Diabetes mellitus is a metabolic disorder that occurs when the body either doesn’t produce sufficient insulin or doesn’t use insulin properly causing blood sugar (glucose) levels to rise (hyperglycemia).
There are three main types:
- Type 1 diabetes (formerly called juvenile or insulin-dependent diabetes)
- An autoimmune condition in which little to no insulin is produced by the pancreas
- Type 2 diabetes
- Gestational diabetes
- Disrupts the way the body uses sugar (glucose) during pregnancy
- Pregnancy increases the body's need for insulin, but the body is not always able to make enough
There is no specific diet for diabetes. Patients should follow a diabetes meal plan as recommended by a doctor or nutritionist. In general, patients with diabetes should:
- Limit sugar intake
- Limit or avoid sodium to keep blood pressure under control
- Read all nutrition labels carefully: “sugar-free” or “fat-free” products are not necessarily low in calories or carbohydrates
Specific foods diabetics should avoid or limit include:
- Limit starchy vegetables
- Beets
- Corn
- Peas
- Sweet potatoes
- White potatoes
- Avoid certain fruits
- Canned fruit in syrup
- Dried fruit
- Fresh juices as part of fad cleanses
- Packaged juices
- Avoid certain starches and carbohydrates
- Cereal with no whole grains and added sugars
- Crackers
- French fries
- Graham crackers
- Packaged snacks high in salt and carbohydrates
- Pastries and confections
- Pretzels
- Processed grains
- White bread
- White flour
- White flour tortillas
- White pasta
- White rice
- Avoid certain proteins
- Avoid high fat dairy products
- Avoid certain fats
- Saturated fats and trans fats should be kept as low as possible
- Frozen foods
- Donuts
- Coffee creamer
- Packaged and processed foods
- Cakes
- Pies
- Pastries
- Margarine
- Oils that are partially hydrogenated, or do not originate from seeds, nuts, or plant sources
- Avoid certain beverages
- All sodas, except diet sodas
- All sweetened beverages including:
Foods to eat include:
- A variety of eating patterns are acceptable, such as:
- A diet high in fiber can help keep blood sugar levels under control
- Carbohydrates from fruits, vegetables, whole grains, legumes, and low-fat milk
- Monounsaturated and polyunsaturated fatty acids such as those found in fish, olive oil, and nuts are recommended
- Good protein sources include beans, soy, lean meats, fish, eggs, and nuts
- Drink plenty of water
- Some sugar-free foods, such as sugar-free gelatin and sugar-free gum, do not have a significant number of calories or carbohydrates and are considered “free foods”
- Any food with fewer than 20 calories and 5 grams of carbohydrate is considered a “free” food, meaning it does not affect body weight or require an adjustment to medication
What Are Symptoms of Diabetes?
Symptoms of diabetes include:
- Increased thirst
- Increased urination
- Increased hunger
- Blurred vision
- Fatigue
- Frequent infections
- Sores/cuts/bruises that do not heal
- Darkened skin, often in the armpits and neck
- Unexplained weight loss (more common in type 1)
- Numbness, tingling, or pain in the feet or hands (more common in type 2)
What Causes Diabetes?
Type 1 diabetes is believed to be caused by an autoimmune reaction in which the body mistakenly attacks itself and destroys beta cells in the pancreas that make insulin.
Risk factors for developing type 1 diabetes include:
- Genetics/family history
- Age: more likely to occur in children, teens, and young adults, though it can develop at any age
- Ethnicity: Caucasians are more likely to develop type 1 diabetes than African Americans and Hispanic/Latino Americans
- Certain triggers, such as viruses
Type 1 diabetes is not caused by diet or lifestyle factors.
Type 2 diabetes is caused by several factors, including:
- Genetics
- Family history
- Tends to occur more in certain ethnic groups: African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
- Lifestyle factors
- Being overweight or obese
- Physical inactivity
Risk factors for developing type 2 diabetes include:
- Low HDL (“good”) cholesterol or high triglycerides
- High blood pressure
- Age 45 or older
- A history of heart disease or stroke
- A history of gestational diabetes
- Giving birth to a baby weighing 9 pounds or more
- Polycystic ovary syndrome (PCOS)
- Depression
The cause of gestational diabetes is not known and it is difficult to predict which women could develop the condition when they are pregnant.
Risk factors for developing gestational diabetes include:
- Family history of diabetes
- Being overweight/obese
- Prior gestational diabetes during pregnancy
- Age older than 25
- Ethnicity: Hispanic-American, African-American, Native American, South or East Asian, or Pacific Islander
How Is Diabetes Diagnosed?
Diabetes is diagnosed with the following tests:
- A1C test
- Fasting plasma glucose (FPG) test
- Glucose challenge test
- Oral glucose tolerance test (OGTT)
- Random plasma glucose (RPG) test
What Is the Treatment for Diabetes?
Diabetes is treated with lifestyle modifications and medications when needed.
Lifestyle changes to manage diabetes include:
- Check blood glucose levels daily
- Manage A1C (average blood glucose level over the past 3 months)
- Follow a diabetes meal plan as recommended by your doctor or nutritionist
- Exercise regularly
- Don’t smoke
- Get adequate sleep
- Keep blood pressure in check
- Maintain healthy cholesterol levels
- Manage stress/practice relaxation techniques
- Take prescribed diabetes medications
Medications used to treat diabetes include:
- Insulin
- Alpha-glucosidase inhibitors
- Amylin analog
- Biguanides
- Bile acid sequestrants
- Dopamine receptor agonists
- DPP- 4 Inhibitors
- GLP-1 receptor agonists
- Meglitinides
- SGLT2 inhibitors
- Sulfonylureas
- Thiazolidinediones
- Combination medicines, which may be made up of more than one medication in the above classes
If lifestyle changes and medications are insufficient, other treatments for diabetes may include:
- Weight-loss surgery (bariatric surgery) for certain patients who are obese
- Artificial pancreas
From
https://www.fda.gov/media/119148/download
https://www.cdc.gov/diabetes/basics/type1.html
https://www.uptodate.com/contents/gestational-diabetes-beyond-the-basics?search=Gestational%20Diabetes%5C&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://www.uptodate.com/contents/type-2-diabetes-and-diet-beyond-the-basics?search=diabetes&topicRef=15730&source=see_link
https://www.thediabetescouncil.com/diabetes-foods-to-eat-foods-to-avoid/