Even if you have not been told that you have prediabetes, you could be worried about it, since 90% of the people with prediabetes are unaware that they have it. You are at higher risk if you are over 45 years old, do not get much exercise, have a family history of diabetes, or are African American, Native American, Hispanic/Latino, or Pacific Islander.

Smoking 16 to 20 cigarettes a day or more can increase a person's risk of developing diabetes to more than three times that of nonsmokers. The exact reason for this isn't well understood. It may be that smoking directly decreases the body's ability to utilize insulin. Moreover, it has been observed that after smoking, blood sugar levels increase. Finally, there is also an association between smoking and body fat distribution, smoking tends to encourage the "apple" shape, which is a risk factor for diabetes.
Like refined grains, sugary beverages have a high glycemic load, and drinking more of this sugary stuff is associated with increased risk of diabetes. In the Nurses’ Health Study II, women who drank one or more sugar-sweetened beverages per day had an 83 percent higher risk of type 2 diabetes, compared to women who drank less than one sugar-sweetened beverage per month. (26)
The more intense the exercise, the better. According to the British diabetes association diabetes.co.uk, high-intensity interval training (HIIT) may be better for weight loss and glucose control than continuous aerobic activity like jogging. HIIT involves alternating between short bursts of increased intensity exercise and rest — for instance, running and then walking on and off throughout the workout.
Every single part of the body just starts to rot. This is precisely why type 2 diabetes, unlike virtually any other disease, affects every part of our body. Every organ suffers the long term effects of the excessive sugar load. Your eyes rot – and you go blind. Your kidneys rot – and you need dialysis. You heart rots – and you get heart attacks and heart failure. Your brain rots – and you get Alzheimers disease. Your liver rots – and you get fatty liver disease. Your legs rot – and you get diabetic foot ulcers. Your nerves rot – and you get diabetic neuropathy. No part of your body is spared.

The types of fats in your diet can also affect the development of diabetes. Good fats, such as the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes. (39) Trans fats do just the opposite. (8, 40) These bad fats are found in many margarines, packaged baked goods, fried foods in most fast-food restaurants, and any product that lists “partially hydrogenated vegetable oil” on the label. Eating polyunsaturated fats from fish—also known as “long chain omega 3” or “marine omega 3” fats—does not protect against diabetes, even though there is much evidence that these marine omega 3 fats help prevent heart disease. (41) If you already have diabetes, eating fish can help protect you against a heart attack or dying from heart disease. (42)


Globally, T2DM is at present one of the most common diseases and its levels are progressively on the rise. It has been evaluated that around 366 million people worldwide or 8.3% in the age group of 20-79 years had T2DM in 2011. This figure is expected to rise to 552 million (9.9%) by 2030.10 This disease is associated with severe complications which affect patient’s health, productivity, and quality of life. More than 50% of people with diabetes die of cardiovascular disease (CVD) (primarily heart disease and stroke) and is a sole cause of end stage renal disease which requires either dialysis or kidney transplantation. It is also a major cause of blindness due to retinal damage in adult age group referred to as diabetic retinopathy (DR). People with T2DM have an increased risk of lower limb amputation that may be 25 times greater than those without the disease. This disease caused around 4.6 million deaths in the age-group of 20-79 years in 2011.11
How do sugary drinks lead to this increased risk? Weight gain may explain the link: In both the Nurses’ Health Study II and the Black Women’s Health Study, women who increased their consumption of sugary drinks gained more weight than women who cut back on sugary drinks. (26, 28) Several studies show that children and adults who drink soda or other sugar-sweetened beverages are more likely to gain weight than those who don’t, (28, 30) and that switching from these to water or unsweetened beverages can reduce weight. (31) Even so, however, weight gain caused by sugary drinks may not completely explain the increased diabetes risk.  There is mounting evidence that sugary drinks contribute to chronic inflammation, high triglycerides, decreased “good” (HDL) cholesterol, and increased insulin resistance, all of which are risk factors for diabetes. (32)
When adjusted for family history, the benefits of exercise can be evaluated based on previous studies. Of note, for every 500 kcal burned weekly through exercise, there is a 6% decrease in relative risk for the development of diabetes. This data is from a study done in men who were followed over a period of 10 years. The study also notes a greater benefit in men who were heavier at baseline. There have been similar reports on the effects of exercise in women.
Choose lean sources of protein. Lean sources of protein include: eggs, egg whites, chicken breast, turkey breast, lean beef, pork tenderloin, fish (e.g., cod, tilapia, orange roughy), beans, or tofu. Adding protein to your daily intake helps to control spikes in blood sugar and helps with fullness to prevent unnecessary snacking on poor choices later.

Paleolithic diets include a moderate amount of protein, and have gained a lot of attention recently. The theory behind this dietary pattern is that our genetic background has not evolved to meet our modern lifestyle of calorically dense convenience foods and limited activity, and that returning to a hunter-gatherer way of eating will work better with human physiology. This has been studied in a few small trials, and it does seem beneficial for people with type 2 diabetes.
Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might combine drugs from different classes to help you control your blood sugar in several different ways.
Interventional studies showed that high carbohydrate and high monounsaturated fat diets improve insulin sensitivity, whereas glucose disposal dietary measures comprise the first line intervention for control of dyslipidemia in diabetic patients.78 Several dietary interventional studies recommended nutrition therapy and lifestyle changes as the initial treatment for dyslipidemia.79,80 Metabolic control can be considered as the cornerstone in diabetes management and its complications. Acquiring HbA1c target minimizes the risk for developing microvascular complications and may also protect CVD, particularly in newly diagnosed patients.81 Carbohydrate intake has a direct effect on postprandial glucose levels in people with diabetes and is the principal macronutrient of worry in glycemic management.82 In addition, an individual’s food choices and energy balance have an effect on body weight, blood pressure, and lipid levels directly. Through the mutual efforts, health-care professionals can help their patients in achieving health goals by individualizing their nutrition interventions and continuing the support for changes.83-85 A study suggested that intake of virgin olive oil diet in the Mediterranean area has a beneficial effect on the reduction of progression of T2DM retinopathy.86 Dietary habits are essential elements of individual cardiovascular and metabolic risk.87 Numerous health benefits have been observed to the Mediterranean diet over the last decades, which contains abundant intake of fruit and vegetables. The beneficial effects of using fish and olive oil have been reported to be associated with improved glucose metabolism and decreased risk of T2DM, obesity and CVD.88

Eating right and exercising more often is good for everyone. But it's especially important for people with type 2 diabetes. When people put on too much body fat, it's because they're eating more calories than they use each day. The body stores that extra energy in fat cells. Over time, gaining pounds of extra fat can lead to obesity and diseases related to obesity, like type 2 diabetes.
A terrific rule to follow is to use a luncheon size plate rather than a dinner plate.  This is an easy way to guide your portion sizes without having to think so much about it. Enjoy a glass of red wine or similar drinks only occasionally since your body treats alcohol more like a fat than a carb when it comes to calories. Eat a sound breakfast and try to eat a bigger lunch so the bulk of your calories are consumed by the midafternoon as a way to keep your blood glucose level in a healthy range, and lessen the chance of undesirable weight gain.1

Treat yourself as you would a good friend who is struggling with a lifestyle change. You would be supportive and encouraging – a slip is not the end of it all. Sometimes it’s OK to indulge in a treat, but don’t feel guilty – enjoy it to the fullest – then get back on track. It’s OK to sit and read a book one day – just try to not make it the normal thing to do. I realized this morning when I had breakfast with a friend who is struggling with weight loss and I saw that the biggest difference was our attitude. She was moaning about how hard it was to lose and what she couldn’t eat and how much she had to work out, instead of looking at the fact that she has lost 20 pounds! That said, it’s not always easy to be positive, but all I really need to do is look back 4 months and I know I am making a difference.”
Diet becomes a critical issue when dealing with disease processes. When exploring dietary factors as a contributor to disease processes, one must take a number of things into account, for example, is it the specific food itself or the weight gain associated with its consumption that causes the risk? Is it the food, or the age/lifestyle of those consuming it that causes the risk? While cinnamon, coffee, and fenugreek seeds are among the many food products that some feel are associated with development/prevention of diabetes, none of these claims have truly been fully scientifically evaluated.

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


Food sources of carbohydrates including breads, cereals, crackers, pasta, starchy vegetables (peas, corn, potatoes), fruit and sweets/desserts need to be eaten consistently throughout the day by focusing on small and frequent meals every 3-4 hours. Patients with type 2 diabetes should work with a dietitian who can prescribe a goal number of carbohydrate servings (or grams) at each meal and snack and teach appropriate portion size for each carbohydrate food. Daily carbohydrate needs will vary based on the individual.
Eat every two to three hours. Spreading your energy needs throughout the day allows for healthier choices to be made and your blood sugar to stabilize. Work towards achieving a healthy meal pattern of breakfast (the first meal), followed by a small snack, then lunch (mid-day meal), another snack, dinner (last-meal of the day) and sometimes a small end of the day snack.
In fact, in a study published in the German journal Naturheilpraxis mit Naturalmedizin (Naturopathic Practice with Natural Medicine) the dry concentrated bark extract of Hintonia latiflora—combined with additional nutrients— significantly lowered HgBA1C values (average levels of blood sugar), fasting glucose levels (blood sugar before a meal) and postprandial (after eating) blood sugar levels.
Other than gestational (which occurs in pregnant women and usually disappears after giving birth), there are two types of diabetes: Type 1 and Type 2. Type 1 diabetes accounts for only 5 percent of all instances in the United States, according to the Centers for Disease Control and Prevention. Type 2 diabetes is the most common, clocking in as the seventh leading cause of death in the United States. Type 2 diabetes is also the only one that’s considered preventable. It generally develops later in life, sometimes as a consequence of lifestyle or other health factors.
One serving in a category is called a "choice." A food choice has about the same amount of carbohydrates, protein, fat and calories — and the same effect on your blood glucose — as a serving of every other food in that same category. So, for example, you could choose to eat half of a large ear of corn or 1/3 cup of cooked pasta for one starch choice.
The only reason to continue to give this bad advice is the lingering fear of natural fat. If you’re going to avoid fat you need to eat more carbohydrates in order to get satiated. But in recent years the old theory about fat being dangerous has been proven incorrect and is today on its way out. Low-fat products are simply unnecessary. So this reason doesn’t hold up either.
Diabetes mellitus (DM) was first recognized as a disease around 3000 years ago by the ancient Egyptians and Indians, illustrating some clinical features very similar to what we now know as diabetes.1 DM is a combination of two words, “diabetes” Greek word derivative, means siphon - to pass through and the Latin word “mellitus” means honeyed or sweet. In 1776, excess sugar in blood and urine was first confirmed in Great Britain.2,3 With the passage of time, a widespread knowledge of diabetes along with detailed etiology and pathogenesis has been achieved. DM is defined as “a metabolic disorder characterized by hyperglycemia resulting from either the deficiency in insulin secretion or the action of insulin.” The poorly controlled DM can lead to damage various organs, especially the eyes, kidney, nerves, and cardiovascular system.4 DM can be of three major types, based on etiology and clinical features. These are DM type 1 (T1DM), DM type 2 (T2DM), and gestational DM (GDM). In T1DM, there is absolute insulin deficiency due to the destruction of β cells in the pancreas by a cellular mediated autoimmune process. In T2DM, there is insulin resistance and relative insulin deficiency. GDM is any degree of glucose intolerance that is recognized during pregnancy. DM can arise from other diseases or due to drugs such as genetic syndromes, surgery, malnutrition, infections, and corticosteroids intake.5-7
The health benefits of a low-fat vegetarian diet such as portions of vegetables, grains, fruits, and legumes (excluding animal products) in people with type-2 diabetes. The vegan diet is based on American Diabetes Association (ADA) guidelines; the results of this study were astounding: Forty-three percent of the vegan group reduced their diabetes medications. Among those participants who didn't change their lipid-lowering medications, the vegan group also had more substantial decreases in their total and LDL cholesterol levels.
Trigylcerides are fatty molecules that travel in the bloodstream. Excess sugar and fat can increase triglyceride levels. Triglycerides are also manufactured in the liver. The body uses triglycerides for energy, but excess triglycerides are a risk factor for heart attack, stroke, and obesity. Many lifestyle factors can influence triglyceride levels.
People are missing the forest through the trees while trying to be perfect in the way they eat. It has become difficult to accept the tip “eat more fruits and vegetables”. All the food “philosophers” (aka non-science based food guru) have filled our heads with lies about the types, packaging and serving of these foods. Saying things like “they are worthless if they are packaged in such-and-such a way”. STOP with the “all-prefect or nothing” mentality. Just eat fruits and vegetables! Canned, fresh, frozen, cooked, raw, or pulverized; just get them in your belly.

Stay Hydrated. Drinking water throughout the day is always good to keep your organs and skin healthy. Of course, getting some fluid before, during and after exercise is just as important to avoid becoming dehydrated. However, what you choose matters a lot. For example, skip the soda. New findings come out regularly to warn against the negative health effects of added sugar, including fructose (ie, high fructose corn syrup), honey, and agave.
Aside from weight, certain nutrients are linked to improved health and lower diabetes risk. For example, increasing consumption of vegetables, fruits, and beans, eating more whole grains instead of refined, and choosing olive oil can all lower diabetes risk. Limiting sweets, refined carbohydrates such as white bread and pasta, and unhealthy fats from fried foods and fatty meats are examples of dietary patterns to slow any progression of prediabetes.

Chia is a type of seed that provides fiber, protein, and omega-3 fatty acids. Chia is a superfood because it brings down the glycemic load of any meal, increases hunger satisfaction (satiety), and stabilizes bloods sugar. Adding chia to your breakfast will help keep you full longer. They primary type of fiber in chia is soluble fiber. Soluble fibers turn to a gel when mixed with water. This makes chia seeds excellent to use in baking and cooking when a thickener is needed. Chia mixed with almond milk, cocoa, and a low-glycemic index sweetener like agave or stevia makes an excellent healthy pudding!


But just as with grains, it’s important to roll out your carb-counting skills when noshing on nature’s candy. The ADA notes that a small piece of whole fruit or ½ cup of canned fruit in natural juices or frozen fruit typically contains 15 g of carbs, while fruit juice — a less ideal source of fruit for diabetes — can have that much in 1/3 to ½ cup.
Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It's also a good idea to limit red meat, and avoid processed meats.

Another area that I focus on is portion sizes. With the increase in portion sizes in our society, it can be hard to manage food intake. I recommend listening to your body and identifying your needs by being aware of your hunger and fullness. If you are feeling hungry, it is an indicator to eat, and once you start to feel satisfied, it is an indicator to stop eating, knowing that you can eat again later. This small change where someone begins to leave food on their plate or stops eating when feeling satisfied and not overly full can make a big difference in overall health.
Eat Slower: Once we start eating, it takes about 15 to 20 minutes for our bodies to realize we are full. Eating too fast can lead to overeating, which can lead to a spike in blood sugar and/or weight gain…which can lead to greater insulin resistance. Consciously aim to eat slowly – give yourself at least 15 minutes – especially if you start a meal very hungry. If you are a fast eater or do not have a lot of time, eat 50% to 75% of your planned portion and then wait 10 to 15 minutes (call a friend, work a little, take a walk, anything). If you are still hungry, then eat half of what’s left. Repeat until you are satisfied, not stuffed. Pay attention to how much food it actually takes to make you full so if you are in a pinch, you can make sure your eyes don’t become bigger than your stomach.
A relatively small weight loss of 7 percent of body weight has been shown to help prevent diabetes. Strive to stay at your own lowest sustainable weight, even if that is above what the charts say you should be. It is better to aim for a smaller weight loss and be able to keep that weight off than aim for an unrealistically low number, which could cause a "rebound" effect.
Hemoglobin A1c or HbA1c is a protein on the surface of red blood cells. The HbA1c test is used to monitor blood sugar levels in people with type 1 and type 2 diabetes over time. Normal HbA1c levels are 6% or less. HbA1c levels can be affected by insulin use, fasting, glucose intake (oral or IV), or a combination of these and other factors. High hemoglobin A1c levels in the blood increases the risk of microvascular complications, for example, diabetic neuropathy, eye, and kidney disease.
Carry a Rescue Snack: Going too long without eating can lead to dips in blood sugar, sometimes called “lows”, which create unpleasant symptoms, including ravenous hunger. This often leads to poor food choices, since we’re more focused on eating anything in sight, even if it’s not healthy. Rather than getting to this point, keep a healthy snack with you throughout the day in case you get stuck somewhere you didn’t plan at a mealtime. A balanced snack will combine a nutritious carb or veggie + source of protein or healthy fat.The chart below provides portable options you can mix and match to your tastes:
The result of his hard work? He lost 160 pounds in two years, normalized his high blood pressure and high cholesterol, has an A1C of 5.6, and no longer takes metformin and glyburide. His advice to others with type 2: "You need to have a plan, and you need to be consistent," he says. "[Diet and exercise are] something you need to do to survive and control it. Look at it as the same thing as taking a pill or insulin."

When the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs – the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.


So how does one prevent a diabetes diagnosis from happening? Diet is definitely a factor in the development of diabetes, though not the only factor. Other potential influences include age, genetics, family history, physical activity, mental health, income, hormonal conditions, and ethnicity. So even if your diet is perfectly engineered towards preventing the chronic disease, you still might be at risk. That being said, your diet does still play a role. Why not reduce your risk as much as you can?


To follow a healthy diet for diabetes, you must first understand how different foods affect your blood sugar. Carbohydrates, which are found to the largest degree in grains, bread, pasta, milk, sweets, fruit, and starchy vegetables, are broken down into glucose in the blood faster than other types of food, which raises blood sugar, potentially leading to hyperglycemia. Protein and fats do not directly impact blood sugar, but both should be consumed in moderation to keep calories down and weight in a healthy range.
Jitahadi bought books on diabetes, nutrition, the glycemic index, and diabetes-friendly meals. Instead of slightly modifying her diet, Jitahadi decided to completely overhaul it. "I started realizing that what ['watch what you eat'] really meant was I needed to eat healthier, more balanced meals," she says. She wrote down everything she ate. And instead of dining out, she cooked meals from scratch. Jitahadi swapped white sugar for lower-glycemic sweeteners, traded in white rice for brown, lowered the amount of sodium she consumed, cut a lot of carbs, and made veggies the mainstay of each meal. (Her favorite: grated cauliflower sautéed with veggies and chicken or egg for low-carb fried "rice.")
This pattern of eating is very nutrient-dense, meaning you get many vitamins, minerals, and other healthful nutrients for every calorie consumed. A very large recent study demonstrated that two versions of the Mediterranean diet improved diabetes control including better blood sugar and more weight loss. The two versions of the Mediterranean diet that were studied emphasized either more nuts or more olive oil. Since both were beneficial, a common-sense approach to adopting the Mediterranean diet would include both of these. For example, sprinkle chopped almonds on green beans or drizzle zucchini with olive oil, oregano, and hemp seeds.
Foods might sometimes appear to be packaged into individual serving sizes even though they contain two or more servings per package. To determine that, look at "serving size" and "servings per container" at the top of any food label. For example, if a serving size is 1 and there are 2 servings per container, you will need to double all of the nutrient values on the label in order to get a clear picture of the value of the entire container.
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