Diet recommendations for people with type 2 diabetes include a
Type 2 diabetes is the most common type of diabetes. It is a chronic condition in which blood glucose (sugar) can no longer be regulated. There are two reasons for this. First, the cells of the body become resistant to insulin (insulin resistant). Insulin works like a key to let glucose (blood sugar) move out of the blood and into the cells where it is used as fuel for energy. When the cells become insulin resistant, moving sugar into the cells requires more and more insulin, and too much sugar stays in the blood. Over time, if the cells require more and more insulin, the pancreas can't make enough insulin to keep up and begins to fail.
This type of diabetes develops gradually, over years, so the signs and symptoms can seem subtle, and you might think it is something you "just have to live with." If you are overweight or obese, this is the major symptom, but not everyone will be overweight. In fact, weight loss can be a symptom.
Other symptoms and signs include:
Type 2 diabetes is a condition of blood sugar dysregulation. In general blood sugar is too high, but it also can be too low. This can happen if you take your diabetes medications then skip a meal. Blood sugar also can rise very quickly after a high glycemic index meal, and then fall a few hours later, plummeting into hypoglycemia (low blood sugar). The signs and symptoms of hypoglycemia can include
Hyperglycemia, or high blood sugar, is common in type 2 diabetes. Its signs and symptoms can be either acute (short in duration) or chronic (last over a long period of time).
Type 2 diabetes can be reversed with diligent attention to changing lifestyle behaviors. Type 2 diabetes is caused by a combination of genetics and unhealthy lifestyle habits.
Risk factors for type 2 diabetes are:
Lifestyle habits can contribute to a person developing the disease, for example:
Yes, there is a blood test to diagnose this disease. The blood is tested for glucose, and if it is greater than 125 fasting, or more than 200 when randomly tested, the diagnosis is diabetes. If the fasting blood sugar is between 100-125, the person has a diagnosis of prediabetes.
Tests also can measure average blood sugar over time. A hemoglobin A1c (HbA1c) test greater than 6.5% indicates the diagnosis of the disease. Prediabetes is diagnosed with an HbA1c of 5.7% - 6.4%.
Treatment for this type of diabetes can include:
Not all people with diabetes need drug therapy. A healthy eating plan and exercise alone can be enough if the person makes significant lifestyle changes. Other signs, symptoms, and complications also may need treatment. For example, nutritional deficiencies should be corrected, heart or kidney disease may need to be treated, and vision must be checked for eye problems like diabetic retinopathy.
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If you have this type of diabetes, the foods you eat should have a low-glycemic load (index) -- foods higher in fiber, protein, or fats -- like vegetables and good quality protein such as fish, chicken, beans, and lentils. From that base, add other types of nutritious foods like fruit, whole grains, low-fat dairy products, and nuts.
Avoid foods with a high glycemic index (foods that raise blood sugar too quickly) such as processed foods, and foods high in carbohydrates, sugars, or animal fat. Examples of foods to avoid include:
A good rule of thumb is to avoid white foods (except for cauliflower!).
Exercise is very important if you have this health condition. Exercise makes cells more insulin sensitive, pulling glucose out of the blood. This brings down blood sugar, and more importantly, gives you better energy because the glucose is being transferred to the cells. Any type of exercise will do this, but you gain extra benefit when the activity helps build muscle, such as weight training or using resistance bands. The benefits of exercise on blood sugar last about 48-72 hours, so it is important for you to be physically active almost every day.
There are different types of diabetes drugs. They work in different ways to either stop the liver from making glucose, make the pancreas release more insulin, or block glucose from being absorbed. Insulin replaces the natural insulin when the pancreas can't make it any longer.
Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) belongs to a class of drugs called biguanides. Metformin is first-line therapy for most type 2 diabetics. It works to stop the liver from making excess glucose, and has a low risk of hypoglycemia. Hypoglycemia, or very low blood sugar can cause symptoms such as sweating, nervousness, heart palpitations, weakness, intense hunger, trembling, and problems speaking. Many patients lose some weight taking metformin, which is also helpful for blood sugar control.
Sulfonureas and meglitinides are classes of drugs also prescribed for treatment. These drugs cause the pancreas to release more insulin. Since the pancreas can only work so hard, these drugs have a limited duration of usefulness.
The sulfonureas include:
The meglitinides include:
Canagliflozin (Invokana) and dapagliflozin (Farxiga) are oral medications prescribed to treat type 2 diabetics. These drugs belong to the drug class referred to as sodium-glucose co-transporter 2 (SGLT2) inhibitors. These drugs work by stopping the absorption of glucose in the kidneys, enabling some of it to be urinated out.
There are other oral and injectable drugs for patients with type 2 diabetics such as:
For people who want to avoid drugs, taking an aggressive approach to healthy eating plan and lifestyle change is an option. It isn't easy, but if someone is very committed and motivated, lifestyle changes can be enough to maintain a healthy blood sugar level and to lose weight. Learning about a healthy diabetes diet (a low-glycemic load diet) can be a good place to start.
Insulin is only recommended for individuals with type 2 diabetes when they have not been able to get blood sugars low enough to prevent complications through other means. To avoid insulin, those with this health condition should work very hard to follow a healthy eating plan that includes a lot of vegetables and lean proteins, exercise every day, and keep stress in perspective. They also should take their oral drugs regularly. It can be difficult to follow these recommendations and the help of your doctor, nutritionist, diabetes educator, health coach, or integrative medicine practitioner may be helpful. If you want to avoid taking medicine, work with health professionals who are knowledgeable about lifestyle medicine and can help you understand how to fit the changes into your life.
If you are a diabetic and are pregnant you can have a normal, healthy pregnancy, but you need to take extra steps to avoid gaining excess weight and high blood sugars. Lifestyle habits (eating primarily vegetables and lean protein and exercising every day) will prevent problems during pregnancy. If you are a diabetic and become pregnant, monitor your blood sugar levels often. Talk with your doctor about exploring additional health care professionals, for example, a nutritionist, health coach, or naturopathic doctor about a healthy eating plan. If your blood sugar gets out of control you may:
If blood sugar is not controlled over time, complications can develop. These include:
If you have diabetes, you have a higher risk of heart disease and heart attack. Because of this, it is important to control cholesterol and high blood pressure in addition to blood sugar. The good news is that all of these diseases are responsive to healthy lifestyle changes.
A healthy lifestyle can prevent almost all cases of type 2 diabetes. A large research study called the Diabetes Prevention Program, found that people who made intensive lifestyle changes including diet and exercise reduced their risk of developing diabetes by 58%. Those over 60 years old seemed to experience extra benefit; they reduced their risk by 71%. In comparison, people who were given the drug metformin for diabetes prevention only reduced their risk by 31%.
Some research shows that people with type 2 diabetes may die 10 years earlier than those without diabetes. Most people with the disease die of secondary complications of it, for example kidney failure or heart disease. However, with good blood sugar control and healthy lifestyle choices, complications can be prevented.
Adult and pediatric endocrinologists, specialists in treating hormone imbalances and disorders of the endocrine system, are experts in helping patients with diabetes manage their disease. People with the disease also may seek care from a number of primary care providers including family or internal medicine practitioners, naturopathic doctors, or nurse practitioners. When complications arise, these patients often consult other specialists, including neurologists, gastroenterologists, ophthalmologists, acupuncturists, surgeons, and cardiologists. Nutritionists, integrative and functional medicine doctors, and physical activity experts such as personal trainers are also important members of a diabetes treatment team. It is important to interview new health care professionals about their experience, expertise, and credentials to make sure they are well qualified to help you.
Elevated homocysteine levels in the blood called hyperhomocysteinemia, is a sign that the body isn't producing enough of the amino acid homocysteine. is a rare and serious condition that may be inherited (genetic). People with homocystinuria die at an early age. Symptoms of hyperhomocysteinemia include developmental delays, osteoporosis, blood clots, heart attack, heart disease, stroke, and visual abnormalities.
There are other causes of hyperhomocysteinemia, for example, alcoholism.
Supplementing the diet with folic acid and possibly vitamins B6 and B12 supplements can lower homocysteine levels. Currently there is no direct proof that taking folic acid and B vitamins lower homocysteine levels and prevent heart attacks and strokes. Talk to your doctor if you feel you need to have your homocysteine blood levels checked.
If your blood sugars become too low, use these nearby as a quick treatment table sugar, soda, juice, and glucose tablets.
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