At the close of the DPP trial, investigators offered lifestyle intervention to all 3 groups. Patients in the original metformin group continued to take metformin (with participants unblinded to assignment); patients in the original lifestyle intervention group were offered additional lifestyle support.5 At a median follow-up of 10 years after initial enrollment in the DPP trial, metformin reduced the incidence of overt diabetes by 18% compared with placebo (95% CI, 7%-28%), and lifestyle intervention reduced it by 34% (95% CI, 24%-42%; no statistic of comparison supplied).
Although most vegetable oils are in some ways healthier than animal fats, you will still want to keep them to a minimum. All fats and oils are highly concentrated in calories. A gram of any fat or oil contains 9 calories, compared with only 4 calories for a gram of carbohydrate. Avoid foods fried in oil, oily toppings, and olives, avocados, and peanut butter. Aim for no more than 2-3 grams of fat per serving of food, e.g., white or wheat bread, most cold cereals, watermelon, pineapple, baking potatoes, sugar.
The American Diabetes Association (ADA) recommends lean proteins low in saturated fat for people with diabetes. If you’re following a vegan or vegetarian diet, getting enough and the right balance of protein may be more challenging, but you can rely on foods like beans, nuts, and tofu to get your fix. Just be sure to keep portion size in mind when snacking on nuts, as they are also high in fat and calories.
If you are at risk for diabetes or insulin resistance, be sure to get an annual testing for fasting blood glucose and hemoglobin A1c. If you see these rising over time, this is a sign that your body is having more trouble processing sugar. Your healthcare provider can provide further recommendations for medication and lifestyle changes that can reduce your risk of progressing to type 2 diabetes.
But some pleasant news: When consumed in moderation and made with whole ingredients and without added sugar, fruit smoothies can be a good food for diabetes. Consider stocking your fridge with unsweetened frozen fruit so you can whip up one in a hurry for breakfast. Adding ingredients with protein, such as yogurt or a small amount of nut butter, will also help your body break down the carbohydrates more slowly, leading to less of a spike in blood sugar.
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.
Over a period of years, you went from pre-diabetes, to diabetes, to taking one medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse! Even if your blood sugars get better, your diabetes is getting worse. This is unfortunately what happens to virtually every patient. The body is already overflowing with sugar.
Type 2 diabetes can lead to a number of complications such as kidney, nerve, and eye damage, as well as cardiovascular disease. It also means cells are not receiving the glucose they need for healthy functioning. A calculation called a HOMA Score (Homeostatic Model Assessment) can tell doctors the relative proportion of these factors for an individual with type 2 diabetes. Good glycemic control (that is, keeping sugar/carbohydrate intake low so blood sugar isn't high) can prevent long-term complications of type 2 diabetes. A diet for people with type 2 diabetes also is referred to as a diabetic diet for type 2 diabetes and medical nutrition therapy (MNT) for people with diabetes.