When you have type 1 or type 2 diabetes, you need to be very aware of not only what you eat, but also when and how much you eat. A Certified Diabetes Educator (CDE) at Joslin can work with you to develop a healthy meal plan that fits your lifestyle. Following a meal plan can also help you lose weight and lower your risk of developing complications.
You can talk to your diabetes health care team about making any necessary meal or medication adjustments when you exercise. They'll offer specific suggestions to help you get ready for exercise or join a sport and give you written instructions to help you respond to any diabetes problems that may happen during exercise, like hypoglycemia (low blood sugar), or hyperglycemia (high blood sugar).

Keeping close tabs on your diet is a major way to help manage type 2 diabetes. A healthy diet for people with type 2 diabetes includes fresh or frozen fruit and vegetables, whole grains, beans, lean meats, and low-fat or fat-free dairy. Focus on eating fruit and non-starchy vegetables, like broccoli, carrots, and lettuce, and having smaller portions of starchy foods, meats, and dairy products. Be especially careful about loading up on foods that are high on the glycemic index (GI) and especially the glycemic load (GL), systems that rank foods according to how they affect glucose levels.
Sometimes pills for diabetes — even when combined with diet and exercise — aren't enough to keep blood sugar levels under control. Some people with type 2 diabetes also have to take insulin. The only way to get insulin into the body now is by injection with a needle or with an insulin pump. If someone tried to take insulin as a pill, the acids and digestive juices in the stomach and intestines would break down the medicine, and it wouldn't work.
If I could only prescribe one supplement for a diabetes patient, I would prescribe R-alpha-lipoic acid. Alpha-lipoic acid has numerous benefits to the diabetic patient. It is a water- and fat-soluble antioxidant and has been shown to protect patients with fatty liver from liver disease progression. It can help reduce insulin resistance and has been shown to protect people with diabetes from developing complications in their nerves, eyes, and kidneys. R-ALA can prevent glycosylation of proteins, which reduces the A1C level. It is safe, although very rarely it can cause stomach upset. Alpha-lipoic acid is listed either as ALA or R-ALA. When listed as ALA, this means it contains two forms—the S isomer form and the R isomer form, in a 50:50 ratio. The key is to find a product that says it contains “R-ALA” instead of just “ALA.” A good daily working dose of R-ALA is 300 to 1,200 mg a day, which is the equivalent of 600 to 2,400 mg a day of regular ALA, if you buy a regular ALA listed product.
Imagine that you hide your kitchen garbage under the rug instead throwing it outside in the trash. You can’t see it, so you can pretend your house is clean. When there’s no more room underneath the rug, you throw the garbage into your bedroom, and bathroom, too. Anywhere where you don’t have to see it. Eventually, it begins to smell. Really, really bad.
If diagnosed at an early stage, diabetes can be controlled with some minor lifestyle changes. A person can straightaway keep a check on his/her diet and start exercising on a regular basis. At any stage of diabetes, however, lifestyle changes are required. Therefore, it is better to imbibe these changes in one's life as soon as one comes to know about this disease.

Evidence linking hepatic insulin sensitivity to intraorgan triglyceride content has been steadily accumulating. In insulin-treated type 2 diabetes, insulin dose correlates with the extent of fatty liver (35), and in turn, this is associated with insulin sensitivity to suppression of hepatic glucose production (36). Decreasing the fat content of liver is associated with improvement in insulin suppression of glucose production and, thereby, with improvement in fasting plasma glucose (20,23).
Ordinary calorie restriction through any diet can lead to weight loss and make it easier to manage blood sugar. Intermittent fasting is thought to go a step further by lowering serum insulin, which triggers the body to burn stored sugar, called glycogen, along with fat, in the absence of glucose from food, Dr. Fung says. These processes (called glycogenolysis and lipolysis, respectively) can temporarily lower blood sugar and cause weight loss.
It is also known as insulin-dependent diabetes mellitus (IDDM) and results from body's inability to produce insulin. Usually, it occurs in childhood or adolescence, but can surface up at any age. In this, the patient needs to take insulin injections on regular intervals (generally daily) in order to absorb glucose in the body. Type 1 diabetes mellitus is also referred to as juvenile diabetes, at times.
Consider a form of regular fasting (more to come in a later blog), such as intermittent fasting or time-restricted feeding (TRF). TRF means eating your calories during a specific window of the day, and choosing not to eat food for the rest. It’s a great way to reduce insulin levels in your body and help undo the effects of chronically elevated levels.

“Our findings suggest that even if you have had type 2 diabetes for six years, putting the disease into remission is feasible”, says Prof Michael Lean from the University of Glasgow who co-led the study. “In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimise individual results.”

Chinese medicine teaches us that we do not treat a patient based solely on a Western medical diagnosis, but, rather, based on the symptoms that present, and the health of the body as a whole system. There are several beneficial herbal formulas that have been developed to treat some of the general symptoms, but it is important to remember that not everyone will present symptoms in the same way, and treatment should be individualized to suit the specific needs of the patient.
8. Get your protein from vegetable sources, fish, and dairy: Plant-based proteins have a balanced nutritional profile (providing fiber, fat, and protein) and are low in saturated fats. Some saturated fats, like those that are heavily processed or from unhealthy animals, can be dangerous, as they raise cholesterol levels and contribute to heart disease. Dairy from pastured animals (such as yogurt) that is low in sugar provides protein, carbohydrates, and beneficial probiotics, and non-mercury contaminated, wild caught fish is a great source of protein that is low in saturated fat and high in amino acids and fatty acids like Omega-3.
Called ALA for short, this vitamin-like substance neutralizes many types of free radicals. A build-up of free radicals, caused in part by high blood sugar, can lead to nerve damage and other problems. ALA may also help muscle cells take up blood sugar. In a German study, a team of scientists had 40 adults take either an ALA supplement or a placebo. At the end of the four-week study, the ALA group had improved their insulin sensitivity 27 percent. The placebo group showed no improvement. Other studies have shown a decrease in nerve pain, numbness, and burning.
Diabetes can be very complicated, and the physician needs to have as much information as possible to help the patient establish an effective management plan. Physicians may often experience data overload resulting from hundreds of blood-glucose readings, insulin dosages and other health factors occurring between regular office visits which must be deciphered during a relatively brief visit with the patient to determine patterns and establish or modify a treatment plan.[5]

Whether you were diagnosed with type 2 diabetes a week ago or 8 years ago like Jacquie, this life-altering day is almost impossible to forget. Your diagnosis day often marks the beginning of a daily routine of prescription medications or injections, and now there is growing evidence that the burden of diabetes may take a huge toll on your mental health over time as well.
As self-management of diabetes typically involves lifestyle modifications, adherence may pose a significant self-management burden on many individuals.[65] For example, individuals with diabetes may find themselves faced with the need to self-monitor their blood glucose levels, adhere to healthier diets and maintain exercise regimens regularly in order to maintain metabolic control and reduce the risk of developing cardiovascular problems. Barriers to adherence have been associated with key psychological mechanisms: knowledge of self-management, beliefs about the efficacy of treatment and self-efficacy/perceived control.[65] Such mechanisms are inter-related, as one's thoughts (e.g. one's perception of diabetes, or one's appraisal of how helpful self-management is) is likely to relate to one's emotions (e.g. motivation to change), which in turn, affects one's self-efficacy (one's confidence in their ability to engage in a behaviour to achieve a desired outcome).[66]

In general, “remission” in diabetes means a person’s blood sugar levels remain normal. While some refer to this as a “cure,” diabetes is not a “one and done,” disease. That is, it could always return if the patient regains the weight or returns to unhealthy habits. In 2009, a group of diabetes experts wrote that “remission” is a term used when a person has normal blood sugar levels for one year without therapy or surgery.
Normally, the process goes like this: The carbohydrates from your food are converted into a form of sugar called glucose. Glucose is the preferred fuel for your body's cells, and it's the only food your brain can use. The glucose floats along in the bloodstream until the pancreas, a large gland located behind the stomach, goes into action. The pancreas produces insulin, a hormone that signals body cells to take in the glucose. Once inside the cell, the glucose is either used as fuel to produce heat or energy or is stored as fat.

Diabetes is a serious disease that you cannot treat on your own. Your doctor will help you make a diabetes treatment plan that is right for you -- and that you can understand. You may also need other health care professionals on your diabetes treatment team, including a foot doctor, nutritionist, eye doctor, and a diabetes specialist (called an endocrinologist).
Alcohol: Alcohol can dangerously increase blood sugar and lead to liver toxicity. Research published in Annals of Internal Medicine found that there was a 43 percent increased incidence of diabetes associated with heavy consumption of alcohol, which is defined as three or more drinks per day. (8) Beer and sweet liquors are especially high in carbohydrates and should be avoided.
Both type 1 and type 2 diabetes mellitus are chronic conditions that can only be managed using insulin, anti-diabetes medications, lifestyle changes, etc., but cannot be cured. Gestational diabetes generally resolves on itself after the delivery. If not managed properly, diabetes can cause several other complications, like hypoglycemia, diabetic ketoacidosis, nonketotic hyperosmolar coma, etc. Other serious and long-term complications include cardiovascular diseases, chronic renal failure, diabetic retinopathy, etc.
Because the initial symptoms (fatigue, weakness, frequent urination) are usually mild, about 30 percent of all people with diabetes do not realize that they have the disease. And that can have tragic consequences, because with early diagnosis and treatment, the chances of living a long and productive life are higher than if the disease creeps along until irreversible damage occurs.
I’m glad you talk about personal tolerance. My doc wants me to go on a ketogenic diet, but even when on the Autoimmune Paleo Diet, my adrenals would go a bit nuts. I can’t go any longer than 6 hours without food overnight…my adrenals start pumping out the adrenalin after about 3 to 6 hours of sleep (no matter what I eat or don’t eat before bed) and I wake up with anxiety. Adding a bit of carbs (3/4 cup at dinner and 1/2 cup at lunch) has allowed me to go a full 6 hours (would love 7 or 8) but it still feels terrible when I wake up.

A 2012 review of ginseng in animals and human beings found that not only does ginseng reduce insulin resistance, it also lowers HbA1C levels. It’s been used in traditional Chinese medicine for centuries as one of the most potent herbs for blood sugar control. Indian ginseng, also called Ashwagandha, offers fantastic all round benefits. Scientists are also researching the connection between diabetes and Alzhiemer’s. Panax Ginseng is a type of ginseng that is able to help with both diabetes and Alzheimer’s.
Second, all minerals and vitamins should be taken in the most absorbable, bioactive forms. This makes the product a little more expensive, but there is a huge difference in the body’s ability to absorb and metabolize different forms of nutrients. I recommend Pure Encapsulations’ Polyphenol Nutrients to my patients, as part of a natural home remedies protocol for diabetes.
Sugars raise insulin levels, and over extended periods of time, damage the pancreas and cause insulin resistance, a precursor for diabetes. Fructose is the top offender in the sugar world, as it is recognized as a toxin the body and has no proven benefit to the body. Fructose is immediately taken to the liver, where it must be processed, and some doctors now suggest that this may be a large factor in development of fatty liver disease. Excess sugar in the bloodstream also increases the release of cortisol and adrenaline (more on those in a minute), slows the immune response, decreases necessary Leptin levels and promotes fat storage. There are various types of sugar and sweeteners, and while all should be limited, some are worse than others:
First, the health of your gut is critical to your overall health. This is because your gut is home of trillions of microbes called the gut microbiome. These microbes work in symbiotic and antagonistic relationships within your body. A 2017 study using multiple therapies to manipulate the gut microbiome composition, found they could impact the individual’s health more rapidly. This study also found manipulating the gut microbiome as an effective way to avoid insulin resistance and therefore prevent diabetes.
Green tea contains the bioflavinoid epigallocatechin gallate (EGCG), which has been shown to be a safe and effective antioxidant. In a study in Japan, green tea was shown to reduce the risk for Type 2 Diabetes Mellitus onset. It has been shown to improve glucose tolerance in patients, and decrease blood sugar production and over-secretion in Type 2 Diabetes Mellitus  patients. Green tea has also been shown to have an effective anti-angiogenesis factor, that is, it reduces problematic overgrowth of blood vessels, which may have a significant effect on preventing diabetic retinopathy. It has also been shown to promote fat oxidation and thermogenesis. Last, green tea can provide antioxidant protection for the pancreas and the fatty liver. A good dose is 200 to 400 mg a day. It’s also beneficial to drink organic green tea.
Type 2 diabetes is the most common form of diabetes, and unlike type 1 diabetes, it usually occurs in people over the age of 40, especially those who are overweight. Type 2 diabetes is caused by insulin resistance, which means that the hormone insulin is being released, but a person doesn’t respond to it appropriately. Type 2 diabetes is a metabolic disorder that’s caused by high blood sugar. The body can keep up for a period of time by producing more insulin, but over time the insulin receptor sites burn out. Eventually, diabetes can affect nearly every system in the body, impacting your energy, digestion, weight, sleep, vision and more. (5)
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas. This release of insulin promotes the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.
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