listed on the package. If “wheat flour” or “enriched wheat flour” is the first ingredient, it is mostly white flour. To be whole grain, one of the following will be listed as the first ingredient:

• Whole grain wheat
• Brown rice
• Wild rice
• Buckwheat
• Bulgur
• Cracked wheat
• Millet
• Oatmeal
• Rolled oats
• Whole oats
• Whole grain barley
• Whole grain corn
• Whole grain sorghum
• Quinoa
• Whole rye

Another good rule of thumb is to look at the fiber content. If it is 5g or more per serving, it is likely to be whole grain.

Healthy Grocery List

Several food items can help you control your blood sugar level and reduce the risk of diabetes-related complications. Great foods to use when planning your meals include the following.

Vegetables:

• Leafy greens like spinach, kale, arugula, romaine lettuce, watercress and collard greens have antioxidants that protect your eyes from common diabetes conditions and are high in fiber.
• Baked sweet potatoes have the same amount of carbohydrates as regular potatoes, but more fiber, vitamin A, vitamin B6, vitamin C and calcium.
• Garlic reduces your blood pressure and regulates cholesterol levels.
• Broccoli, cauliflower, brussels sprouts, cabbage and other cruciferous vegetables contain a compound that lowers blood glucose levels as well as antioxidants that help prevent eye diseases.
• Squash including winter (butternut, acorn, pumpkin) and summer (yellow and zucchini) can help improve insulin tolerance and decrease blood sugar.

Fruits:

• Blackberries and strawberries lower your chances of chronic diseases by providing fiber and a type of antioxidant that reduces cholesterol and insulin levels.
• Apples, oranges, bananas, mangoes, dates and pears are high in fiber.
• Low-sugar or sugar-free jam or preserves are better than jellies high in sugar.
• Avocados reduce insulin resistance with a fat molecule only found in avocados.

Grains:

• Whole grains like brown rice, oatmeal, quinoa, millet or amaranth have fiber, and a diet rich in them can lower risk of developing type 2 diabetes.

Proteins:

• Fatty fish like salmon, mackerel, herring, anchovies and sardines contain heart-healthy omega-3 fatty acids.
• Nuts like almonds, brazil nuts, cashews, hazelnuts, macadamias, pecans, pistachios and walnuts reduce inflammation and lower blood glucose levels.
• Chia seeds and flaxseed are high in fiber, low in carbs and actively lower blood sugar by slowing digestion.
• Lean meats like chicken or turkey without the skin help you feel full and slow digestion when eaten with foods higher in carbohydrates.
• Eggs decrease inflammation, increase good cholesterol and improve insulin sensitivity.

Dairy:

• Greek yogurt is high in protein and has fewer carbs than regular yogurt.
• String cheese is a good source of protein that also has little fat and carbs.
• Alternative milks like goat, almond, and soy have less fat than cow milk.
• Swiss cheese has lower fat content and sodium than other processed cheeses.

Fat:

• Extra-virgin olive oil and other plant-based oils like canola and grapeseed oil are healthier alternatives to cooking oils with saturated fats.

Meal Planning

Planning your meals in advance and knowing the food that will keep your blood sugar within a healthy range can help you successfully manage your condition. Speak to your doctor about your specific nutrient needs to select or create a diet type that works for you. Consider the following questions: Are you looking to lose weight; do you want to better manage your blood sugar level; or do you just want to try new diabetic-friendly foods?

To help stick to your healthy diet, make sure it can be incorporated into your life. Consider how much time you have to make meals. Ask yourself: Can you dedicate one day a week to meal planning and creating dishes to last seven days; do you only have 30 minutes a night to put dinner on the table for your family? 

Before investing in a whole new diet, start with the following basics:

• Consider your portions.
• Keep calorie count and carb count in mind.
• Try to maintain the same eating times each day.
• Remember to incorporate foods from each group (fruits, veggies, protein, etc.).
• Do not deprive yourself of everything.

Healthy Diets and Recipes

The Diabetes Plate Method

This eating plan is the simplest one since there are no lists of food to remember. If you think of a standard size dinner plate (about nine inches across), your meals should be in the following proportions of the plate:

• One half of the plate – non-starchy vegetables
• One quarter of the plate – lean protein
• One quarter of the plate – higher carb foods like starchy vegetables, beans and legumes, fruits and dairy
• Beverage should be water or a low-calorie choice

Low-Carb Diets

Carbohydrates are one of the three essential sources of fuel, but too many can cause a sugar spike and increase your insulin use. Low-carb meals have been a principal diet for diabetics since the 1920s.

The number of carbs you can consume in a day will depend on you, as there is no one-size-fits-all number of daily carbs. However, many diets recommend sticking to 20 or fewer carbs per day. Your doctor and healthcare team can help you determine your ideal goal.

One of the easiest ways to cut out carbs is to avoid bread products, so low-carb diets are great if you are also gluten-free.

What You Eat:

• Avocados
• Cheese, butter, cream, sour cream and cream cheese
• Eggs, meat, poultry, and seafood
• Non-starchy vegetables
• Olives, olive oil and coconut oil

What You Avoid:

• Beer
• Bread, pasta, cereal, corn and other grains
• Desserts, baked goods, candy, ice cream, etc.
• Fruit other than berries
• Juice, soda, punch, sweetened tea, etc.
• Milk
• Starchy vegetables, like potatoes, sweet potatoes, yams and taro

Recipes

Sheet Pan Mediterranean Snapper

Ingredients:

For the topping:

• 1 cup 2% Greek yogurt
• 2 tbsp lemon juice
• 1 garlic clove, minced
• 1 tbsp za’atar
• 1/2 tsp salt

For the fish:

• 4 (4-6oz) wild-caught red snapper fillets (or mahi-mahi, barramundi, trout)
• 1/4 red onion, thinly sliced into rounds
• 1 cup halved cherry tomatoes
• 1 cup diced zucchini
• 1 large lemon, thinly sliced
• 2 tbsp capers
• 2 tbsp extra virgin olive oil
• Kosher salt and freshly ground black pepper

Instructions:

1. Preheat the oven to 425 degrees F, and spray a large sheet pan with olive oil cooking spray.
2. In a small bowl, stir topping ingredients together and set aside.
3. Pat fish dry with a paper towel. Place the fish on a sheet pan and season with salt and pepper.
4. Top each filler liberally with yogurt sauce. You can use leftovers for serving.
5. Arrange red onion, tomatoes, zucchini, lemon and capers on a sheet pan, evenly covering fish and surrounding space. Drizzle with olive oil and season with a pinch of salt, pepper and za’atar.
6. Bake for 20 minutes, or until snapper is cooked through.

Chilled Avocado Zucchini Soup

Ingredients:

• 2 leeks cleaned and thinly sliced
• 1 tablespoon olive oil
• 2 medium zucchini chopped
• 1 medium cucumber chopped
• 1/2 cup fresh cilantro
• 1/4 cup scallions chopped
• 1/2 teaspoon ground cumin
• Salt & pepper to taste
• 3/4 cup coconut milk
• 1 – 1 1/2 cups water
• 1 ripe avocado

Instructions:

1. Heat the oil in a small pan. Add the leeks and sauté until softened, about 3 to 5 minutes.
2. Transfer the leeks to a blender, followed by the cucumber, zucchini, cilantro, scallions and spices.
3. Add 1/2 cup coconut milk and 1 cup of water. Blend on high until smooth.
4. Remove the lid and add the avocado and remaining liquid, blending again until smooth. For a thinner soup, add additional liquid 1/4 cup at a time (blending between each addition), until you’ve reached your desired consistency.
5. Taste and adjust seasonings as desired. If the soup is at your desired temperature, serve immediately. If not, chill in the fridge until cold.
6. To serve, pour the soup into bowls and optionally garnish with chopped zucchini, a drizzle of olive oil, and some fresh cracked pepper.

Cherry Balsamic Grilled Pork Tenderloin

Ingredients:

• 1 ½ cups fresh or frozen and thawed cherries, halved and pitted
• ¼ cup balsamic vinegar
• ¼ cup extra-virgin olive oil
• 1 tablespoon Dijon mustard
• 1 tablespoon honey
• 2 teaspoons fresh thyme, plus a few sprigs for garnish
• 1 teaspoon kosher salt
• ½ teaspoon black pepper
• 2 garlic cloves, peeled
• 2 pork tenderloins, about 1 pound each

Instructions:

1. Combine the first 9 ingredients in a high-powered blender or food processor and blend the mixture until smooth and pureed, about 45 seconds. This mixture makes about 1 ¾ cups. Reserve ¾ cup of marinade to pass when serving.
2. Trim pork tenderloins of any excess fat or silver skin. Place pork in a resealable plastic bag.
3. Pour the remaining marinade over the tenderloins. Seal the bag and make sure all the meat is coated.
4. Marinate at least 30 minutes at room temperature or chill up to 24 hours. Remove pork from the refrigerator 30-45 minutes before grilling or roasting.
5. Prepare grill on medium-high heat.
6. Remove the tenderloins from the bag and place them in the center of the grill. Discard the bag with marinade.
7. Cover and cook for 12 to 15 minutes, turning every 4 to 5 minutes until the tenderloin reaches an internal temperature of 140 to145 degrees F. Use an instant-read thermometer.
8. Let pork rest for 10 minutes before slicing. Serve with reserved marinade.

Mediterranean Diet

The Mediterranean Diet gets its name from the area, which is between Africa and Europe. The people there have a heart-healthy diet with lots of fruits, vegetables, lean proteins, good fats and whole grains. Researchers have noted that the Mediterranean diet can help diabetics keep their glucose levels under control.

What You Eat:

• Fish, chicken and nuts
• Legumes, lentils and beans
• Fruits and vegetables
• Whole grains like quinoa, brown rice and oatmeal

What You Avoid:

• Red meat
• Butter
• Salt

Recipes

Caprese Stuffed Portobello Mushrooms

Ingredients:

• 3 tablespoons extra-virgin olive oil, divided 
• 1 medium clove garlic, minced
• ½ teaspoon salt, divided
• ½ teaspoon ground pepper, divided
• 4 portobello mushrooms (about 14 ounces), stems and gills removed
• 1 cup halved cherry tomatoes
• ½ cup fresh mozzarella pearls drained and patted dry
• ½ cup thinly sliced fresh basil
• 2 teaspoons best-quality balsamic vinegar

Instructions:

1. Preheat the oven to 400 degrees F.
2. Combine 2 tablespoons oil, garlic, 1/4 teaspoon salt and 1/4 teaspoon pepper in a small bowl.
3. Using a silicone brush, coat mushrooms all over with the oil mixture. Place on a large rimmed baking sheet and bake until the mushrooms are mostly soft, about 10 minutes.
4. Meanwhile, stir tomatoes, mozzarella, basil and the remaining 1/4 teaspoon salt, 1/4 teaspoon pepper and 1 tablespoon oil together in a medium bowl. Once the mushrooms have softened, remove them from the oven and fill them with the tomato mixture.
5. Bake until the cheese is fully melted and the tomatoes have wilted, about 12 to 15 minutes more.
6. Drizzle each mushroom with 1/2 teaspoon vinegar and serve.

Salmon-Stuffed Avocados

Ingredients:

• ½ cup nonfat plain Greek yogurt
• ½ cup diced celery
• 2 tablespoons chopped fresh parsley
• 1 tablespoon lime juice 
• 2 teaspoons mayonnaise
• 1 teaspoon Dijon mustard
• ⅛ teaspoon salt
• ⅛ teaspoon ground pepper
• 2 (5-ounce) cans salmon, drained, flaked, skin and bones removed
• 2 avocados
• 1 medium chopped chives for garnish

Instructions:

1. Combine yogurt, celery, parsley, lime juice, mayonnaise, mustard, salt and pepper in a medium bowl; mix well. Add salmon and mix well.
2. Halve avocados lengthwise and remove pits. Scoop about 1 tablespoon flesh from each avocado half into a small bowl. Mash the scooped-out avocado flesh with a fork and stir into the salmon mixture.
3. Fill each avocado half with about 1/4 cup of the salmon mixture, mounding it on top of the avocado halves. Garnish with chives, if desired.

Sheet Pan Chicken & Vegetables with Romesco Sauce

Ingredients:

• 2 large Yukon Gold potatoes, cubed 
• 4 tablespoons extra-virgin olive oil, divided 
• 1 teaspoon ground pepper, divided
• ½ teaspoon salt, divided
• 4 bone-in chicken thighs, skin removed, excess fat trimmed
• 4 cups broccoli florets
• 1 (7-ounce) jar roasted red peppers, rinsed
• ¼ cup slivered almonds
• 1 small clove garlic, crushed
• 1 teaspoon paprika
• ½ teaspoon ground cumin
• ¼ teaspoon crushed red pepper
• 2 tablespoons chopped fresh cilantro for garnish

Instructions:

1. Preheat the oven to 450 degrees F.
2. Toss potatoes with 1 teaspoon oil, 1/4 teaspoon pepper and 1/8 teaspoon salt in a medium bowl. Place on one side of a large rimmed baking sheet.
3. Toss chicken with 1 tablespoon oil, 1/4 teaspoon pepper and 1/8 teaspoon salt in the bowl. Place on the empty side of the baking sheet. Roast for 15 minutes.
4. Toss broccoli with 2 teaspoons oil, 1/4 teaspoon pepper and 1/8 teaspoon salt in a clean bowl.
5. After the chicken and potatoes have roasted for 10 minutes, add the broccoli to the potato side of the baking sheet.
6. Stir the vegetables together and continue roasting until the chicken is cooked through and the vegetables are tender, about 15 minutes more.
7. Combine roasted peppers, almonds, garlic, paprika, cumin, crushed red pepper, and the remaining 2 tablespoons oil, 1/8 teaspoon salt and 1/4 teaspoon pepper in a mini food processor. Process until fairly smooth.
8. Serve the chicken and vegetables with the roasted pepper sauce. Sprinkle with cilantro, if desired.

DASH

The acronym of this diet stands for Dietary Approaches to Stop Hypertension. The DASH diet lowers blood pressure and can improve insulin sensitivity. High blood pressure is a common condition of diabetes, making this diet a strong choice for those managing both conditions. 

DASH is a low sodium-based plan, and it is low in saturated fat, trans fat and total fat. It also includes ingredients high in potassium, calcium and magnesium.

What You Eat:

• Red meat, fish and poultry
• Beans and legumes
• Nuts and seeds
• Grains like cereal, rice and pasta

What You Avoid:

• Desserts, baked goods, candy, ice cream, etc.
• Fatty meats
• Full-fat dairy products
• Sweets
• Salt

Recipes

DASH Diet Mexican Bake

Ingredients:

• 1 ½ cups cooked rice, preferably brown
• 1 pound skinless, boneless chicken breast, cut into bite-sized pieces
• 2 (14.5-ounce) cans no-salt-added tomatoes, diced or crushed
• 1 (15-ounce) can no-salt-added black beans, drained and rinsed
• 1 cup frozen yellow corn kernels
• 1 cup chopped red bell pepper
• 1 cup chopped poblano pepper
• 1 tablespoon chili powder
• 1 tablespoon cumin
• 4 garlic cloves, crushed
• 1 cup shredded reduced-fat Monterey Jack cheese 
• ¼ cup jalapeno pepper slices (optional)

Instructions:

1. Preheat the oven to 400 degrees.
2. Spread rice in a shallow 3-quart casserole. Top with chicken.
3. In a bowl, combine tomatoes, beans, corn, peppers, seasonings and garlic; pour over chicken.
4. Top with cheese and optional jalapeno.
5. Bake for 45 minutes.

Penne Tossed With Cherry Tomatoes, Asparagus and Goat Cheese

Ingredients:

• 1/3 pound whole-wheat penne pasta
• 1/2 cup chopped asparagus, 1-inch pieces
• 1 tablespoon water
• 1/2 cup halved cherry tomatoes
• 1/4 cup chopped fresh basil, plus whole leaves for garnish
• 1 tablespoon minced garlic
• 1/8 teaspoon freshly ground black pepper
• 2 ounces goat cheese

Instructions:

1. Fill a large pot 3/4 full with water and bring to boil. Add the pasta and cook until tender (al dente), 10 to 12 minutes or according to the package directions. Drain the pasta thoroughly.
2. While the pasta is cooking, put the asparagus and water in a microwave-safe bowl. Heat the asparagus on high power until tender-crisp, about 3 minutes.
3. In a bowl, combine the cherry tomatoes, basil, garlic and pepper. Add the asparagus, pasta and goat cheese, and toss until well-mixed.
4. Place in the refrigerator for at least 20 minutes to cool.
5. Divide the pasta between the plates. Garnish with fresh basil leaves and serve.

Quick Bean and Tuna Salad

Ingredients:

• 1/2 whole-grain baguette, torn into 2-inch pieces (about 1 cup)
• 2 tablespoons olive oil
• 1 (16-ounce) can cannellini beans, no salt added, drained and rinsed
• 2 small dill pickles, cut into bite-size pieces (about 2 tablespoons)
• 1 small red onion, thinly sliced (about 1/2 cup)
• 2 tablespoons red wine vinegar
• 1/4 teaspoon pepper
• 1 (7-ounce) can water-packed tuna, no salt added, drained and rinsed
• 2 tablespoons finely chopped fresh parsley

Instructions:

1. Heat broiler.
2. Place the baguette pieces on a heavy cookie sheet and brush with 1 tablespoon of the oil. Place under broiler for about 1 to 2 minutes, until golden.
3. Turn the bread pieces and broil for an additional 1 or 2 minutes.
4. In a large bowl, combine the remaining oil, beans, pickles, onion, vinegar and pepper.
5. Fold in the broiled baguette pieces. Divide the mixture among four bowls and top with the tuna and parsley.

Exercise

Along with eating a healthy diet, getting regular exercise is the most important lifestyle change recommended by doctors to help you manage diabetes. People who are prediabetic can even prevent type 2 diabetes by eating well and getting plenty of physical activity. Be sure to talk to your doctor before starting an exercise plan.

The different types of exercise include:

• Aerobic, or cardio exercise – This increases your heart rate. Examples are brisk walking, jogging, running, cycling and swimming.
• Strength training – This method uses free weights, your body weight, weight machines and resistance bands to increase your lean muscle mass.
• Flexibility – This reduces the risk of injury and falls. It includes stretching and yoga.
• Balance – These exercises strengthen your core (abdominal and back) muscles by, for example, standing on one foot or practicing tai chi.

How Exercise Helps

When you exercise, your body uses the glucose in your blood in order to power your muscles. While consistent exercise can add quality years to your life regardless of your medical condition, age or ability, it has particularly important benefits for those with diabetes:

• Exercise lowers A1C, regardless of whether you lose weight.
• Resistance training and aerobic exercise lower insulin resistance and help your body respond to insulin more efficiently.
• Diabetics who walk at least two hours a week significantly lower their risk of dying of heart disease.
  • Those who exercise three or four hours a week are even less at risk.
• Exercise helps you to lose weight, which allows your pancreas to produce more insulin.
• Cardiovascular exercise improves your lipid levels and lowers your blood pressure.
• Strength training can restore muscle mass that you may have lost as a result of your diabetes.
• Flexibility and balance exercises improve flexibility and range of motion, which can be negatively impacted by diabetes.
• Even gentle exercise like stretching can improve your blood sugar.
• Exercise helps you to reduce stress and get better sleep.

Getting Motivated

Your motivation to exercise when you first start might be strong at first and then decline. Or, you might keep putting off starting an exercise program indefinitely. If you are having difficulty making exercise a routine in your life, here are five tips for sticking to your fitness goals.

1. Start small with low-impact exercises, like walking. You do not need a machine or much time to add a walk into your daily routine. Try parking your car in the back of the parking lot or opt to take the stairs instead of the elevator or escalator.
2. Add a social aspect to improving your health by joining a group or asking a friend to work out with you. Working out with other people keeps you accountable and makes the experience more enjoyable. You can make exercise more fun by organizing a hiking group, joining a sports team, or signing up for group workout classes.
3. Find the exercise that works for you. If you dread working out, you decrease your likelihood of exercising. Try a few types of exercise until you find the one you like best. You can also try different environments like the gym, outside or at home. An exercise routine is not a one-size-fits-all situation.
4. Join a cause for extra motivation. It can be easier to let yourself down than others, especially those in need. Sign up to participate in a community event that helps a charity organization such as a walk-a-thon. The event will give you a training deadline and additional incentive.
5. Make time for fitness by adding it to your schedule. Carve out a specific time for your workouts, so your routine does not fall by the wayside. Even if it is a 30-minute walk during your lunch break, add it to your calendar. Visual reminders in your schedule will reinforce the importance of your fitness routine.

Engaging in exercise consistently will improve how you feel physically and mentally. In addition to the benefits mentioned, sticking to a fitness routine can boost your confidence. The results of your efforts can raise your self-esteem as you see and feel your body change positively.

Exercise Tips

Since diabetes creates certain vulnerabilities and sensitivities in the body, people with diabetes should take special care when exercising. Follow these tips so that you can exercise safely and get the most out of it:

• You can exercise any time, but the optimal time to exercise is one to three hours after eating, when blood sugar is at its highest.
• Ask your doctor if you should check your blood sugar level before and/or after exercising.
• Keep hard candy, a piece of fruit or glucose tablets with you while exercising in case your blood sugar gets too low.
• Unless you are already very fit and used to strenuous workouts, avoid high-intensity workouts like HIIT (high-intensity interval training), which can cause a steep drop in blood sugar.
• Once you get into a workout schedule, stay active and try not to skip workouts, as this can boost your blood sugar.
• Especially if you have joint pain, avoid exercise with fast or overly strenuous moves, which can compound your symptoms.
• If you have any diabetes complications like neuropathy or eye problems, talk to your doctor about what kind of exercises you should avoid. These may include jumping, lifting heavy weights and positions where your head is pointed down.
• Wear supportive, well-fitting shoes that are designed for the type of exercise you are doing (running shoes for running, etc.).

How to Start

Every small step forward is still a movement in the right direction. Whether you hate the idea of exercising or simply do not have the time, you can make small changes to your everyday life that will positively impact your health. Use these strategies to add more physical activity to your daily routine.

Get there faster – Pick up your pace when walking to class, a meeting or your living room. Instead of moving leisurely to your car, take a hurried walk instead. A brisk walk is about the speed you go when you are running a little late. It is the extra burst of speed you use to catch the elevator doors before closing.

On average, a walking pace is around 3 miles per hour (mph). When you walk briskly, your speed ramps up to 4.5 to 5 mph. Brisk walking increases your heart rate faster than walking slowly. Quickening your steps can even start you on the path to jogging.

Take the stairs instead of the elevator or escalator – Stair climbing burns more calories than jogging on a flat surface. According to studies, climbing at least 20 flights of stairs a week reduces the risk of stroke and improves cardiovascular fitness.

If you have a desk job, consider getting a stepper to use while working. They are great options for stand-up desks when you want to do more than stand still.

Do not sit longer than an hour – Most people have a sedentary job, sitting behind a desk. Every 50 minutes or so, stand up and take a walk around your desk, to the restroom or outside for a breath of fresh air. Just moving for three minutes every hour can help clear your mind and increase your energy. Even when you are unwinding at home, make sure to move every waking hour.

Work out during downtime – It might not be easy to find the time for a daily workout. However, you can engage in physical activities while doing routine things. Some examples include:

• Walking around your living room during commercial breaks
• Walking in place while brushing your teeth
• Lifting weights or stretching while watching television
• Playing an active game, like tag or basketball, with your family
• Doing knee lifts while making dinner
• Dancing while cleaning the house

Find ways to add movement into your daily routine. Small changes can make a big difference in how you feel and your fitness level.

If you are new to exercise or it is difficult to work out, try low-impact activities. Low-impact movements are gentle on your joints. Many athletes do low-impact routines when recovering from an injury or intense training day.

Exercises to Try

Low-impact activities can help you start a physical activity routine because you already do them daily.

Pilates

Pilates is a low-impact fitness system that focuses on strengthening core muscles, improving posture and increasing body alignment. After a few weeks, you will notice you have better balance, flexibility and endurance.

The movements are slow, so you can concentrate on precision and breathing. You do not have to stress about exhausting your muscles or gasping to catch your breath. The goal of the fitness system is to connect with your body.

Pilates works almost every muscle in your body. While most motions exercise your core and help you build a strong foundation, they also work your hips, thighs, arms and more. It can be a total body workout from a horizontal position.

Because Pilates targets very specific muscles in a way that you might not be familiar with, it is helpful to have the guidance of someone who is certified in the system. Search for a Pilates studio near you; it will have specialized equipment and someone to show you the moves. If you want to try it at home, you will need an exercise floor mat and a smart TV or mobile device.

Tai Chi

Tai chi is a Chinese martial art, but do not let that scare you away. Instead of combat, you are battling your mind through thoughtful movements and meditation. Tai chi improves flexibility, strength and your overall fitness. Studies have also shown that it can relieve pain, improve immunity and increase your quality of life.

You might have seen a group practicing Tai Chi in the park or another community area. The students moving slowly in unison might look like a strange dance, or like they are fighting in slow motion. The popularity of “moving meditation” is increasing as more people see the benefits of tai chi. Some of the benefits include:

• Weight loss
• Reduced stress, anxiety and depression
• Better mood and sleep
• Improved cognition, like having a better memory

Studies have shown that consistent tai chi lowers your fasting blood glucose levels if you have type 2 diabetes. While the practice does not leave you huffing and puffing like aerobic exercise, it produces similar effects to walking and jogging. 

Like Pilates, Tai Chi is a practice that you will have to learn and practice, at least at first, with an instructor. Search for a Tai Chi class near you or start with one beginner’s classes online. YouTube is a great resource for free online classes.

Yoga

Yoga is an ancient practice that combines stretching, meditation, and movement. It increases your flexibility, builds muscle and improves your posture. By doing it regularly, you can also gain better control of your blood sugar levels and lower your blood pressure.

Like Tai Chi, yoga promotes a better quality of life through reduction of anxiety and depression and improvement of sleep, mood and concentration. Additionally, yoga helps your circulatory, digestion and respiratory organs.

Yoga is another practice that should be learned from an instructor. You can go to an in-person class in your area or try doing it at home first with a video. You will need an exercise mat.

Swimming

Swimming is a fun, relaxing and peaceful way to exercise. It is a low-impact activity since you are not putting weight or pressure on your joints.

It improves coordination, flexibility, balance, and posture. If you intensify your swimming workout, you can improve the strength in your core, arms, legs, glutes and back. You can use swimming as part of your aerobic or strength training.

If you have a pool, great! If not, you may be able to find a public pool near you or a community center or gym with a pool. Try different strokes to work muscles in your chest and back.

Brisk Walking

Walking is an exercise that you can do practically anywhere. Wear supportive, comfortable shoes and go! If you walk at a pace at which you are slightly out of breath when you try to talk, that is considered a moderate level of exercise. Do this for a half hour, five days a week and you will have achieved the recommended goal of 150 minutes per week of moderate exercise.

Taking a 30-minute walk has numerous health benefits, including:

• Increased heart and lung fitness
• Stronger bones and improved balance
• Increased endurance and strength
• Reduced risk of heart disease and stroke
• Reduce body fat

Going for a daily walk can also be a form of meditation or a way to unplug from the world and appreciate nature. Focus on your breaths and steps to relax your mind. Or you can use the time to listen to an audiobook, podcast or TED talk while you walk.

You can increase your daily steps by parking farther back in the parking lot. When you are on the phone, walk around the space. You can also walk in place when you are watching your favorite TV shows. If you prefer to walk inside, you can use a treadmill or go to your local shopping mall and walk briskly through it.

When you start out, you may have trouble walking for 30 minutes at one time. If this is the case, break up the time into 10-minute chunks. Short walks can help build the activity into a habit. Once you are used to it, steadily increase the length of your walks.

Bicycling

Like brisk walking and swimming, riding a bicycle gives you an aerobic or cardio workout. All you need is a bicycle. If you feel unsure about your balance, you can get a full-size adult tricycle to give you some stability. Ride your bike as a form of transportation for short, and then increasingly longer trips, on bike trails or just around your neighborhood. Biking can also be done with a family member or friend, for an added social and motivational boost. Stationary bikes at the gym or at home give you the same workout.

Weight Training

Weight training, also called resistance training, increases your lean muscle mass, which helps you maintain a steady blood sugar level. Experts recommend doing weight training at least twice a week to help manage diabetes.

There are three kinds of weight training:

• Weights – Using hand weights, medicine balls, kettlebells or most exercise machines in gyms
• Resistance bands – Using stretchy rubber bands with handles
• Body weight exercises – Using no equipment, just your own body as the weight such as doing push-ups, lunges or squats

Most people do weight training at a gym, but you can also buy the weights or resistance bands and do it at home. Online, you can find free training videos for at-home workouts.

When you sleep, your body and brain can rest, reenergize and restore. Your body repairs its cells and releases essential proteins and hormones while you sleep. Your brain gets rid of toxic buildup from the day and converts memories from short-term to long-term. Rest also supports healthy brain functioning and allows you to regulate your emotional stability.

Sleep

On average, adults need 7 to 9 hours of rest each night. About a half of people with diabetes report having trouble sleeping. Unbalanced blood sugar (hyperglycemia and hypoglycemia) can cause insomnia. Hyperglycemia may cause a need to urinate multiple times during the night, which interrupts sleep. Hypoglycemia can result in nightmares, night sweats and irritability or confusion upon waking.

If you are tired, you are more likely to reach for something that will give you energy. Consuming more carbs and sugar for energy can spike your blood sugar levels. Not enough sleep and too much sugar can create a vicious cycle.

Sleep deprivation can affect how your brain and body work. Without time to recharge, your body can make it more challenging to manage your condition. For instance, scientists believe that sufficient high-quality sleep can protect against insulin resistance.

Some other effects of not getting enough rest include:

• Forgetfulness or memory problems
• Difficulty learning and problem-solving
• Weight gain
• Heart disease
• Weakened immunity
• Longer time to recover
• Mood changes
• Decreased creativity

Getting a Good Night’s Sleep

You can typically get better sleep by making some changes to your lifestyle and habits. Below are tips on how to sleep better when you have diabetes:

• Keep your blood sugar under control, especially before bed – Choose high protein bedtime snacks, like nuts, rather than treats high in sugar.
• Avoid caffeine several hours before bed – Only drink water or non-caffeinated beverages in the three to four hours before sleep.
• Exercise regularly – Physical activity improves blood sugar movement and increases the quality of sleep. Try to exercise or get your blood pumping for 30 minutes five times a week.
• Strive for a healthy weight – Weight loss can improve your sleep and help you better control your blood sugar, and decrease your risk of sleep apnea, which is a condition that affects your breathing while you sleep.
• Eliminate distractions like television and smartphones before bed – Blue light suppresses your ability to create melatonin, a hormone that regulates sleep and wake cycles.
• Stick to a consistent bedtime – Waking up and going to bed at the same time every day helps regulate your body’s internal clock.
• Create a bedtime routine – Wind your body and brain down with relaxing activities one to two hours before bed. A bedtime ritual might include brushing your teeth, taking a warm bath and meditation.

Stress

Managing diabetes can be stressful. It may feel overwhelming to regularly take readings, think about what and how much you are eating, and depend on insulin. In turn, stress can make it more challenging to manage your diabetes, affecting you physically, mentally and emotionally.

Physical Effects

When stressed, your body releases cortisol, adrenaline and other hormones that boost your energy, so you can react to what is causing your stress. However, these chemicals can make it more difficult for your body to produce and use insulin, which causes high blood sugar.

Consistent high blood sugar and stress can put you at a higher risk for diabetes-related complications.

Emotional Effects

Stress alters your mood and can change how you take care of yourself. Worrying about your diabetes can make you feel overwhelmed. Excessive stress can make you so preoccupied that you forget to eat, or so stressed that you overeat, turn to unhealthy comfort foods or drink alcohol.

Mental Effects

People with diabetes are at increased risk for depression, anxiety and eating disorders, each of which can cause behaviors that aggravate diabetes and lead to complications.

Stress Management Techniques

In order to avoid a cycle of stress causing worsening diabetes, which then results in more stress, it is important to develop healthy coping skills. Practicing mindfulness, mediation and other techniques can help you better manage stress. Here are some tips on how to calm your mind:

• Exercise helps you destress by releasing mood-boosting chemicals. Physical exertion can also discharge excess energy from stress.
• Meditation is the practice of inner focus through breathing and reflexive thought. You can meditate through yoga, prayer or simple breathing techniques. The length of time you meditate is your personal preference, but just 10 minutes a day can improve your stress levels.
• Unplug from the internet, social media and news. Taking a few minutes to detach from the world can help you relax and recharge, even in the middle of a hectic day.
• Staying positive might seem easier said than done when you are stressed. Focus on the positive aspects of your life and practice positive self-talk. To make it a habit, jot down a few things you are grateful for each morning to start the day on a positive note.

You can also seek professional help if you are having difficulty managing stress on your own. A mental health professional can help you:

• Reframe your thought processes
• Heal from past pains and trauma
• Come to terms with your current situation
• Change behaviors that are holding you back
• Feel emotionally stronger to face challenges
• Come up with problem-solving plans
• Give you healthy coping skills

Ask your doctor, family, friends and trusted advisors for local mental health professionals’ names and contact information. Look up their reviews, work history and experiences to find the best fit, as you will want to feel comfortable with this individual.

Your health insurance company may also have a list of in-network providers. Before selecting someone, asking questions about what sessions consist of and how much treatment costs can let you know what to expect.

Supplements

Your meals should provide all the vitamins and minerals you need. But, if you need help making sure you get your recommended daily dosage, you can try vitamin supplements. Specific vitamins can help manage your blood sugar level.

Vitamin B-1: Vitamin B-1 is another name for thiamine. Many people with diabetes have a thiamine deficiency, which can contribute to complications related to the condition. There is a link between heart disease and low thiamine. Beef, liver, nuts, pork, eggs, oats, peas and legumes are all good sources of vitamin B-1.

Vitamin D: Diabetics are more prone to vitamin D deficiency. Vitamin D can improve A1C and blood sugar control.

Alpha-lipoic Acid (ALA): Studies have suggested that using ALA can lower fasting blood sugar levels, decrease insulin resistance and reduce oxidative stress. However, it can also dangerously lower your blood glucose, so check with your physician before taking it. You can find ALA in potatoes, broccoli, spinach, kidney, liver and yeast.

Resveratrol: This chemical prevents high blood sugar and may reduce oxidative stress. You can find resveratrol in grapes and wine.

Berberine: This compound can reduce fasting blood sugar and improve insulin sensitivity. It comes from a bitter-tasting root, so you may want to take it as a capsule.

Magnesium: Magnesium helps regulate blood pressure, and it can regulate and improve insulin sensitivity. You can get magnesium through dark chocolate, avocados, nuts, legumes, leafy greens and bananas.

American ginseng: Studies have shown that American ginseng lowers post-meal blood glucose in about 20 percent of healthy individuals with type 2 diabetes. You should take it about two hours before your meal; otherwise, your blood sugar could dip too low.

Probiotics – Probiotic supplements can counteract unhealthy fats in your blood and improve fasting plasma glucose, A1C and other levels in those with type 2 diabetes.

Holistic Remedies

For generations, people have leaned on holistic remedies to manage their illnesses and conditions. Even to this day, some diabetics go to holistic doctors about their condition. While holistic means “whole body,” most think of holistic remedies as those that are natural. Consult your doctor before using any of these supplements.

This includes consuming foods and spices known to help manage diabetes, such as:

• Bitter Melon – Countries in Asia and South America use bitter melon to treat diabetes-related conditions. Numerous scientific studies have confirmed the ability of the naturally occurring mixed steroids in bitter melon to lower blood sugar. You can consume bitter melon as a food or in capsule form if you are not a fan of the taste.
• Fenugreek – Fenugreek is a seed that has a distinctive smell (it smells like maple syrup) and is used as a remedy for diabetes in India. The defatted portion of the seed has several compounds including alkaloid gonelline, nicotinic acid and coumarin that lower both glucose and lipids. Fenugreek also has fiber, which may contribute to its positive effect.
• Gurmar – This herb is commonly sold as a “sugar blocker,” and in studies it did significantly improve blood sugar control in patients with type 2 diabetes.
• Aloe Vera – Juice from this plant can help lower fasting blood sugar. Studies suspect that aloe stimulates the production of insulin.
• Neem – Neem oil is extracted from the leaves of the neem tree and has traditionally been used to treat diabetes. It works in a variety of ways: by decreasing blood sugar levels, increasing peripheral glucose utilization and preventing adrenaline- and glucose-induced hyperglycemia, possibly due to presence of a flavonoid called quercetin.
• Green Tea – Tea has been a staple in holistic remedies for hundreds of years. Green tea contains antioxidants that can improve glucose control and insulin activity. It can also lower the risk of cardiovascular disease, which is a common diabetes complication.
• Cinnamon – This spice can lower blood sugar and improve diabetes control. It may make your cells more responsive to insulin. You can consume cinnamon as the spice, a supplement or in its extracted form.

Alternative Therapies

There are also alternative therapies that many people with diabetes use. Before using one of these therapies, consult with your doctor. The therapies include:

• Acupuncture – Acupuncture has been used to treat diabetes patients in China for decades. While in the U.S., it is primarily known as a treatment that focuses on triggering the body’s natural painkillers, it has been shown to act on the pancreas to improve insulin synthesis, increase the number of receptors on target cells and quicken the utilization of glucose, all of which lower blood sugar. In addition, some diabetics who have regular acupuncture treatment for nerve damage claim to get relief from their chronic pain.
• Massage therapy – Doctors have recommended massage for diabetes for almost 100 years. Massage can normalize blood glucose and improve diabetic neuropathy in the legs and feet. Scientists are not sure how it works, but think it might be because the relaxation response from massage controls the counter-regulatory stress hormones, allowing the body to use insulin more efficiently. Massage also improves circulation, which counteracts neuropathy and other diabetes complications.
• Meditation – Mediation can help calm your mind and reconnect with your body. Studies show that regular meditation can reduce stress and its effects. By being in a more relaxed state, you are likely to lower blood glucose levels.
• Aromatherapy – Aromatherapy is the therapeutic use of essential oils derived from plants, by inhaling or applying topically. Aromatherapy has been used to mitigate the symptoms of some diabetes complications like ulcers on the skin and can be combined with massage. Recommended essential oils for diabetes include eucalyptus, juniper and geranium oils.
• Biofeedback – This therapy involves attaching monitors to the person to measure physiological activity like skin temperature and muscle tension. The patient is able to see the results and then do relaxation and breathing exercises to lower these stress markers. Biofeedback has been shown to decrease blood glucose and may have an effect on mood disorders that are common in diabetics such as depression and anxiety.
• Hydrotherapy – This form of therapy uses hot and cold water to treat illness and injury. It helps the body release toxins, relax muscles and improve circulation. Hot tub therapy has been used to help diabetes patients who are unable to exercise, and it helps decrease plasma glucose levels. Those with diabetic neuropathy should use care with hydrotherapy to make sure that the water is not too hot, as they may have trouble feeling the excessive heat.

Glossary of Diabetic Terms

Albuminuria – This condition arises when there is more than a normal amount of a protein called albumin in the urine, and may be a sign of kidney disease.

Autoimmune disease – A disorder where the body’s immune system attacks healthy cells. Type 1 diabetes is an autoimmune disease.

Basal rate – Continuous infusion of insulin in small amounts, like via an insulin pump.

Carbohydrate – One of the main three classes of nutrients, carbohydrates provide energy to the body. They are mostly sugars and starches that the body breaks down into glucose.

Certified diabetes educator (CDE) – Health care professional who is certified by the National Certification Board for Diabetes Educators to teach people how to manage diabetes.

Continuous glucose monitor – A device that consists of a sensor inserted under the skin that measures and reports glucose levels about every five minutes.

Dawn phenomenon – A sudden rise in glucose levels in the early morning. This is more common with type 1 than type 2 diabetes.

Diabetic Ketoacidosis:  Diabetic Ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body is unable to produce enough insulin.

Endocrinologist – A doctor specializing in problems involving endocrine glands such as the pancreas. Endocrinologists often treat those with diabetes.

Fasting plasma glucose test – A diagnostic test that measures blood glucose levels after fasting for 10-12 hours. Normal fasting blood glucose is less than 100 milligrams per deciliter (mg/dL) for people without diabetes. If this test shows blood glucose of 126 mg/dL or more twice, a diagnosis of diabetes is made.

Gangrene – The death of body tissues usually resulting from restricted circulation, especially in the legs and feet. Gangrene results in a need to amputate.

Glaucoma – An eye disease characterized by increased pressure in the eye that may damage the optic nerve and result in impaired vision and blindness.

Glucose – Glucose is the form of sugar found in blood. It is one of the body’s main energy sources.

Glucose tolerance test – A test done to see if a person has diabetes. A blood sample is taken in the morning before the person has eaten, and then after drinking a glucose drink and then again 1-2 hours afterward.

Hyperglycemia: Hyperglycemia is a condition that occurs when the body does not produce or use enough insulin, leading to high blood sugar.

Hypoglycemia – This is where one has low blood glucose, which may be caused by an imbalance in diabetes medications, food intake and/or activity levels.

Injection site rotation – Changing the areas of the body where a person injects insulin. This is necessary because otherwise, hardened areas, lumps or indentations can form under the skin that interfere with proper usage of insulin.

Insulin – Insulin is a hormone produced by the pancreas. It is crucial for maintaining a balanced glucose level. It goes like this: Every time we eat, glucose builds up in our body. In a healthy body, insulin helps move glucose from our blood into cells that then produce energy.

Insulin resistance – Insulin resistance is when the body does not respond well to insulin, and as a result, blood glucose is unable to convert into energy. This resilience leads to the pancreas producing more insulin, which causes blood glucose levels to rise.

Insulin shock – Loss of consciousness as a result of severe hypoglycemia.

Neuropathy – A diabetes complication where high blood sugar causes nerve damage and damage to the blood vessels. Neuropathy causes tingling and numbness, which can lead to falls and injury.

Pancreas – The pancreas is an organ located in the abdomen. It plays an essential role in converting the food we eat into fuel for the body’s cells. In diabetes, the pancreas is not able to function in this way.

Peripheral vascular disease (PVD) – Any condition that negatively affects the blood vessels outside of the heart and lymphatic vessels. This is a complication of diabetes, which occurs when there is decreased blood flow to the hands and feet.

Polydipsia – Excessive thirst over long periods of time, may be a sign of diabetes.

Polyuria – Increased need to urinate often, which may be a sign of diabetes.

Prediabetes – Prediabetes is a condition that occurs when the body’s blood glucose levels are higher than the normal range but not high enough to be deemed diabetic.

Retinopathy – A disease of the small blood vessels in the retina of the eye, which is a complication of diabetes.

Somogyi effect (rebound effect) – A sudden increase to high blood sugar from an extremely low level of blood sugar. This may happen as a result of untreated low blood sugar at night.

Triglyceride – These are fats in the blood from food that are then stored in fat cells. These are removed from the blood by insulin when the system is working properly.

Unit of insulin – The basic measure of insulin. U-100 is the most common concentration of insulin, which means that there are 100 units of insulin per milliliter of liquid.