The diet of people with type 2 diabetes must be individualized, making sure to take into consideration nutritional requirements, as well as personal level of comfort of the changes the patient is willing to make at that time.  A full adjustment to a new diet plan may take some time, so incorporating gradual changes to meal plans can be easier.

The content of the diet is very important.  There is now a listing of different food items with their glycemic index (GI) or sugar content.  Diabetics should always make sure to have foods with low GI.  A diet rich in natural fibers are also good choices for diabetics.  These foods include whole grains, fruits and leafy vegetables.  There are also now several food items for the diabetic diet that have low GI , and have an added effect of lowering blood sugar levels.

Another recommendation is to have alternative sources to animal proteins.  The kidney function of diabetics do not metabolize proteins as efficiently as normal kidneys, and animal protein can bring too much stress on already compromised kidney functions.  Protein from plant sources such as beans and nuts are better metabolized by the body.

When it comes to exercise, first make sure that there are no other underlying or concomitant diseases that can compromise the function of the heart.  To be safe, it is best to first consult a physician so he/she can give advice on the type of exercises the person can do.  Some diabetic complications, such as eyesight problems and nerve damage, can limit the exercise a person can do.  It is wise to individualize an exercise routine according to the patient’s current health status.

If the person has been inactive for a while, start out with light exercises such as brisk walking or light aerobics.  For those who are overweight or with joint problems, swimming is a very good option as this exercise has very low impact on the joints.  In general, it is recommended to have physical activity three times a week for 30 minutes per day.  It has been shown that moderate exercise can eventually improve the body’s response to insulin.

It must be remembered that diabetics are already on medication that lowers their blood sugar levels.  Therefore, any diet and exercise plan must be carefully planned out and monitored so the patient will not have too low blood sugar levels that can be a medical concern as well.  Keeping in mind these tips on diet and exercise can surely help diabetics cope with necessary changes.

Normally, when we consume food, especially those high in sugar and carbohydrates, the body keeps the sugar balance through the action of the hormone insulin.  Insulin, from the pancreas, acts to lower blood sugar levels.  However, among diabetic people, they either have poor insulin production (Type 1) or resistance to the effects of insulin (Type 2).

So when tested, what is the normal blood glucose level?  Actually, rather than just a normal value, there is a normal range. The acceptable range is also different for the different methods of measuring blood glucose levels. There are currently different tests for measuring blood sugar.  One example is the fasting blood sugar test, wherein the patient needs to have no food consumption for at least 8 hours prior to taking a blood sample for analysis.  Results should range from 70-99 mg/dL to be considered normal.  A value ranging from 100-125 mg/dL is called impaired fasting glucose which means the patient has a high likelihood of having diabetes in the future. If on at least two occasions, the results are greater than or equal to 126 mg/dL, the patient is diagnosed with diabetes mellitus.

There is another test called random blood sugar test that can be taken anytime regardless of the last food intake. This time the target value should be below 200 mg/dL.  If above that value, and in the presence of symptoms, diabetes mellitus is the diagnosis.  Pre-diabetes may also be detected if the random blood sugar value is from 140-199 mg/dL.    A blood test called oral glucose tolerance test wherein a patient is asked to drink a solution containing 75mg of sugar after a period of fasting.  Two hours later, a blood sample is taken and analyzed for its sugar content.  The desired value should be below 140 mg/dL.

The diagnosis of pre-diabetes, impaired fasting glucose, or impaired glucose tolerance all indicate that the patient is a high-risk candidate for having diabetes.  Therefore, advice on a healthier diet and lifestyle must be stressed to prevent the progression of the condition.  Blood sugar testing does not end with diagnosis of diabetes mellitus alone.  Among diabetics, proper monitoring of blood glucose is a must as keeping it within normal levels will be a very important way of preventing diabetic conditions that affect the kidneys, eyes, heart and blood vessels.

If you suspect you have diabetes, or if you have a strong family history of the disease, it is best to consult a physician so he/she can order the necessary tests.

1. Take a walk

Walking regularly can help make your body more sensitive to insulin, increase weight loss, and give you better control of your blood sugar levels. Not only is it easy on your muscles and joints, but it rarely causes low blood sugar. Other modes of exercise, such as cycling, swimming, jogging, aerobics, and weight lifting can also be included in your exercise plan.

2. Take good care of your feet

Tending to your feet is essential in maintaining an active, healthy lifestyle. Your feet are vulnerable to poor circulation and diabetic nerve damage, making it easier for you to sustain injuries that do not heal and get infected. Be sure to wear well-fitting, comfortable shoes and socks, and be sure to check your feet at the end of each day to look for cuts, blisters, or other skin irritations.

3. Know high blood sugar symptoms

The symptoms of hyperglycemia differ for everyone, but, generally, if your blood sugar is high, you will:

• Have to urinate more frequently
• Feel extremely tired or will lack energy
• Feel hungrier or thirstier than usual
• Have blurry or distorted vision

Regulating your blood glucose levels is critical to living healthy.  Hyperglycemia puts you at risk for heart problems, infections, stroke, vision impairment, amputation, kidney disease, and sexual problems.

4. Lose weight

Being overweight makes blood sugar control especially difficult since this causes resistance to insulin. Excess weight may also raise your blood pressure, making you more prone to kidney disease or stroke.

5. Always carry healthy snacks

Carrying healthy snacks can help you avoid unhealthy alternatives, such as junk food or fast food, and can significantly reduce the chance of developing hypoglycemia. Choose wholesome snacks with 15 grams of carbohydrates or less per serving, particularly whole grain foods, fruits, and vegetables.

6. Understand that sugar-free foods are not calorie- and carb-free

While a food labeled “sugar-free” must have less than 0.5 grams of sugar per serving, it could still contain calories and carbohydrates. Sugar-free pudding, for example, contains 0 grams of sugar per serving, but still has 70 calories and 6 grams of carbohydrates.

7. Limit alcohol

Alcohol will interfere with your body’s ability to produce blood sugar. While a minimal amount will generally not cause low blood sugar, too much can result in low blood sugar, or hypoglycemia.

8. Get an annual eye exam

Diabetes is the leading cause of blindness in the United States; however, many eye problems are treatable if detected early. People with diabetes are also prone to developing cataracts or double vision. An annual eye exam by a doctor who specializes in diabetic eye disease is the best way to detect eye problems in the early stages when they are most easily treated.

9. Be especially cautious about blood sugar during pregnancy

Babies born to diabetic mothers have greater risks for birth defects and stillbirth. However, many problems can be averted if you maintain near normal blood sugar before and during pregnancy. It is most critical to control your blood sugar during the first 12 weeks of pregnancy when the baby’s organs are forming in order to reduce these risks.

10. Employ a good healthcare team

Having a competent and compassionate healthcare team is the best strategy to manage diabetes.  Your family physician, a diabetes education nurse, and a nutritionist are all core members of your team and can help you live healthy with diabetes.

With type 1 diabetes, studies show that total carbohydrates have the most effect on the maintenance of blood sugar control and the amount of insulin needed. Without a proper balance of insulin, carbohydrate intake, and physical activity, there can be radical changes in blood glucose levels. Additionally, if you have type 1 diabetes and are on a fixed dose of insulin, the carbohydrate content of your snacks and meals should be consistent on a day to day basis.  In regards to children with type 1 diabetes, weight and growth patterns have proven to be useful in determining if they are getting enough nutrition in their diet.

When dealing with type 2 diabetes, the focus is primarily on weight control since 80 – 90% of people with this disease are overweight. A meal plan with reduced calories, an even distribution of carbohydrates, and healthier monounsaturated fats can help improve blood glucose levels.  Examples of foods high in monounsaturated fat include peanut butter, walnuts, and almonds, as well as other nuts. These can be substituted for carbohydrates, but because these foods are high in calories, portions should be relatively small.  In many cases, moderate weight loss and increased physical activity can control type 2 diabetes, although some people may require oral medications or insulin in addition to lifestyle changes.  For children with type 2 diabetes, meal plans should be recalculated often to account for the child’s change in calorie requirements due to growth. Moreover, it is best to serve children three smaller meals and three snacks in order to meet calorie needs.  Changes in eating habits and increased physical activity help reduce insulin resistance and improve blood sugar control. It is also important to note that during times of excessive sweet consumption, such as holidays or birthday parties, children may still continue to eat sugar-containing foods, however, their daily amount of pastas, potatoes or rice should be eliminated to maintain an appropriate balance between calories and carbohydrates.

For both types of diabetes, here are some general guidelines to follow to create the proper balance between carbohydrates, protein, and fat:

Carbohydrates

Carbohydrate choices should come from whole-grain breads or cereals, brown rice, beans, pasta, fruits, and vegetables. Increasing dietary fiber is a general guideline for the entire population rather than specifically for people with diabetes. Because carbohydrates vary in their calorie content, they essentially affect weight and blood glucose control.

Protein

Protein intake should be approximately 15 – 20% of total calories. Proteins that are low in fat are recommended, such as non-fat dairy products, skinless poultry, legumes, fish, and lean meats, with portion sizes being no larger than a deck of cards.

Fat

Reduce the amount of dietary fat. Less than 7% of calories should come from saturated fat, which raise LDL (”bad”) cholesterol.  Dietary cholesterol should be less than 200 mg per day. Additionally, intake of trans-unsaturated fats, which are more commonly known as partially hydrogenated oils, should be minimized. Reduction of fat intake may help contribute to weight loss.

Sugars

Limit sources of high-calorie and low-nutritional-value foods, including those with a high content of sugars. Foods containing sugar should be substituted for other carbohydrate sources (such as potatoes) rather than merely adding them on to the meal.

Stretching

Stretching should take place both before and after exercise.  It involves holding positions that lengthen the muscles and is considered an exercise on its own because of the various benefits it provides.

Advantages of stretching:

• Improves posture
• Improves circulation
• Improves flexibility
• Improves equilibrium and coordination
• Relieves stress
• Can reduce lower back pain

Aerobic Exercise

Despite what physical condition you are in, there is an aerobic exercise suitable for you since aerobic exercise can be done at various levels of intensity. This is the type of activity where you exercise without becoming short of breath. It allows you to perform continuous and rhythmic movements of the major muscles in the arms, legs, and hips to get your heart pumping and your lungs working while maintaining the ability to breathe in as much oxygen as your body requires.  Aerobic exercise is often associated with being a “fat burner.” This is because after about 20 minutes of aerobic exercise, the body begins to use its stored fat as fuel, and if done regularly, aerobic exercise can help speed up your metabolism.

Types of aerobic activities include:

• Walking
• Running
• Dancing
• Jumping rope
• Biking
• Stair climbing
• Swimming
• Water aerobics
• Basketball
• Roller skating

Doctors recommend 30 minutes of aerobic exercise each day to stay healthy and fit.  Exercise should begin at levels of low-intensity and can gradually increase over time.
Advantages of aerobic exercise includes:

• Cardiovascular benefits Increases stamina and energy
• Increases good (HDL) cholesterol
• Helps you sleep
• Relieves stress
• Helps regulate and reduce body fat
• Psychological benefits

Anaerobic Exercise

Anaerobic exercise is exercising to the point where you become out of breath. This occurs when your body needs more oxygen than you are able to supply.  Generally, it consists of short bursts of energy followed by rest periods, working one part of the body at a time.  Although you will become tired quickly, you will also use up blood sugar. This is also known as “resistance exercise” as one performs movements against resistance with the focus of increasing muscle mass, which assists you in using more calories and  leads to a decrease in insulin resistance.

Types of anaerobic activities include:

• Sprinting
• Weight lifting
• Push ups
• Sit ups

Advantages of anaerobic exercise includes:

• Increases insulin sensitivity
• Lowers blood pressure
• Raises “good” cholesterol levels and lowers “bad” ones
• Increases strength of bones, joints, and muscles
• Lowers overall blood sugar readings
• Increases muscle mass over fat to help lose inches

Remain Hydrated

Be sure to drink 16 ounces of water one hour before exercise, 8 ounces 15 minutes prior, and 4 ounces every 15-20 minutes during exercise. Since exercise can cause significant fluid loss, staying hydrated is especially important when you are out in the sun. Be sure to choose your beverage wisely, staying away from caffeine, and only drinking sports drinks when exercising more than an hour or if the weather causes you to sweat more than normal.

Pay Attention to Your Feet

Wear comfortable and well-fitting shoes and natural-fiber socks. Check your feet before and after activities for any potential damage such as cuts, sores, or blisters.

Kidneys: Diabetes can cause damage to the kidneys which contain millions of tiny blood vessels that filter waste from your blood. Severe damage can lead to irreversible end-stage kidney disease or kidney failure, which would require dialysis or a kidney transplant.

Cardiovascular System: Diabetes severely increases the risk of various cardiovascular problems, including heart attack, stroke, coronary artery disease, and the narrowing of arteries. People who have diabetes are twice as likely to develop stroke or heart disease.

Nerves: Excess sugar can damage the walls of the tiny blood vessels that nourish your nerves, particularly in the legs. This can cause tingling, burning, numbness, or pain that generally begins at the fingertips or toes, and gradually spreads upward over several months or years. When left untreated, this condition can cause you to lose all sense of feeling in the affected limbs. Any damage to the nerves that is related to digestion can cause problems with nausea, vomiting, diarrhea or constipation and can lead to erectile dysfunction in men.

Skin and Mouth: Diabetes may leave you more vulnerable to skin conditions, including itching, bacterial infections, and fungal infections. Additionally, gum infections may also be an issue if you have a history of poor dental hygiene.

Feet: Insufficient circulation or nerve damage in the feet can increase the risk of various foot complications. If left untreated, cuts and blisters can become serious infections, which severe damage might require amputation.

Bones and Joints: Diabetes may put you at risk of bone and joint problems such as osteoporosis.

Eyes: Diabetes can damage the retina’s blood vessels which can lead to visual impairment.

There are also some conditions that are more common in seniors with diabetes.   And worsen as a person ages.

Pain: Elderly people with diabetes often suffer from undiagnosed or under-treated pain.

Depression: The risk of depression is remarkably higher in elderly diabetics. They may have suffered the loss of other loved ones which leaves them feeling socially isolated.

Falling: There is a higher risk of falling in elderly diabetics due to diabetes-related complications such as visual impairments, loss of sensation in the feet, and dizziness from low blood sugar.

Urinary Incontinence: This is caused by low blood sugar or other correctable problems.  Incontinence is generally more common in older women who have diabetes and should be treated by a medical professional.

Memory Problems: Older diabetics may be incapable of remembering to check blood sugar on time or may forget to take medications.

Here are some helpful tips to stay healthy and prevent some of these long-term complications of type 1 diabetes from developing:

Eye care: Have your eyes checked by an eye doctor annually to prevent eye problems such as retinopathy that can lead to blindness as a result of diabetes. Treat problems early to avoid serious complications.

Skin care: High blood glucose and poor circulation can lead to skin problems such as frequent infections or slow healing after an injury. Wash every day with a mild soap and lukewarm water, always use sunscreen, and treat any cuts or scrapes with proper cleansing and bandaging.

Foot care: Diabetes can reduce sensitivity in the feet through poor circulation and nerve damage. It is important to regularly check your feet, searching for any sores, cuts, or blisters. Always keep your feet clean and dry and protect them by wearing socks made from natural fibers and comfortable shoes.

Whereas kidney damage is generally the cause of high blood pressure in type 1 diabetes, obesity and insulin resistance are the factors associated with hypertension in type 2 diabetes.  Obesity is common in both type 2 diabetes and hypertension and clinical testing indicates that obesity is the one common element linking insulin, type 2 diabetes, and high blood pressure. However, studies have found a stronger association between hypertension and insulin resistance in thin patients as well as overweight people with type 2 diabetes.

The development of hypertension in patients with diabetes is particularly harmful, as it is responsible for up to 75% of diabetic cardiovascular complications, including coronary artery disease, peripheral vascular disease, and stroke. Hypertension is also thought to play a significant role in the development of retinopathy (eye damage), nephropathy (kidney disease), and possibly neuropathy (nerve damage).

The gas nitric oxide also plays a predominant role in hypertension.  It can be produced in the body, affecting the smooth muscle cells that line blood vessels by keeping them relaxed and flexible. It may also help prevent blood clotting. Low levels of nitric oxide have been observed in people with high blood pressure (particularly in African Americans) and may be a significant factor in essential hypertension.

Clinical testing and research has explored the benefits of lowering blood pressure in individuals with diabetes, such as a reduction in cardiovascular disease, stroke, or nephropathy events. In older individuals with type 2 diabetes, females in particular, the incidence of heart failure is rapidly increasing, and hypertension is often the primary cause.  Additionally, aside from diabetes, hypertension is the leading cause of end-stage renal disease (ESRD).  Coexisting hypertension and diabetes is a common clinical scenario that can ignite a vicious cycle of rising blood pressure, increasing renal damage, and increased cardiovascular morbidity.  Treatment of hypertension often requires multiple drugs to effectively minimize and prevent complications of diabetes. In patients with type 2 diabetes mellitus, the impact of blood pressure control on micro vascular and macro vascular health may be equal to or even greater than that of strict glycemic control.

Those who have type 2 diabetes must also be aware of secondary hypertension, which has recognizable causes that are usually treatable or reversible.  There are a number of medical conditions that can cause secondary high blood pressure.  The most common of which is kidney disease, although it occurs more often in older diabetics.  Sleep apnea, a disorder in which breathing briefly ceases repeatedly during sleep, is also highly associated with hypertension. A weak but still higher than normal association with high blood pressure has even been observed in those who snore or have mild sleep apnea. The link between sleep apnea and hypertension is thought to be largely due to obesity, but major studies are finding a higher rate of hypertension in people with sleep apnea regardless of their weight. Treating sleep apnea with a device known as nasal continuous positive airway pressure (CPAP) may have modest benefits on blood pressure as well.  Additionally, some medical conditions may contribute to temporary hypertension such as cirrhosis, pregnancy, and Cushing’s disease.

To help temporarily aid blood-pressure, people with type 2 diabetes can attain certain prescription and over-the-counter medication.  This includes cough medicines that contain pseudo ephedrine, oral contraceptives, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.  Other causes of secondary hypertension in type 2 diabetics include stress and vigorous exercise, as well as caffeine, cigarettes, and alcohol, all of which could increase the risk of stroke if not limited.

Most people are generally raised on three square meals per day with a snack in between; however, it is recommended for type 2 diabetics to eat six smaller meals throughout the day, allowing room for snacks that fit within their daily allotted amount of food.  Many physicians recommend that their diabetic patients speak with a nutritionist to make healthy choices in regards to what specific foods should be consumed, and he or she will assist you in planning a low carbohydrate diet, as well as monitoring your blood sugar to help regulate the disease.

Sugar, starch, and dietary fiber are the three main types of carbohydrates. Sugar and starch are what increases the glucose in the blood, and dietary fiber is a necessity for our bodies. Grains, beans, fruits, and dairy products all have carbohydrates, so be sure to consult your physician to discuss the right amount of carbohydrates for you. A low carbohydrate diet is important since carbohydrates can increase the glucose levels in the blood. The normal blood sugar range runs between 70 to 140 mg/dl. The glucose levels assume a higher reading just after consuming a meal, and go down as time passes. Diet control is essential to managing these levels and to live healthy with type 2 diabetes.

The following is a list of recommended food for type 2 diabetics:
Vegetables with higher fiber content are recommended, especially when eaten raw, since fiber content does not allow fats and blood glucose to deposit in the blood flow. The micro level fiber molecules flush out the saturated fats and glycogenic bonds as waste products from the body and consequently lower blood sugar levels.

Beans, particularly kidney beans and soy beans, are rich in protein and low in starch which aids in reducing diabetes urine sugar.

Onions, raw or cooked, is another healthy choice since they reduce the sugar levels in blood.  The more onions are eaten, the faster it helps lower blood sugar.

Fruits that contain nuts, such as guava and red grapes, are good sources for controlling blood sugar. The amino acids in fruits help lowers blood glucose.

Meats, which include beef, pork, and poultry, are essential to eating healthy and managing blood sugar levels.  Seafood is especially healthy and should be eaten often.

The following is a list of foods to avoid for type 2 diabetics:
Food with increased sodium salt will flag up your blood pressure and is relatively bad for your health. Instead, try to eat non-sodium or low sodium foods, making sure to avoid chips, crackers, canned foods like soups and sardines, and processed or preserved meat products.

Fats are highly harmful in causing cardiovascular diseases for diabetics. It is advised to consume low-fat food only, avoiding dairy products like cheese, butter cakes, and solid vegetable fats since all of these foods contain saturated fats. Chicken preparation with skin should also be avoided.
Butter and margarine should be replaced by canola or olive oil. Choose skimmed, low-fat, or non-fat milk, and yogurt instead of milk products with full cream.
Fried foods are prepared by being dipped in oil or butter which can add a harmful coating to your cardiovascular system.  Instead, prepare foods by either boiling or baking.

Sugars can increase blood sugar levels and should always be limited.  Avoid chocolate and cake or any other sweetened treats, as well as soft drinks and fruit juices as they contain high sugar content.