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.


Magnesium is a mineral found naturally in foods such as green leafy vegetables, nuts, seeds, and whole grains and in nutritional supplements. Magnesium is needed for more than 300 biochemical reactions. It helps regulate blood sugar levels and is needed for normal muscle and nerve function, heart rhythm, immune function, blood pressure, and for bone health.

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.
“Diabetes type 1 is very different from your standard disease. Insulin requirements vary greatly from one day to another and there is no way patients can know what they need,” Roman Hovorka, Professor at the University of Cambridge, explained to me during an interview. His research group is working on the development of an algorithm that can accurately predict insulin requirements for a specific patient at any moment.
If your cells aren’t responding to insulin, your pancreas produces more to turn up the volume on the signal that glucose is available and the cells should absorb it. When your pancreas can keep up, blood glucose stays within healthy ranges, and all is well. When your pancreas starts to poop out, you end up with insulin deficiency, which leads to blood sugar fluctuations and weight gain.
Some people with type 2 diabetes can manage their disease by making healthy food choices and being more physically active. Many people with type 2 diabetes need diabetes medicines as well. These medicines may include diabetes pills or medicines you inject under your skin, such as insulin. In time, you may need more than one diabetes medicine to control your blood glucose. Even if you do not take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.
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.

Levels which are significantly above or below this range are problematic and can in some cases be dangerous. A level of <3.8 mmol/L (<70 mg/dL) is usually described as a hypoglycemic attack (low blood sugar). Most diabetics know when they are going to "go hypo" and usually are able to eat some food or drink something sweet to raise levels. A patient who is hyperglycemic (high glucose) can also become temporarily hypoglycemic, under certain conditions (e.g. not eating regularly, or after strenuous exercise, followed by fatigue). Intensive efforts to achieve blood sugar levels close to normal have been shown to triple the risk of the most severe form of hypoglycemia, in which the patient requires assistance from by-standers in order to treat the episode.[8] In the United States, there were annually 48,500 hospitalizations for diabetic hypoglycemia and 13,100 for diabetic hypoglycemia resulting in coma in the period 1989 to 1991, before intensive blood sugar control was as widely recommended as today.[9] One study found that hospital admissions for diabetic hypoglycemia increased by 50% from 1990–1993 to 1997–2000, as strict blood sugar control efforts became more common.[10] Among intensively controlled type 1 diabetics, 55% of episodes of severe hypoglycemia occur during sleep, and 6% of all deaths in diabetics under the age of 40 are from nocturnal hypoglycemia in the so-called 'dead-in-bed syndrome,' while National Institute of Health statistics show that 2% to 4% of all deaths in diabetics are from hypoglycemia.[11] In children and adolescents following intensive blood sugar control, 21% of hypoglycemic episodes occurred without explanation.[12] In addition to the deaths caused by diabetic hypoglycemia, periods of severe low blood sugar can also cause permanent brain damage.[13] Although diabetic nerve disease is usually associated with hyperglycemia, hypoglycemia as well can initiate or worsen neuropathy in diabetics intensively struggling to reduce their hyperglycemia.[14]
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]
Practitioners agree that nutrition is the cornerstone of diabetes management, and that a range of nutrition intervention strategies can be used to meet the metabolic goals and individual preferences of the person with diabetes. However, there are significant differences in the approach and methodologies used by alternative and conventional practitioners to manage the disease. One difference is in terminology. When is remission really remission?

Replacing humans with computers could make patients better control their sugar levels and suffer less complications in the long term. The French company Cellnovo has already shown that just a partially automated system, where blood sugar levels can be monitored wirelessly but patients still select insulin amounts, can reduce the chances of reaching life-threatening low sugar levels up to 39%. The company is now working towards developing a fully automated artificial pancreas in collaboration with Imperial College, the Diabeloop consortium and the Horizon2020 program.
Anti-diabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients - https://www.ncbi.nlm.nih.gov/pubmed?term=Baskaran%20K%20et%20al.%20Antidiabetic%20effect%20of%20a%20leaf%20extract%20from%20gymnema%20sylvestre%20in%20non-insulin-dependent%20diabetes%20mellitus%20patients Possible regeneration of the islets of langerhans in streptozotocin-diabetic rats given gymnema sylvestre leaf extracts - http://www.sciencedirect.com/science/article/pii/0378874190901064 Effects of a cinnamon extract on plasma glucose, HbA1c, and serum lipids in diabetes mellitus type 2 - http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2362.2006.01629.x/full Effectiveness of Cinnamon for Lowering Hemoglobin A1C in Patients with Type 2 Diabetes: A Randomized, Controlled Trial - http://www.jabfm.org/content/22/5/507.short Cloves protect the heart, liver and lens of diabetic rats - http://www.sciencedirect.com/science/article/pii/S0308814610003870 Cloves improve glucose, cholesterol and triglycerides of people with type 2 diabetes mellitus - http://www.fasebj.org/content/20/5/A990.3.short Effects of rosemary on lipid profile in diabetic rats - http://www.academicjournals.org/article/article1380120780_Aljamal%20et%20al.pdf Inhibition of Advanced Glycation End-Product Formation by Origanum majorana L. In Vitro and in Streptozotocin-Induced Diabetic Rats - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447365/ Evaluation of clonal herbs of Lamiaceae species for management of diabetes and hypertension - http://apjcn.org/update%5Cpdf%5C2006%5C1%5C107%5C107.pdf Metformin-like effect of Salvia officinalis (common sage): is it useful in diabetes prevention? - https://www.ncbi.nlm.nih.gov/pubmed/16923227 Antidiabetic effect of garlic (Allium sativum L.) in normal and streptozotocin-induced diabetic rats - http://www.sciencedirect.com/science/article/pii/S0944711305002175 Antiglycation Properties of Aged Garlic Extract: Possible Role in Prevention of Diabetic Complications - http://jn.nutrition.org/content/136/3/796S.full#fn-1 Effect of ethanolic extract of Zingiber officinale on dyslipidaemia in diabetic rats - http://www.sciencedirect.com/science/article/pii/S0378874104005732 Effect of Ginger Extract Consumption on levels of blood Glucose, Lipid Profile and Kidney Functions in Alloxan Induced-Diabetic Rats - http://s3.amazonaws.com/academia.edu.documents/35273868/17.pdf?AWSAccessKeyId=AKIAJ56TQJRTWSMTNPEA&Expires=1484639718&Signature=Zb4rY42u7WJrbngfV6pCQzu61e0%3D&response-content-disposition=inline%3B%20filename%3DEffect_of_Ginger_Extract_Consumption_on.pdf Efficacy of turmeric on blood sugar and polyol pathway in diabetic albino rats - http://link.springer.com/article/10.1023/A:1013106527829 Hypolipidemic action of curcumin, the active principle of turmeric (Curcuma longa) in streptozotocin induced diabetic rats - http://link.springer.com/article/10.1023/A:1006819605211 A REVIEW ON ROLE OF MURRAYA KOENIGII (CURRY LEAF) IN (DIABETES MELLITUS – TYPE II) PRAMEHA - http://www.journalijdr.com/sites/default/files/4740.pdf Capsaicin and glucose absorption and utilization in healthy human subjects - https://www.ncbi.nlm.nih.gov/pubmed/16612838 Inhibition of Advanced Glycation End-Product Formation by Origanum majorana L. In Vitro and in Streptozotocin-Induced Diabetic Rats - https://www.ncbi.nlm.nih.gov/pubmed/23008741 Use of Fenuqreek seed powder in the management of non-insulin dependent diabetes mellitus - http://www.sciencedirect.com/science/article/pii/0271531796001418 Ginseng and Diabetes: The Evidences from In Vitro, Animal and Human Studies - http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.797.4558&rep=rep1&type=pdf  
The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance. The pancreas of a person with type 2 diabetes may be producing normal or even abnormally large amounts of insulin. Other forms of diabetes mellitus, such as the various forms of maturity onset diabetes of the young, may represent some combination of insufficient insulin production and insulin resistance. Some degree of insulin resistance may also be present in a person with type 1 diabetes.

Cyrus Khambatta earned a PhD in Nutritional Biochemistry from UC Berkeley after being diagnosed with type 1 diabetes in his senior year of college at Stanford University in 2002. He is an internationally recognized nutrition and fitness coach for people living with type 1, type 1.5, prediabetes and type 2 diabetes, and has helped hundreds of people around the world achieve exceptional insulin sensitivity by adopting low-fat, plant-based whole foods nutrition.

The information on this website is provided as general health guidelines and may not be applicable to your particular health condition. Your individual health status and any required medical treatments can only be properly addressed by a professional healthcare provider of your choice. Remember: There is no adequate substitution for a personal consultation with your physician. Neither Desert Springs Hospital Medical Center, or any of their affiliates, nor any contributors shall have any liability for the content or any errors or omissions in the information provided by this website.            

Together with evidence of normalization of insulin secretion after bariatric surgery (84), insights into the behavior of the liver and pancreas during hypocaloric dieting lead to a hypothesis of the etiology and pathogenesis of type 2 diabetes (Fig. 6): The accumulation of fat in liver and secondarily in the pancreas will lead to self-reinforcing cycles that interact to bring about type 2 diabetes. Fatty liver leads to impaired fasting glucose metabolism and increases export of VLDL triacylglycerol (85), which increases fat delivery to all tissues, including the islets. The liver and pancreas cycles drive onward after diagnosis with steadily decreasing β-cell function. However, of note, observations of the reversal of type 2 diabetes confirm that if the primary influence of positive calorie balance is removed, then the processes are reversible (21).

Although chromium does have an effect on insulin and on glucose metabolism, there is no evidence that taking chromium supplements can help in the treatment of diabetes. But chromium is found in many healthy foods, such as green vegetables, nuts, and grains. Studies have suggested that biotin, also called vitamin H, when used with chromium, may improve glucose metabolism in people with diabetes. But no studies have shown that biotin by itself is helpful.
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.
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