Q:
Is the timing of meals important for everyone with diabetes?
A:
People with diabetes should aim to spread the carbohydrates they consume in meals and snacks—if you want or need them—as evenly as possible throughout the day. However, if you take a blood-glucose-lowering medication like rapid-acting insulin, you can adjust your doses based on the amount of carbohydrates you eat. Eating similar amounts of carbohydrates throughout the day helps your body keep your blood glucose levels more even and can keep you from being too hungry between meals.
Q:
I've just learned I have prediabetes. What changes do I need to make in my lifestyle?
A:
By eating healthy, being active, and losing a few pounds, you may be able to prevent the progression to type 2 diabetes, or at least delay this progression. The Diabetes Prevention Program (DPP), a three-year National Institutes of Health study including more than 3,000 people with prediabetes, found that people in the intensive lifestyle group who were counseled and received regular support in their efforts reduced their likelihood of developing type 2 diabetes by nearly 60%. Lifestyle changes involved eating fewer calories, less fat, and smaller portions, and exercising (such as walking) moderately for at least 30 minutes a day five times a week.
Weight loss doesn't have to be dramatic to have an effect; the goal for DPP participants was to lose 7% of their body weight. At the close of the 24-week intensive lifestyle intervention, participants had lost an average of about 12 pounds, and they managed to keep most of it off; average weight loss in the group about three years afterward was nearly nine pounds. All DPP participants are being followed in an ongoing study to determine if continued weight control, exercise, and support can help them continue to prevent and/or delay type 2 diabetes.
Q:
I have type 2 diabetes. Should I get a referral to a diabetes nutrition educator or a diabetes education program? If so, why?
A:
Yes. You should seek out diabetes education from a diabetes educator when you're first diagnosed with diabetes and on an ongoing basis over the years. Certified diabetes educators (CDE) are nurses, dietitians, pharmacists, and other health-care professionals who can provide you with the education and support you need to make important and challenging lifestyle changes. Research has shown that support is a critical element in helping people achieve their diabetes and health goals. Working with diabetes educators or participating in a diabetes education program can also help you make sense of new diabetes research and how to apply the findings to you.
You can find diabetes education programs that have been recognized for their quality through the American Diabetes Association. Find diabetes educators through the American Association of Diabetes Educators. Find dietitians with expertise in diabetes through the American Dietetic Association.
Q:
Will I be able to control my blood glucose levels through weight loss and physical activity, or will I likely need to take one or more blood-glucose-lowering medications?
A:
When many people are diagnosed with type 2 diabetes, they have generally had elevated blood glucose levels for many years (estimated at an average of seven to 10 years). If type 2 is detected and treated early, some people can control their blood glucose levels for a time with a healthy eating plan and physical activity. However, most people will need one or more blood-glucose-lowering medications when they are diagnosed or over time. The way to stay healthy with type 2 diabetes is to keep your blood glucose, blood lipids, and blood pressure in healthy ranges. If your health-care provider suggests you take one or more blood-glucose-lowering medications, don't resist. You likely need it to control your blood glucose levels. But it's still important to keep active and eat healthy even if you do begin taking blood-glucose-lowering medications, because the medications are most effective in conjunction with lifestyle changes.
Q:
Are nutrition recommendations different for people who have just been diagnosed with type 2 diabetes than they are for those who've had diabetes for years and take insulin injections?
A:
No, the Dietary Guidelines for Americans, which are supported by the American Diabetes Association, are appropriate for pretty much everyone, including most people with type 1 and type 2 diabetes: Eat more whole grains, low-fat and fat-free dairy foods, fruits, and vegetables; limit consumption of high sodium processed foods and saturated and trans fats; get more of your protein from seafood and poultry and nonmeat sources, like beans (legumes); and eat all sources of protein in portions no larger than three ounces cooked. The Dietary Guidelines for Americans also recommend getting 45% to 65% of your calories from carbohydrates (with less than 25% of your total carbohydrates from added sugar); 20% to 35% from fat; and 10% to 35% from protein.
Type 2 Diabetes:Eating Healthy
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