Use of a "Diabetes Coach" is becoming an increasingly popular way to manage diabetes. A Diabetes Coach is usually a Certified diabetes educator (CDE) who is trained to help people in all aspects of caring for their diabetes. The CDE can advise the patient on diet, medications, proper use of insulin injections and pumps, exercise, and other ways to manage diabetes while living a healthy and active lifestyle. CDEs can be found locally or by contacting a company which provides personalized diabetes care using CDEs. Diabetes Coaches can speak to a patient on a pay-per-call basis or via a monthly plan.
The chart above gives averages. Follow your doctor’s advice on when and how to take your insulin. Your doctor might also recommend premixed insulin, which is a mix of two types of insulin. Some types of insulin cost more than others, so talk with your doctor about your options if you're concerned about cost. Read about financial help for diabetes care.

Your care team may recommend that you use a continuous glucose monitor (CGM). A CGM is a wearable device that can measure blood sugar every few minutes around the clock. It's measured by a thread-like sensor inserted under the skin and secured in place. The more frequent CGM blood sugar readings can help you and the care team do an even better job of troubleshooting and adjusting your insulin doses and diabetes management plan to improve blood sugar control.


Diet management allows control and awareness of the types of nutrients entering the digestive system, and hence allows indirectly, significant control over changes in blood glucose levels. Blood glucose monitoring allows verification of these, and closer control, especially important since some symptoms of diabetes are not easy for the patient to notice without actual measurement.
A 2005 study on the anti-diabetic effect of garlic in normal and lab-induced diabetic rats, published in the journal Phytomedicine, found that oral administration significantly decreased serum glucose, total cholesterol, triglycerides, urea, uric acid, creatinine, AST and ALT levels. While it increased serum insulin in diabetic rats, this was not so in the case of normal rats. It concluded that garlic must be considered as an excellent candidate for future human studies on diabetes mellitus. What’s better, garlic also helps reduce high cholesterol levels, a complication that diabetics often face. This makes it an excellent spice to use for in all recipes!

If you have type 2 diabetes and your body mass index (BMI) is greater than 35, you may be a candidate for weight-loss surgery (bariatric surgery). Blood sugar levels return to normal in 55 to 95 percent of people with diabetes, depending on the procedure performed. Surgeries that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss surgeries.

While Type 1 Diabetes is an autoimmune disorder that seems to affect people with certain gene types, Type 2 Diabetes is triggered by lifestyle choices, such as poor diet and obesity. Eating sugary and processed foods contributes to weight gain, and that extra body fat can be released into the bloodstream, impeding the absorption of insulin and other chemicals related to metabolism. When metabolism is slowed, weight gain is more likely, and the cycle repeats itself. Treatment for Type 2 Diabetes is multifaceted, often including insulin injections, a host of medications, and lifestyle modifications such as diet changes and exercise regimens.

India is said to be the diabetes capital of the world. With nearly 50 million people in India suffering from diabetes, the country has a big challenge to face. First, let’s know what is diabetes. The elevated sugar in the blood is called diabetes. There are two primary reasons behind diabetes - one is when our body stops producing insulin and second is when the body does not respond to insulin that is produced by the body. Insulin is broken down by the body and used as energy, which is transported to the cells. There are two types of diabetes - Type I diabetes and Type II diabetes. Let’s know about them in a little detail:
Dr. Steven Lin is a dentist who focusses on the mouth-body connection. Through ancestral nutrition, the oral and gut microbiome, and epigenetics, his programs aim to prevent chronic dental and systemic disease. His book 'The Dental Diet', will be released on January 18'. To receive free updates on functional oral health from Dr. Lin, subscribe to his newsletter below.
I made a mistake in an earlier comment that I need to correct. I thought the VLDL represented the very small particles, and that is totally wrong. Here are the actual test results of the very small particles from a Quest Diagnostics after about 18 months on a ketogenic diet, with abundant use of MCT oil as caprylic acid. If the administrator deletes that comment, to avoid confusion, that would be fine with me. I can also provide much more data, as that test is pretty comprehensive.
Clearly separate from the characteristic lack of acute insulin secretion in response to increase in glucose supply is the matter of total mass of β-cells. The former determines the immediate metabolic response to eating, whereas the latter places a long-term limitation on total possible insulin response. Histological studies of the pancreas in type 2 diabetes consistently show an ∼50% reduction in number of β-cells compared with normal subjects (66). β-Cell loss appears to increase as duration of diabetes increases (67). The process is likely to be regulated by apoptosis, a mechanism known to be increased by chronic exposure to increased fatty acid metabolites (68). Ceramides, which are synthesized directly from fatty acids, are likely mediators of the lipid effects on apoptosis (10,69). In light of new knowledge about β-cell apoptosis and rates of turnover during adult life, it is conceivable that removal of adverse factors could result in restoration of normal β-cell number, even late in the disease (66,70). Plasticity of lineage and transdifferentiation of human adult β-cells could also be relevant, and the evidence for this has recently been reviewed (71). β-Cell number following reversal of type 2 diabetes remains to be examined, but overall, it is clear that at least a critical mass of β-cells is not permanently damaged but merely metabolically inhibited.
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.

Primary Care Provider: Your primary care provider is the provider you see for general checkups or when you get sick. Your primary care provider may also be the one who refers you to specialists or other team members. Other health care providers who provide primary care include nurse practitioners and physician assistants, who typically work with a physician.

Yet Gabbay says preliminary human studies with positive results, like this week’s in BMJ Case Reports, suggest the diet is worthy of further study in a larger population over a longer period of time. For now, he cautions people with diabetes, especially those on insulin and sulfonylureas to lower their blood sugar, against trying intermittent fasting before speaking with their healthcare provider.


The accepted view has been that the β-cell dysfunction of established diabetes progresses inexorably (79,82,83), whereas insulin resistance can be modified at least to some extent. However, it is now clear that the β-cell defect, not solely hepatic insulin resistance, may be reversible by weight loss at least early in the course of type 2 diabetes (21,84). The low insulin sensitivity of muscle tissue does not change materially either during the onset of diabetes or during subsequent reversal. Overall, the information on the inhibitory effects of excess fat on β-cell function and apoptosis permits a new understanding of the etiology and time course of type 2 diabetes.


A series of studies from Newcastle University in Newcastle upon Tyne, United Kingdom, starting in 2011 have supported this notion, including a new report published online August 2 in the journal Cell Metabolism. This current investigation examined reasons why substantial weight loss in some patients produces type 2 diabetes remission, which is a state in which most or all signs and symptoms of diabetes disappear.
This type of discussion occurs all the time. A patient has been assessed by their physician, and informed that they have a medical problem of some sort. The patient, reluctant to accept the physician’s evaluation, heads to the pharmacy for a second opinion. In some cases, the patient may question the physician’s advice: “All my physician wants to do is prescribe drugs.” Yet there’s a disconnect when it comes to strategies for management. More often than not, non-drug approaches are rejected out-of-hand (probably because the sample I speak with have already made the decision to buy something). And in those that are leery of medical management, there’s often a willingness to consider anything that’s available without a prescription – particularly if it’s perceived as “natural.” Natural products are gentle, safe, and effective, while medicine is thought of as unnatural, harsh, and potentially dangerous. This is the appeal to nature fallacy, nothing more. Purveyors of supplements leverage the appeal to nature fallacy into the marketing strategy of choice for almost all supplements and “alternative” medicines.  And it leads to bad health care decisions.
Cinnamonium cassia and its relative C. burmanii are the types of cinnamon that have the best effect on diabetes symptoms. There have been numerous studies on cinnamon and, overall, they have shown cinnamon can slow stomach emptying and lower postprandial glucose levels. It also reduces glucose levels in Type 2 Diabetes Mellitus patients who have had poor diabetic control. It may also be helpful in lowering insulin levels, blood pressure, and A1C, and reduce AGE formation. This is a safe herb for diabetics. A good dose is 1 to 2 g a day or 200 mg or more of a concentrated extract.
Data from the Swedish randomized study of gastric banding showed that a loss of 20% body weight was associated with long-term remission in 73% of a bariatric surgery group, with weight change itself being the principal determinant of glucose control (13). Dietary weight loss of 15 kg allowed for reversal of diabetes in a small group of individuals recently receiving a diagnosis (21). In individuals strongly motivated to regain normal health, substantial weight loss is entirely possible by decreasing food consumption (88). This information should be made available to all people with type 2 diabetes, even though with present methods of changing eating habits, it is unlikely that weight loss can be achieved in those not strongly motivated to escape from diabetes. Some genetic predictors, especially the Ala12 allele at PPARG, of successful long-term weight loss have been identified (89), and use of such markers could guide future therapy. It must be noted that involuntary food shortage, such as a result of war, results in a sharp fall in type 2 diabetes prevalence (90,91).
To help patients learn to manage their diabetes successfully, the Diabetes Treatment Center at Desert Springs Hospital offers educational classes, as well as individualized appointments, (in both English and Spanish) on topics such as behavior change, goal setting, healthy eating concepts, carbohydrate counting, dining out, label reading, lipid, medication, stress and sick day management, benefits of exercise, prevention of complications and foot care. Special Gestational Diabetes Education classes are also available for women diagnosed with diabetes during pregnancy. Learn more about the Diabetes Care Education Series >
Mechanism of interaction between excess amounts of fatty acids, diacylglycerol, and ceramide and insulin action within the hepatocyte. Diacylglycerol activates PKCε and inhibits activation of IRS-1 by the insulin receptor. Ceramides cause sequestration of Akt2 by PKCζ and inhibit insulin control of gluconeogenesis. These mechanisms have recently been reviewed (99). FFA, free-fatty acid; TG, triacylglycerol.
Type 1 diabetes is commonly called “juvenile diabetes” because it tends to develop at a younger age, typically before a person turns 20 years old. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin-producing beta cells in the pancreas. The damage to the pancreatic cells leads to a reduced ability or complete inability to create insulin. Some of the common causes that trigger this autoimmune response may include a virus, genetically modified organisms, heavy metals, vaccines, or foods like wheat, cow’s milk and soy. (4)
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Other medications such as metformin or the DPP4 drug class are weight neutral. While this won’t make things worse, they won’t make things better either. Since weight loss is the key to reversing type 2 diabetes, medications won’t make things better. Medications make blood sugars better, but not the diabetes. We can pretend the disease is better, but that doesn’t make it true.

Artificial Intelligence researcher Dr. Cynthia Marling, of the Ohio University Russ College of Engineering and Technology, in collaboration with the Appalachian Rural Health Institute Diabetes Center, is developing a case based reasoning system to aid in diabetes management. The goal of the project is to provide automated intelligent decision support to diabetes patients and their professional care providers by interpreting the ever-increasing quantities of data provided by current diabetes management technology and translating it into better care without time consuming manual effort on the part of an endocrinologist or diabetologist.[56] This type of Artificial Intelligence-based treatment shows some promise with initial testing of a prototype system producing best practice treatment advice which anaylizing physicians deemed to have some degree of benefit over 70% of the time and advice of neutral benefit another nearly 25% of the time.[5]
Some studies show that certain plant foods may help your body fight inflammation and use insulin, a hormone that controls blood sugar. Cinnamon extracts can improve sugar metabolism, triggering insulin release, which also boosts cholesterol metabolism. Clove oil extracts (eugenol) have been found to help insulin work and to lower glucose, total cholesterol, LDL, and triglycerides. An unidentified compound in coffee (not caffeine) may enhance insulin sensitivity and lower the chances of developing type 2 diabetes.
The twin cycle hypothesis of the etiology of type 2 diabetes. During long-term intake of more calories than are expended each day, any excess carbohydrate must undergo de novo lipogenesis, which particularly promotes fat accumulation in the liver. Because insulin stimulates de novo lipogenesis, individuals with a degree of insulin resistance (determined by family or lifestyle factors) will accumulate liver fat more readily than others because of higher plasma insulin levels. In turn, the increased liver fat will cause relative resistance to insulin suppression of hepatic glucose production. Over many years, a modest increase in fasting plasma glucose level will stimulate increased basal insulin secretion rates to maintain euglycemia. The consequent hyperinsulinemia will further increase the conversion of excess calories to liver fat. A cycle of hyperinsulinemia and blunted suppression of hepatic glucose production becomes established. Fatty liver leads to increased export of VLDL triacylglycerol (85), which will increase fat delivery to all tissues, including the islets. This process is further stimulated by elevated plasma glucose levels (85). Excess fatty acid availability in the pancreatic islet would be expected to impair the acute insulin secretion in response to ingested food, and at a certain level of fatty acid exposure, postprandial hyperglycemia will supervene. The hyperglycemia will further increase insulin secretion rates, with consequent enhancement of hepatic lipogenesis, spinning the liver cycle faster and driving the pancreas cycle. Eventually, the fatty acid and glucose inhibitory effects on the islets reach a trigger level that leads to a relatively sudden onset of clinical diabetes. Figure adapted with permission from Taylor (98).
A useful test that has usually been done in a laboratory is the measurement of blood HbA1c levels. This is the ratio of glycated hemoglobin in relation to the total hemoglobin. Persistent raised plasma glucose levels cause the proportion of these molecules to go up. This is a test that measures the average amount of diabetic control over a period originally thought to be about 3 months (the average red blood cell lifetime), but more recently[when?] thought to be more strongly weighted to the most recent 2 to 4 weeks. In the non-diabetic, the HbA1c level ranges from 4.0–6.0%; patients with diabetes mellitus who manage to keep their HbA1c level below 6.5% are considered to have good glycemic control. The HbA1c test is not appropriate if there has been changes to diet or treatment within shorter time periods than 6 weeks or there is disturbance of red cell aging (e.g. recent bleeding or hemolytic anemia) or a hemoglobinopathy (e.g. sickle cell disease). In such cases the alternative Fructosamine test is used to indicate average control in the preceding 2 to 3 weeks.

Known for its immune-boosting and disease-fighting benefits, this Chinese herb has several positive diabetes studies behind it. Re­searchers have found that ginseng slows carbohydrate absorption; increases cells’ ability to use glucose; and increases insulin secretion from the pancreas. A team from the University of Toronto has repeatedly demonstrated that ginseng capsules lower blood glucose 15 to 20 percent compared to placebo pills. These are the best superfoods for people with diabetes.


Try to keep carbohydrate amounts stable across the day (some choose lower carbohydrate targets), stand more and sit less and include activities that increase the heart rate and also strength based activities most days across the week. Think about the amount of stress you experience to see how it is increasing your blood glucose levels. If you smoke – stop because it is speeding up the damage to your blood vessels. If you drink alcohol, limit how much you drink.
A healthy balance of carbohydrates, proteins, and fats in your diet will help keep your blood glucose on target. How much of each will depend on many factors, including your weight and your personal preferences. Watching your carbohydrates -- knowing how much you need and how many you are eating -- is key to blood sugar control. If you are overweight, either a low-carbohydrate, low-fat/low calorie, or Mediterranean diet may help you get your weight to goal. No more than 7% of your diet should come from saturated fat, and you should try to avoid trans fats altogether.
“Whether it be the patient saying for the fifth time ‘I will start watching my diet and start exercising,’ or a physician saying ‘the A1c is close to goal and I don’t really want to add yet another medication and copay, we will wait and see what happens in another 3 months,’ the end result is lack of intensification and A1c goal attainment,” Pantalone said.

Chromium plays a vital role in binding to and activating the insulin receptor on body cells, reducing insulin resistance. Supplemental chromium has been shown to lower blood sugar levels, lipids, A1C, and insulin in diabetic patients. It can also help decrease one’s appetite, particularly for sweets. A dosage from 200 mcg to 2,000 mcg a day is safe. Higher doses are unnecessary and can cause acute kidney failure.
At his first visit, the naturopathic doctor told John he’d be “off medication and free of diabetes in three months.” John left the doctor’s office with instructions to eat a low-carb diet. He’d been on a low-fat diet for years because of heart problems, but while he’d cut the fat, his meals included many highly processed foods. His new diet included “a lot of salads and healthful, organic foods.” He was given several whole food supplements that he says were “simple to mix and tasted good.”

Diabetes Forum App Find support, ask questions and share your experiences with 281,823 members of the diabetes community. Recipe App Delicious diabetes recipes, updated every Monday. Filter recipes by carbs, calories and time to cook. Low Carb Program Join 250,000 people on the award-winning education program for people with type 2 diabetes, prediabetes and obesity. Hypo Awareness Program The first comprehensive, free and open to all online step-by-step guide to improving hypo awareness. DiabetesPA Your diabetes personal assistant. Monitor every aspect of your diabetes. Simple, practical, free.
the remedies you have mentioned has given me heart ,as i am having half cup of of karela juice....but i have not taken my blood test as i am fed up and my finger tips are also fed up...so i take my dose of insulin and also the juice.;-)...and hope it works. or is working . i do my daily morning and evening walk of half hour.eat nothing sweet.or starchy 15th july 08

Is this okay to use against gestational diabetes? I have PCOS and am pre-diabetic. I actually followed this way of eating (before seeing the Ted talk) with my first GD pregnancy and was scolded by the nutritionist. Yet my blood sugar was kept below 98 and I lost 15 lbs and our son’s blood sugar was perfect with an apgar of 10. So I’m thinking of just going this way again despite the ADA’s recommendations.


Alpha lipoic acid is an antioxidant that helps turn glucose into fuel for the body. It effectively improves insulin sensitivity and reduces symptoms of diabetic neuropathy, such as weakness, pain and numbness that’s caused by nerve damage. Although we make alpha lipoic acid and it can be found in some food sources, like broccoli, spinach and tomatoes, taking an ALA supplement will increase the amount that circulates in your body, which can be extremely beneficial when trying to reverse diabetes naturally. (17)
A study published in 2014 by the Second University of Naples showed that a low-carbohydrate Mediterranean diet was able to achieve significant rates of remission in people with type 2 diabetes. After one year of following the diet, 15% of participants achieved remission and, after six years, 5% had achieved remission on the diet – a stunning achievement.
Relying on their own perceptions of symptoms of hyperglycemia or hypoglycemia is usually unsatisfactory as mild to moderate hyperglycemia causes no obvious symptoms in nearly all patients. Other considerations include the fact that, while food takes several hours to be digested and absorbed, insulin administration can have glucose lowering effects for as little as 2 hours or 24 hours or more (depending on the nature of the insulin preparation used and individual patient reaction). In addition, the onset and duration of the effects of oral hypoglycemic agents vary from type to type and from patient to patient.
Because blood sugar levels fluctuate throughout the day and glucose records are imperfect indicators of these changes, the percentage of hemoglobin which is glycosylated is used as a proxy measure of long-term glycemic control in research trials and clinical care of people with diabetes. This test, the hemoglobin A1c or glycosylated hemoglobin reflects average glucoses over the preceding 2–3 months. In nondiabetic persons with normal glucose metabolism the glycosylated hemoglobin is usually 4–6% by the most common methods (normal ranges may vary by method).
Glycemic control is a medical term referring to the typical levels of blood sugar (glucose) in a person with diabetes mellitus. Much evidence suggests that many of the long-term complications of diabetes, especially the microvascular complications, result from many years of hyperglycemia (elevated levels of glucose in the blood). Good glycemic control, in the sense of a "target" for treatment, has become an important goal of diabetes care, although recent research suggests that the complications of diabetes may be caused by genetic factors[15] or, in type 1 diabetics, by the continuing effects of the autoimmune disease which first caused the pancreas to lose its insulin-producing ability.[16]

An insulin pump is a small machine that gives you small, steady doses of insulin throughout the day. You wear one type of pump outside your body on a belt or in a pocket or pouch. The insulin pump connects to a small plastic tube and a very small needle. You insert the needle under your skin and it stays in place for several days. Insulin then pumps from the machine through the tube into your body 24 hours a day. You also can give yourself doses of insulin through the pump at mealtimes. Another type of pump has no tubes and attaches directly to your skin, such as a self-adhesive pod.
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.
Sage can have metformin-like effects, according to a study published in the British Journal of Nutrition. So you may want to consider cooking with this herb often. It has been used on traditional medicine for centuries, as one of the important herbs to reduce blood sugar. A word of warning – taking high doses of sage along with diabetes medications might cause your blood sugar to go too low, a condition called hypoglycemia. Monitor your blood sugar closely.
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.
Cinnamon’s effectiveness as a treatment for diabetes has not been established. A prescription drug as ineffective as cinnamon likely wouldn’t pass FDA muster. Existing drug treatments for diabetes, on the other hand, are cheap, effective, and generally well tolerated. Compared to drug therapy, we don’t know if cinnamon can reduce the risk of mortality due to diabetes, or the progression to any of the other serious outcomes of diabetes.   For my patients that insist on trying cinnamon, I’d caution them of the risks, and reinforce that cinnamon is no alternative for lifestyle changes and medication if necessary. It may be natural, sure, but that doesn’t mean it’s either safe or effective.

Your care team may recommend that you use a continuous glucose monitor (CGM). A CGM is a wearable device that can measure blood sugar every few minutes around the clock. It's measured by a thread-like sensor inserted under the skin and secured in place. The more frequent CGM blood sugar readings can help you and the care team do an even better job of troubleshooting and adjusting your insulin doses and diabetes management plan to improve blood sugar control.
Some people with diabetes use a computerized pump -- called an insulin pump -- that gives insulin on a set basis. You and your doctor program the pump to deliver a certain amount of insulin throughout the day (the basal dose). Plus, you program the pump to deliver a certain amount of insulin based on your blood sugar level before you eat (bolus dose).
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