Diabetes

Diabetes types

Diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make. 

Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs.

There are a few different types of diabetes:
  • Type 1 diabetes is an autoimmune disease. The immune system attacks and destroys cells in the pancreas, where insulin is made. It’s unclear what causes this attack. About 10 percent of people with diabetes have this type.
  • Type 2 diabetes occurs when your body becomes resistant to insulin, and sugar builds up in your blood. 
  • Prediabetes occurs when your blood sugar is higher than normal, but it’s not high enough for a diagnosis of type 2 diabetes.
  • Gestational diabetes is high blood sugar during pregnancy. Insulin-blocking hormones produced by the placenta cause this type of diabetes. 

A rare condition called diabetes insipidus is not related to diabetes mellitus, although it has a similar name. It’s a different condition in which your kidneys remove too much fluid from your body.

Each type of diabetes has unique symptoms, causes, and treatments. Learn more about how these types differ from one another.

Symptoms of diabetes:

Diabetes symptoms are caused by rising blood sugar. 

General symptoms

The general symptoms of diabetes include:

Symptoms in men

In addition to the general symptoms of diabetes, men with diabetes may have a decreased sex drive, erectile dysfunction (ED), and poor muscle strength.

Symptoms in women 

Women with diabetes can also have symptoms such as urinary tract infections, yeast infections, and dry, itchy skin. 

Type 1 diabetes
Symptoms of type 1 diabetes can include: 
  • extreme hunger
  • increased thirst
  • unintentional weight loss
  • frequent urination
  • blurry vision
  • tiredness

It may also result in mood changes. 

Type 2 diabetes
Symptoms of type 2 diabetes can include:
  • increased hunger 
  • increased thirst
  • increased urination
  • blurry vision
  • tiredness
  • sores that are slow to heal 

It may also cause recurring infections. This is because elevated glucose levels make it harder for the body to heal.

Gestational diabetes 

Most women with gestational diabetes don’t have any symptoms. The condition is often detected during a routine blood sugar test or oral glucose tolerance test that is usually performed between the 24th and 28th weeks of gestation. 

In rare cases, a woman with gestational diabetes will also experience increased thirst or urination. 

Bottom line:

Diabetes symptoms can be so mild that they’re hard to spot at first. Learn which signs should prompt a trip to the doctor.

Causes of diabetes

Different causes are associated with each type of diabetes. 

Type 1 diabetes

Doctors don’t know exactly what causes type 1 diabetes. For some reason, the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas.

Genes may play a role in some people. It’s also possible that a virus sets off the immune system attack. 

Type 2 diabetes

Type 2 diabetes stems from a combination of genetics and lifestyle factors. Being overweight or obese increases your risk too. Carrying extra weight, especially in your belly, makes your cells more resistant to the effects of insulin on your blood sugar.

This condition runs in families. Family members share genes that make them more likely to get type 2 diabetes and to be overweight.

Gestational diabetes

Gestational diabetes is the result of hormonal changes during pregnancy. The placenta produces hormones that make a pregnant woman’s cells less sensitive to the effects of insulin. This can cause high blood sugar during pregnancy. 

Women who are overweight when they get pregnant or who gain too much weight during their pregnancy are more likely to get gestational diabetes. 

Bottom line:

Both genes and environmental factors play a role in triggering diabetes. Get more information here on the causes of diabetes.

Diabetes risk factors:

Certain factors increase your risk for diabetes.

Type 1 diabetes

You’re more likely to get type 1 diabetes if you’re a child or teenager, you have a parent or sibling with the condition, or you carry certain genes that are linked to the disease.

Type 2 diabetes

Your risk for type 2 diabetes increases if you: 

  • are overweight
  • are age 45 or older
  • have a parent or sibling with the condition
  • aren’t physically active
  • have had gestational diabetes
  • have prediabetes
  • have high blood pressure, high cholesterol, or high triglycerides
  • have African American, Hispanic or Latino American, Alaska Native, Pacific Islander, American Indian, or Asian American ancestry
Gestational diabetes

Your risk for gestational diabetes increases if you:

Bottom line:

Your family, environment, and preexisting medical conditions can all affect your odds of developing diabetes. Find out which risks you can control and which ones you can’t.

Diabetes complications

High blood sugar damages organs and tissues throughout your body. The higher your blood sugar is and the longer you live with it, the greater your risk for complications. 

Complications associated with diabetes include:

Gestational diabetes

Uncontrolled gestational diabetes can lead to problems that affect both the mother and baby. Complications affecting the baby can include:

The mother can develop complications such as high blood pressure (preeclampsia) or type 2 diabetes. She may also require cesarean delivery, commonly referred to as a C-section. 

The mother’s risk of gestational diabetes in future pregnancies also increases. 

Bottom line:

Diabetes can lead to serious medical complications, but you can manage the condition with medications and lifestyle changes. Avoid the most common diabetes complications with these helpful tips.

Treatment of diabetes

Doctors treat diabetes with a few different medications. Some of these drugs are taken by mouth, while others are available as injections.

Type 1 diabetes

Insulin is the main treatment for type 1 diabetes. It replaces the hormone your body isn’t able to produce.

There are four types of insulin that are most commonly used. They’re differentiated by how quickly they start to work, and how long their effects last:

  • Rapid-acting insulin starts to work within 15 minutes and its effects last for 3 to 4 hours.
  • Short-acting insulin starts to work within 30 minutes and lasts 6 to 8 hours.
  • Intermediate-acting insulin starts to work within 1 to 2 hours and lasts 12 to 18 hours.
  • Long-acting insulin starts to work a few hours after injection and lasts 24 hours or longer.
Type 2 diabetes

Diet and exercise can help some people manage type 2 diabetes. If lifestyle changes aren’t enough to lower your blood sugar, you’ll need to take medication. 

These drugs lower your blood sugar in a variety of ways:

Types of drug 

How they work

Example(s)

Alpha-glucosidase inhibitors

Slow your body’s breakdown of sugars and starchy foods

Acarbose (Precose) and miglitol (Glyset)

Biguanides 

Reduce the amount of glucoseyour liver makes

Metformin (Glucophage)

DPP-4 inhibitors

Improve your blood sugar without making it drop too low

Linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)

Glucagon-like peptides

Change the way your body produces insulin

Dulaglutide (Trulicity), exenatide (Byetta), and liraglutide (Victoza)

Meglitinides

Stimulate your pancreas to release more insulin

Nateglinide (Starlix) and repaglinide (Prandin)

SGLT2 inhibitors

Release more glucose into the urine

Canagliflozin (Invokana) and dapagliflozin (Farxiga)

Sulfonylureas

Stimulate your pancreas to release more insulin

Glyburide (DiaBeta, Glynase), glipizide(Glucotrol), and glimepiride (Amaryl)

Thiazolidinediones

Help insulin work better

Pioglitazone (Actos) and rosiglitazone (Avandia)

You may need to take more than one of these drugs. Some people with type 2 diabetes also take insulin.

Gestational diabetes

You’ll need to monitor your blood sugar level several times a day during pregnancy. If it’s high, dietary changes and exercise may or may not be enough to bring it down.

According to the Mayo Clinic, about 10 to 20 percent of women with gestational diabetes will need insulin to lower their blood sugar. Insulin is safe for the growing baby.

Bottom line:

The drug or combination of drugs that your doctor prescribes will depend on the type of diabetes you have — and its cause. Check out this list of the various medications that are available to treat diabetes.

Diabetes and diet

Healthy eating is a central part of managing diabetes. In some cases, changing your diet may be enough to control the disease. 

Type 1 diabetes

Your blood sugar level rises or falls based on the types of foods you eat. Starchy or sugary foods make blood sugar levels rise rapidly. Protein and fat cause more gradual increases.

Your medical team may recommend that you limit the amount of carbohydrates you eat each day. You’ll also need to balance your carb intake with your insulin doses. 

Work with a dietitian who can help you design a diabetes meal plan. Getting the right balance of protein, fat, and carbs can help you control your blood sugar. Check out this guide to starting a type 1 diabetes diet.

Type 2 diabetes 

Eating the right types of foods can both control your blood sugar and help you lose any excess weight.

Carb counting is an important part of eating for type 2 diabetes. A dietitian can help you figure out how many grams of carbohydrates to eat at each meal.

In order to keep your blood sugar levels steady, try to eat small meals throughout the day. Emphasize healthy foods such as:

Certain other foods can undermine efforts to keep your blood sugar in control. Discover

Gestational diabetes

Eating a well-balanced diet is important for both you and your baby during these nine months. Making the right food choices can also help you avoid diabetes medications.

Watch your portion sizes, and limit sugary or salty foods. Although you need some sugar to feed your growing baby, you should avoid eating too much. 

Consider making an eating plan with the help of a dietitian or nutritionist. They’ll ensure that your diet has the right mix of macronutrients. Go here for other do’s and don’ts for healthy eating with gestational diabetes.

Diabetes diagnosis

Anyone who has symptoms of diabetes or is at risk for the disease should be tested. Women are routinely tested for gestational diabetes during their second or third trimesters of pregnancy.

Doctors use these blood tests to diagnose prediabetes and diabetes:

  • The fasting plasma glucose (FPG) test measures your blood sugar after you’ve fasted for 8 hours. 
  • The A1C test provides a snapshot of your blood sugar levels over the previous 3 months.

To diagnose gestational diabetes, your doctor will test your blood sugar levels between the 24th and 28th weeks of your pregnancy. 

  • During the glucose challenge test, your blood sugar is checked an hour after you drink a sugary liquid.
  • During the 3 hour glucose tolerance test, your blood sugar is checked after you fast overnight and then drink a sugary liquid.

The earlier you get diagnosed with diabetes, the sooner you can start treatment. Find out whether you should get tested, and get more information on tests your doctor might perform.

Diabetes prevention

Type 1 diabetes isn’t preventable because it’s caused by a problem with the immune system. Some causes of type 2 diabetes, such as your genes or age, aren’t under your control either. 

Yet many other diabetes risk factors are controllable. Most diabetes prevention strategies involve making simple adjustments to your diet and fitness routine.

If you’ve been diagnosed with prediabetes, here are a few things you can do to delay or prevent type 2 diabetes:

These aren’t the only ways to prevent diabetes. Discover more strategies that may help you avoid this chronic disease.

Diabetes in pregnancy

Women who’ve never had diabetes can suddenly develop gestational diabetes in pregnancy. Hormones produced by the placenta can make your body more resistant to the effects of insulin. 

Some women who had diabetes before they conceived carry it with them into pregnancy. This is called pre-gestational diabetes.

Gestational diabetes should go away after you deliver, but it does significantly increase your risk for getting diabetes later. 

About half of women with gestational diabetes will develop type 2 diabetes within 5 to 10 years of delivery, according to the International Diabetes Federation (IDF). 

Having diabetes during your pregnancy can also lead to complications for your newborn, such as jaundice or breathing problems. 

If you’re diagnosed with pre-gestational or gestational diabetes, you’ll need special monitoring to prevent complications. Find out more about the effect of diabetes on pregnancy.

Diabetes in children

Children can get both type 1 and type 2 diabetes. Controlling blood sugar is especially important in young people, because the disease can damage important organs such as the heart and kidneys. 

Type 1 diabetes 

The autoimmune form of diabetes often starts in childhood. One of the main symptoms is increased urination. Kids with type 1 diabetes may start wetting the bed after they’ve been toilet trained. 

Extreme thirst, fatigue, and hunger are also signs of the condition. It’s important that children with type 1 diabetes get treated right away. The disease can cause high blood sugar and dehydration, which can be medical emergencies.

Type 2 diabetes

Type 1 diabetes used to be called “juvenile diabetes” because type 2 was so rare in children. Now that more children are overweight or obese, type 2 diabetes is becoming more common in this age group.

About 40 percent of children with type 2 diabetes don’t have symptoms, according to the Mayo Clinic. The disease is often diagnosed during a physical exam.

Untreated type 2 diabetes can cause lifelong complications, including heart disease, kidney disease, and blindness. Healthy eating and exercise can help your child manage their blood sugar and prevent these problems.

Type 2 diabetes is more prevalent than ever in young people. Learn how to spot the signs so you can report them to your child’s doctor.

Bottom Line:

Some types of diabetes — like type 1 — are caused by factors that are out of your control. Others — like type 2 — can be prevented with better food choices, increased activity, and weight loss.

Discuss potential diabetes risks with your doctor. If you’re at risk, have your blood sugar tested and follow your doctor’s advice for managing your blood sugar. 

Check for diabetes from the privacy of your own home.

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The best foods to control diabetes:

Figuring out the best foods to eat when you have diabetes can be tough.

That’s because your main goal should be controlling your blood sugar levels. However, it’s also important to eat foods that help prevent diabetes complications like heart disease. Your diet can have a major role in preventing and managing diabetes (1). Here are the 16 best foods for people living with diabetes, both type 1 and type 2.

  • Fatty Fish

Some people consider fatty fish to be one of the healthiest foods on the planet.

Salmon, sardines, herring, anchovies and mackerel are great sources of the omega-3 fatty acids DHA and EPA, which have major benefits for heart health.

Getting enough of these fats on a regular basis is especially important for people with diabetes, who have an increased risk for heart disease and stroke (2Trusted Source).

DHA and EPA protect the cells that line your blood vessels, reduce markers of inflammation and may help improve the way your arteries function (3456).

Research indicates that people who eat fatty fish regularly have a lower risk for acute coronary syndromes, like heart attacks, and are less likely to die from heart disease (78).

Studies show that eating fatty fish may also help regulate your blood sugar.

A study in 68 adults with overweight and obesity found that participants who consumed fatty fish had significant improvements in post-meal blood sugar levels, compared with participants who consumed lean fish (9).

Fish is also a great source of high quality protein, which helps you feel full and helps stabilize blood sugar levels (10).

SUMMARY:

Fatty fish contain omega-3 fats that help reduce inflammation and other risk factors for heart disease and stroke. Plus, it’s a great source of protein, which is important for blood sugar regulation. 

  • Leafy Greens

Leafy green vegetables are extremely nutritious and low in calories.

They’re also very low in digestible carbs, or carbs absorbed by the body, so they won’t significantly affect blood sugar levels. 

Spinachkale and other leafy greens are good sources of many vitamins and minerals, including vitamin C.

Some evidence suggests that people with diabetes have lower vitamin C levels than people without diabetes and may have greater vitamin C requirements. 

Vitamin C acts as a potent antioxidant and also has anti-inflammatory qualities.

Increasing dietary intake of vitamin C-rich foods can help people with diabetes increase their serum vitamin C levels while reducing inflammation and cellular damage (11).

In addition, leafy greens are good sources of the antioxidants lutein and zeaxanthin.

These antioxidants protect your eyes from macular degeneration and cataracts, which are common diabetes complications (121314).

SUMMARY:

Leafy green vegetables are rich in nutrients like Vitamin C, as well as antioxidants that protect your heart and eye health.

  • Avocados

Avocados have less than 1 gram of sugar, few carbohydrates, a high fiber content, and healthy fats, so you don’t have to worry about them raising your blood sugar levels (15).

Avocado consumption is also associated with improved overall diet quality and significantly lower body weight and body mass index (BMI) (16).

This makes them an ideal snack for people with diabetes, especially since obesity increases your chances for developing diabetes.

Avocados may have properties specific to preventing diabetes.

A 2019 study in mice found that avocatin B (AvoB), a fat molecule found only in avocados, inhibits incomplete oxidation in skeletal muscle and the pancreas, which reduces insulin resistance (17).

More research is needed in humans to establish the connection between avocados and diabetes prevention. 

SUMMARY:

Avocados have less than 1 gram of sugar and are associated with improved overall diet quality. Avocados may also have properties specific to diabetes prevention.

  • Eggs

Eggs provide amazing health benefits.

In fact, they’re one of the best foods for keeping you full and satisfied in between meals (1819).

Regular egg consumption may also reduce your heart disease risk in several ways.

Eggs decrease inflammation, improve insulin sensitivity, increase your HDL (good) cholesterol levels and modify the size and shape of your LDL (bad) cholesterol (20212223).

A 2019 study found that eating a high-fat, low-carb breakfast of eggs could help individuals with diabetes manage blood sugar levels throughout the day (24).

Older research has linked egg consumption with heart disease in people with diabetes.

But a more recent review of controlled studies found that consumption of 6 to 12 eggs per week as part of a nutritious diet did not increase heart disease risk factors in those with diabetes (25).

What’s more, some research suggests that eating eggs may reduce the risk of stroke (26).

In addition, eggs are a good source of lutein and zeaxanthin, antioxidants that provide protection against eye diseases (2728).

Just be sure to eat whole eggs. The benefits of eggs are primarily due to nutrients found in the yolk rather than the white.

SUMMARY:

Eggs may improve risk factors for heart disease, promote good blood sugar management, protect eye health, and keep you feeling full.

  • Chia Seeds

Chia seeds are a wonderful food for people with diabetes.

They’re extremely high in fiber, yet low in digestible carbs.

In fact, 11 of the 12 grams of carbs in a 28-gram (1-ounce) serving of chia seeds are fiber, which doesn’t raise blood sugar (29).

The viscous fiber in chia seeds can actually lower your blood sugar levels by slowing down the rate at which food moves through your gut and is absorbed (3031).

Chia seeds may help you achieve a healthy weight because fiber reduces hunger and makes you feel full. Chia seeds may also help maintain glycemic management in individuals with diabetes.

A study involving 77 adults with obesity or overweight and diagnosed with type 2 diabetes found that chia seed consumption supports weight loss and helps maintain good glycemic control (32). 

Additionally, chia seeds have been shown to help reduce blood pressure and inflammatory markers (33).

SUMMARY:

Chia seeds contain high amounts of fiber, which may help you lose weight. They also help maintain blood glucose levels.

  • Beans

Beans are cheap, nutritious, and super healthy. 

Beans are a type of legume rich in B vitamins, beneficial minerals (calcium, potassium, and magnesium), and fiber. 

They also have a very low glycemic index, which is important for managing diabetes.

Beans may also help prevent diabetes.

In a study involving more than 3,000 participants at high risk for cardiovascular disease, those who had a higher consumption of legumes had a 35 percent reduced chance of developing type 2 diabetes (34).

SUMMARY

Beans are cheap, nutritious, and have a low glycemic index, making them a healthy option for individuals with diabetes.

  • Greek Yogurt

Greek yogurt is a great dairy choice for people with diabetes. 

Some research suggests that eating certain dairy products like yogurt may improve blood sugar management and reduce heart disease risk factors, perhaps partly due to the probiotics it contains (3536).

Studies also indicate that yogurt consumption may be associated with lower levels of blood glucose and insulin resistance (37). 

Additionally, yogurt may reduce your risk for diabetes.

A long-term study involving health data from over 100,000 participants found that a daily serving of yogurt was linked to an 18 percent lower risk of developing type 2 diabetes (38). 

It may also help you lose weight, if that’s a personal goal. 

Studies show yogurt and other dairy foods may lead to weight loss and improved body composition in people with type 2 diabetes (39).

The high levels of calcium, protein, and a special type of fat called conjugated linolic acid (CLA) found in yogurt may help reduce your appetite, making it easier to resist unhealthy foods (4041).

What’s more, Greek yogurt contains only 6–8 grams of carbs per serving, which is lower than conventional yogurt. 

It’s also higher in protein, which may promote weight loss by reducing appetite and decreasing calorie intake (4243).

SUMMARY:

Yogurt promotes healthy blood sugar levels, reduces risk factors for heart disease and may help with weight management.

  • Nuts

Nuts are delicious and nutritious.

All types of nuts contain fiber and are low in net carbs, although some have more than others.

Here are the amounts of digestible carbs, per 1-ounce (28-gram) serving of nuts, according to the U.S. Department of Agriculture (44):

  • Almonds: 2.6 grams
  • Brazil nuts: 1.4 grams
  • Cashews: 7.7 grams
  • Hazelnuts: 2 grams
  • Macadamia: 1.5 grams
  • Pecans: 1.2 grams
  • Pistachios: 5 grams
  • Walnuts: 2 grams

Research on a variety of different nuts has shown that regular consumption may reduce inflammation and lower blood sugar, HbA1c (a marker for long-term blood sugar management) and LDL (bad) cholesterol levels (45464748).

Nuts may also help people with diabetes improve their heart health.

A 2019 study involving over 16,000 participants with type 2 diabetes found that eating tree nuts — such as walnuts, almonds, hazelnuts and pistachios — lowered their risk of heart disease and death (49).

Research also indicates that nuts can improve blood glucose levels.

A study in subjects with type 2 diabetes found that consumption of walnut oil daily improved blood glucose levels (50).

This finding is important because people with type 2 diabetes often have elevated levels of insulin, which are linked to obesity (51).

SUMMARY:

Nuts are a healthy addition to a balanced diet. They’re high in fiber and help reduce blood sugar and LDL (bad) cholesterol levels.

  • Broccoli

Broccoli is one of the most nutritious vegetables around.

A half cup of cooked broccoli contains only 27 calories and 3 grams of digestible carbs, along with important nutrients like vitamin C and magnesium (52).

What’s more, studies in people with diabetes have found that eating broccoli sprouts may help lower insulin levels and protect against cellular damage (5354).

Broccoli may also help manage your blood sugar levels.

One study found that consuming broccoli sprouts led to a 10 percent reduction in blood glucose in people with diabetes (55). 

This reduction in blood glucose levels is likely due to sulforaphane, a chemical in cruciferous vegetables like broccoli and sprouts. 

Additionally, broccoli is another good source of lutein and zeaxanthin. These important antioxidants may help prevent eye diseases (56).

SUMMARY:

Broccoli is a low calorie, low carb food with high nutrient value. It is loaded with healthy plant compounds that may help protect against various diseases.

  • Extra-Virgin Olive Oil

Extra-virgin olive oil is extremely beneficial for heart health.

It contains oleic acid, a type of monounsaturated fat that has been shown to improve glycemic management, reduce fasting and post-meal triglyceride levels, and have antioxidant properties (575859).

This is important because people with diabetes tend to have trouble managing blood sugar levels and have high triglyceride levels.

Oleic acid may also stimulate the fullness hormone GLP-1 (60).

In a large analysis of 32 studies looking at different types of fat, olive oil was the only one shown to reduce heart disease risk (61).

Olive oil also contains antioxidants called polyphenols. 

Polyphenols reduce inflammation, protect the cells lining your blood vessels, keep your LDL (bad) cholesterol from becoming damaged by oxidation, and decrease blood pressure (62636465).

Extra-virgin olive oil is unrefined, so it retains antioxidants and other properties that make it so healthy. 

Be sure to choose extra-virgin olive oil from a reputable source, since many olive oils are mixed with cheaper oils like corn and soy (66).

SUMMARY:

Extra-virgin olive oil contains healthy oleic acid. It has benefits for blood pressure and heart health.

  • Flaxseeds

Flaxseeds are an incredibly healthy food.

Also known as common flax or linseeds, flaxseeds have a high content of heart-healthy omega-3 fats, fiber, and other unique plant compounds (67).

A portion of their insoluble fiber is made up of lignans, which may help decrease heart disease risk and improve blood sugar management (68).

A review analyzing 25 randomized clinical trials found a significant association between whole flaxseed supplementation and a reduction in blood glucose (69).

Flaxseeds may also help lower blood pressure.

A study involving participants with prediabetes found that a daily intake of flaxseed powder lowered blood pressure — but it did not improve glycemic management or insulin resistance (70).

More research is needed to investigate how flaxseed can help prevent or manage diabetes.

But overall, flaxseed is beneficial for your heart and gut health.

Another study suggested that flaxseed may help lower your risk for stroke and potentially reduce the dosage of medication needed to prevent blood clots (71).

Plus, flaxseeds are very high in viscous fiber, which improves gut health, insulin sensitivity, and feelings of fullness (727374).

Your body can’t absorb whole flaxseeds, so purchase ground seeds or grind them yourself. 

It’s also important to keep flaxseeds tightly covered in the refrigerator to prevent them from going rancid.

SUMMARY:

Flaxseeds may help reduce inflammation, lower heart disease risk, decrease blood sugar levels, and improve insulin sensitivity.

  • Apple cider vinegar

Apple cider vinegar has many health benefits.

Although it’s made from apples, the sugar in the fruit is fermented into acetic acid, and the resulting product contains less than 1 gram of carbs per tablespoon.

According to a meta-analysis of six studies, including 317 patients with type 2 diabetes, apple cider vinegar has beneficial effects on fasting blood sugar levels and HbA1c (75). 

It may also reduce blood sugar response by as much as 20% when consumed with meals containing carbs (7677 78).

Apple cider vinegar is believed to have many other healthful properties, including antimicrobial and antioxidant effects. But more studies are needed to confirm its health benefits.

To incorporate apple cider vinegar into your diet, begin with 1 teaspoon mixed in a glass of water each day. Increase to a maximum of 2 tablespoons per day.

SUMMARY:

Apple cider vinegar may help improve fasting blood sugar levels, but more research is needed to confirm its health benefits.

  • Strawberries

Strawberries are one of the most nutritious fruits you can eat.

They’re high in antioxidants known as anthocyanins, which give them their red color.

Anthocyanins have been shown to reduce cholesterol and insulin levels after a meal. They also improve blood sugar and heart disease risk factors for people with type 2 diabetes (79808182).

Strawberries also contain polyphenols, which are beneficial plant compounds with antioxidant properties. 

A 2017 study found that a 6-week consumption of polyphenols from strawberries and cranberries improved insulin sensitivity in adults with overweight and obesity who didn’t have diabetes (83).

This is important because low insulin sensitivity can cause blood sugar levels to become too high. 

A 1-cup serving of strawberries contains about 46 calories and 11 grams of carbs, three of which are fiber.

This serving also provides more than 100% of the RDI for vitamin C, which provides additional anti-inflammatory benefits for heart health (11).

SUMMARY:

Strawberries are low-sugar fruits that have strong anti-inflammatory properties and may help improve insulin resistance.

  • Garlic

For its tiny size and low calorie count, garlic is incredibly nutritious.

One clove (3 grams) of raw garlic, which is roughly 4 calories, contains (84)

  • Manganese: 2% of the Daily Value (DV)
  • Vitamin B6: 2% of the DV
  • Vitamin C: 1% of the DV
  • Selenium: 1% of the DV
  • Fiber: 0.06 grams

Research indicates that garlic contributes to improved blood glucose management and can help regulate cholesterol (85).

Although many studies that determine garlic is a proven healthy option for people living with diabetes include abnormal dietary amounts of garlic, the meta-analysis cited above only included servings from .05–1.5 grams.

For context, one clove of garlic is around 3 grams.

Research also indicates that garlic can help reduce blood pressure and regulate cholesterol levels (86).

In one study, people with high blood pressure that wasn’t well managed who took aged garlic for 12 weeks averaged a 10-point decrease in blood pressure (87).

SUMMARY:

Garlic helps lower blood sugar, inflammation, LDL cholesterol and blood pressure in people with diabetes.

  • Squash

Squash, which has many varieties, is one of the healthiest vegetables around. 

The dense, filling food is fairly low in calories and has a low glycemic index.

Winter varieties have a hard shell and include acorn, pumpkin, and butternut.

Summer squash has a soft peel that can be eaten. The most common types are zucchini and Italian squash.

Like most vegetables, squash contains beneficial antioxidants. Squash also has less sugar than sweet potatoes, making it a great alternative (88). 

Research shows that pumpkin polysaccharides improved insulin tolerance and decreased levels of serum glucose in rats (89).

Research also indicates that pumpkin seeds can help with glycemic management (90).

Although there’s very little research on humans, a small study in humans found that squash decreased high blood glucose levels quickly and effectively in people with diabetes who were critically ill (91).

More studies with humans are needed to confirm the health benefits of squash. 

But the health benefits of squash make it a great addition to any meal. 

SUMMARY:

Summer and winter squash contain beneficial antioxidants and may help lower blood sugar.

  • Shirataki Noodles

Shirataki noodles are wonderful for diabetes and weight management.

These noodles are high in the fiber glucomannan, which is extracted from konjac root.

This plant is grown in Japan and processed into the shape of noodles or rice known as shirataki.

Glucomannan is a type of viscous fiber, which helps you feel full and satisfied (92).

What’s more, it’s been shown to reduce blood sugar levels after eating and improve heart disease risk factors in people with diabetes and metabolic syndrome (9394).

In one study, glucomannan significantly reduced levels of fasting blood glucose, serum insulin, and cholesterol in rats with diabetes (95). 

A 3.5-ounce (100-gram) serving of shirataki noodles also contains just 3 grams of digestible carbs and just 10 calories per serving.

However, these noodles are typically packaged with a liquid that has a fishy odor, and you need to rinse them very well before use. 

Then, to ensure a noodle-like texture, cook the noodles for several minutes in a skillet over high heat without added fat.

SUMMARY:

The glucomannan in shirataki noodles promotes feelings of fullness and can improve blood sugar management and cholesterol levels.

Bottom line:

When diabetes is not well managed, it increases your risk for several serious diseases.

But eating foods that help keep blood sugar, insulin, and inflammation manageable can dramatically reduce your risk for complications.

Just remember, although these foods may help manage blood sugar, the most important factor in healthy blood sugar management is following an overall nutritious, balanced diet.

Ways to prevent type 2 diabetes:

Type 2 diabetes is a chronic disease that affects millions of people worldwide. Uncontrolled cases can cause blindness, kidney failure, heart disease and other serious conditions.

Before diabetes is diagnosed, there is a period where blood sugar levels are high but not high enough to be diagnosed as diabetes. This is known as prediabetes.

It’s estimated that up to 70% of people with prediabetes go on to develop type 2 diabetes. Fortunately, progressing from prediabetes to diabetes isn’t inevitable (1).

Although there are certain factors you can’t change — such as your genes, age or past behaviors — there are many actions you can take to reduce the risk of diabetes.

Here are 13 ways to avoid getting diabetes: 

1. Cut Sugar and Refined Carbs from Your Diet

Eating sugary foods and refined carbs can put at-risk individuals on the fast track to developing diabetes.

Your body rapidly breaks these foods down into small sugar molecules, which are absorbed into your bloodstream.

The resulting rise in blood sugar stimulates your pancreas to produce insulin, a hormone that helps sugar get out of the bloodstream and into your body’s cells.

In people with prediabetes, the body’s cells are resistant to insulin’s action, so sugar remains high in the blood. To compensate, the pancreas produces more insulin, attempting to bring blood sugar down to a healthy level.

Over time, this can lead to progressively higher blood sugar and insulin levels, until the condition eventually turns into type 2 diabetes.

Many studies have shown a link between the frequent consumption of sugar or refined carbs and the risk of diabetes. What’s more, replacing them with foods that have less of an effect on blood sugar may help reduce your risk (2, 3, 4, 5, 6).

A detailed analysis of 37 studies found that people with the highest intakes of fast-digesting carbs were 40% more likely to develop diabetes than those with the lowest intakes (7).

SUMMARY:

Eating foods high in refined carbs and sugar increases blood sugar and insulin levels, which may lead to diabetes over time. Avoiding these foods may help reduce your risk.

2. Work Out Regularly

Performing physical activity on a regular basis may help prevent diabetes.

Exercise increases the insulin sensitivity of your cells. So when you exercise, less insulin is required to keep your blood sugar levels under control.

One study in people with prediabetes found that moderate-intensity exercise increased insulin sensitivity by 51% and high-intensity exercise increased it by 85%. However, this effect only occurred on workout days .

Many types of physical activity have been shown to reduce insulin resistance and blood sugar in overweight, obese and prediabetic adults. These include aerobic exercise, high-intensity interval training and strength training (9, 10, 11, 12, 13, 14).

Working out more frequently seems to lead to improvements in insulin response and function. One study in people at risk of diabetes found that burning more than 2,000 calories weekly via exercise was required to achieve these benefits (14).

Therefore, it’s best to choose physical activity that you enjoy, can engage in regularly and feel you can stick with long-term.

SUMMARY:

Performing physical activity on a regular basis can increase insulin secretion and sensitivity, which may help prevent the progression from prediabetes to diabetes.

3. Drink Water as Your Primary Beverage

Water is by far the most natural beverage you can drink.

What’s more, sticking with water most of the time helps you avoid beverages that are high in sugar, preservatives and other questionable ingredients.

Sugary beverages like soda and punch have been linked to an increased risk of both type 2 diabetes and latent autoimmune diabetes of adults (LADA).

LADA is a form of type 1 diabetes that occurs in people over 18 years of age. Unlike the acute symptoms seen with type 1 diabetes in childhood, LADA develops slowly, requiring more treatment as the disease progresses (15).

One large observational study looked at the diabetes risk of 2,800 people.

Those who consumed more than two servings of sugar-sweetened beverages per day had a 99% increased risk of developing LADA and a 20% increased risk of developing type 2 diabetes (16).

Researchers of one study on the effects of sweet drinks on diabetes stated that neither artificially sweetened beverages nor fruit juice were good beverages for diabetes prevention (17).

By contrast, consuming water may provide benefits. Some studies have found that increased water consumption may lead to better blood sugar control and insulin response (18, 19).

One 24-week study showed that overweight adults who replaced diet sodas with water while following a weight loss program experienced a decrease in insulin resistance and lower fasting blood sugar and insulin levels (19).

SUMMARY:

Drinking water instead of other beverages may help control blood sugar and insulin levels, thereby reducing the risk of diabetes.

4. Lose Weight If You’re Overweight or Obese

Although not everyone who develops type 2 diabetes is overweight or obese, the majority are.

What’s more, those with prediabetes tend to carry excess weight in their midsection and around abdominal organs like the liver. This is known as visceral fat.

Excess visceral fat promotes inflammation and insulin resistance, which significantly increase the risk of diabetes (20, 21, 22, 23).

Although losing even a small amount of weight can help reduce this risk, studies show that the more you lose, the more benefits you’ll experience (24, 25).

One study of more than 1,000 people with prediabetes found that for every kilogram (2.2 lbs) of weight participants lost, their risk of diabetes reduced by 16%, up to a maximum reduction of 96% (25).

There are many healthy options for losing weight, including low-carb, Mediterranean, paleo and vegetarian diets. However, choosing a way of eating you can stick with long-term is key to helping you maintain the weight loss.

One study found that obese people whose blood sugar and insulin levels decreased after losing weight experienced elevations in these values after gaining back all or a portion of the weight they lost (26).

SUMMARY:

Carrying excess weight, particularly in the abdominal area, increases the likelihood of developing diabetes. Losing weight may significantly reduce the risk of diabetes.

5. Quit Smoking

Smoking has been shown to cause or contribute to many serious health conditions, including heart disease, emphysema and cancers of the lung, breast, prostate and digestive tract (27).

There’s also research linking smoking and second-hand smoke exposure to type 2 diabetes (28, 29, 30, 31).

In an analysis of several studies totaling over one million people, smoking was found to increase the risk of diabetes by 44% in average smokers and 61% in people who smoked more than 20 cigarettes daily (30).

One study followed the risk of diabetes in middle-aged male smokers after they quit. After five years their risk had reduced by 13%, and after 20 years they had the same risk as people who had never smoked (31).

Researchers stated that even though many of the men gained weight after quitting, after several smoke-free years, their risk of diabetes was lower than if they’d continued smoking.

SUMMARY:

Smoking is strongly linked to the risk of diabetes, especially in heavy smokers. Quitting has been shown to reduce this risk over time.

6. Follow a Very-Low-Carb Diet

Following a ketogenic or very-low-carb diet can help you avoid diabetes.

Although there are a number of ways of eating that promote weight loss, very-low-carb diets have strong evidence behind them.

They have consistently been shown to lower blood sugar and insulin levels, increase insulin sensitivity and reduce other diabetes risk factors (32, 33, 34, 35, 36).

In a 12-week study, prediabetic individuals consumed either a low-fat or low-carb diet. Blood sugar dropped by 12% and insulin dropped by 50% in the low-carb group.

In the low-fat group, meanwhile, blood sugar dropped by only 1% and insulin dropped by 19%. Thus, the low-carb diet had better results on both counts (35).

If you minimize your carb intake, your blood sugar levels won’t rise very much after you eat. Therefore, your body needs less insulin to maintain your blood sugar within healthy levels.

What’s more, very-low-carb or ketogenic diets may also reduce fasting blood sugar.

In a study of obese men with prediabetes who followed a ketogenic diet, average fasting blood sugar decreased from 118 to 92 mg/dl, which is within the normal range. Participants also lost weight and improved several other health markers (36).

For more info, check out this Guide to Healthy Low-Carb Eating With Diabetes.

SUMMARY:

Following a ketogenic or very-low-carb diet can help keep blood sugar and insulin levels under control, which may protect against diabetes.

7. Watch Portion Sizes

Whether or not you decide to follow a low-carb diet, it’s important to avoid large portions of food to reduce the risk of diabetes, especially if you are overweight.

Eating too much food at one time has been shown to cause higher blood sugar and insulin levels in people at risk of diabetes (37).

On the other hand, decreasing portion sizes may help prevent this type of response.

A two-year study in prediabetic men found that those who reduced food portion sizes and practiced other healthful nutrition behaviors had a 46% lower risk of developing diabetes than the men who made no lifestyle changes (38).

Another study looking at weight loss methods in people with prediabetes reported that the group practicing portion control lowered their blood sugar and insulin levels significantly after 12 weeks (39).

SUMMARY:

Avoiding large portion sizes can help reduce insulin and blood sugar levels and decrease the risk of diabetes.

8. Avoid Sedentary Behaviors

It’s important to avoid being sedentary if you want to prevent diabetes.

If you get no or very little physical activity, and you sit during most of your day, then you lead a sedentary lifestyle.

Observational studies have shown a consistent link between sedentary behavior and the risk of diabetes (40, 41).

A large analysis of 47 studies found that people who spent the highest amount of time per day engaged in sedentary behavior had a 91% increased risk of developing diabetes (41).

Changing sedentary behavior can be as simple as standing up from your desk and walking around for a few minutes every hour.

Unfortunately, it can be hard to reverse firmly entrenched habits.

One study gave young adults at risk of diabetes a 12-month program designed to change sedentary behavior. Sadly, after the program ended, the researchers found that participants hadn’t reduced how much time they sat (42).

Set realistic and achievable goals, such as standing while talking on the phone or taking the stairs instead of the elevator. Committing to these easy, concrete actions may be the best way to reverse sedentary tendencies.

SUMMARY:

Avoiding sedentary behaviors like excessive sitting has been shown to reduce your risk of getting diabetes.

9. Eat a High-Fiber Diet

Getting plenty of fiber is beneficial for gut health and weight management.

Studies in obese, elderly and prediabetic individuals have shown that it helps keep blood sugar and insulin levels low (43, 44 , 45, 46).

Fiber can be divided into two broad categories: soluble and insoluble. Soluble fiber absorbs water, whereas insoluble fiber does not.

In the digestive tract, soluble fiber and water form a gel that slows down the rate at which food is absorbed. This leads to a more gradual rise in blood sugar levels (47).

However, insoluble fiber has also been linked to reductions in blood sugar levels and a decreased risk of diabetes, although exactly how it works is not clear (4, 47, 48).

Most unprocessed plant foods contain fiber, although some have more than others. Check out this list of 22 high-fiber foods for many excellent sources of fiber.

SUMMARY:

Consuming a good fiber source at each meal can help prevent spikes in blood sugar and insulin levels, which may help reduce your risk of developing diabetes.

10. Optimize Vitamin D Levels

Vitamin D is important for blood sugar control.

Indeed, studies have found that people who don’t get enough vitamin D, or whose blood levels are too low, have a greater risk of all types of diabetes (49, 50, 51, 52T).

Most health organizations recommend maintaining a vitamin D blood level of at least 30 ng/ml (75 nmol/l).

One study found that people with the highest blood levels of vitamin D were 43% less likely to develop type 2 diabetes than those with the lowest blood levels (49).

Another observational study looked at Finnish children who received supplements containing adequate levels of vitamin D.

Children who took the vitamin D supplements had a 78% lower risk of developing type 1 diabetes than children who received less than the recommended amount of vitamin D (50).

Controlled studies have shown that when people who are deficient take vitamin D supplements, the function of their insulin-producing cells improves, their blood sugar levels normalize and their risk of diabetes reduces significantly (51, 52).

Good food sources of vitamin D include fatty fish and cod liver oil. In addition, sun exposure can increase vitamin D levels in the blood.

However, for many people, supplementing with 2,000–4,000 IU of vitamin D daily may be necessary to achieve and maintain optimal levels.

SUMMARY:

Consuming foods high in vitamin D or taking supplements can help optimize vitamin D blood levels, which can reduce your risk of diabetes.

11. Minimize Your Intake of Processed Foods

One clear step you can take to improve your health is to minimize your consumption of processed foods.

They’re linked to all sorts of health problems, including heart disease, obesity and diabetes.

Studies suggest that cutting back on packaged foods that are high in vegetable oils, refined grains and additives may help reduce the risk of diabetes (53, 54, 55).

This may be partly due to the protective effects of whole foods like nuts, vegetables, fruits and other plant foods.

One study found that poor-quality diets that were high in processed foods increased the risk of diabetes by 30%. However, including nutritious whole foods helped reduce this risk (55).

SUMMARY:

Minimizing processed foods and focusing on whole foods with protective effects on health may help decrease the risk of diabetes.

12. Drink Coffee or Tea

Although water should be your primary beverage, research suggests that including coffee or tea in your diet may help you avoid diabetes.

Studies have reported that drinking coffee on a daily basis reduced the risk of type 2 diabetes by 8–54%, with the greatest effect generally seen in people with the highest consumption (56, 57, 58, 59, 60, 61).

Another review of several studies that included caffeinated tea and coffee found similar results, with the largest risk reduction in women and overweight men (62).

Coffee and tea have antioxidants known as polyphenols that may help protect against diabetes (63).

In addition, green tea contains a unique antioxidant compound called epigallocatechin gallate (EGCG) that has been shown to reduce blood sugar release from the liver and increase insulin sensitivity (64, 65).

SUMMARY:

Drinking coffee or tea may help reduce blood sugar levels, increase insulin sensitivity and reduce the risk of diabetes.

13. Consider Taking These Natural Herbs

There are a few herbs that may help increase insulin sensitivity and reduce the likelihood of diabetes progression.

Curcumin

Curcumin is a component of the bright gold spice turmeric, which is one of the main ingredients in curries.

It has strong anti-inflammatory properties and has been used in India for centuries as part of Ayurvedic medicine.

Research has shown it can be very effective against arthritis and may help reduce inflammatory markers in people with prediabetes (66, 67).

There’s also impressive evidence that it may decrease insulin resistance and reduce the risk of diabetes progression (68, 69).

In a controlled nine-month study of 240 prediabetic adults, among the group who took 750 mg of curcumin daily, no one developed diabetes. However, 16.4% of the control group did (69).

In addition, the curcumin group experienced an increase in insulin sensitivity and improved functioning of insulin-producing cells in the pancreas.

Berberine

Berberine is found in several herbs and has been used in traditional Chinese medicine for thousands of years.

Studies have shown that it fights inflammation and lowers cholesterol and other heart disease markers (70).

In addition, several studies in people with type 2 diabetes have found that berberine has strong blood-sugar-lowering properties (71, 72, 73, 74).

In fact, a large analysis of 14 studies found that berberine is as effective at lowering blood sugar levels as metformin, one of the oldest and most widely used diabetes medications (74).

Because berberine works by increasing insulin sensitivity and reducing the release of sugar by the liver, it might theoretically help people with prediabetes avoid diabetes.

However, at this point there are no studies that have looked at this.

In addition, since its effects on blood sugar are so strong, it should not be used in conjunction with other diabetes medications unless authorized by a doctor.

SUMMARY:

The herbs curcumin and berberine increase insulin sensitivity, reduce blood sugar levels and may help prevent diabetes.

Bottom Line:

You have control over many of the factors that influence diabetes.

Rather than viewing prediabetes as a stepping stone to diabetes, it may be helpful to see it as a motivator for making changes that can help reduce your risk.

Eating the right foods and adopting other lifestyle behaviors that promote healthy blood sugar and insulin levels will give you the best chance at avoiding diabetes.

DiabetesMines Blog

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Photo Credit: Diabetesmagazijn.nl

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