The basics

There are different types of diabetes mellitus including type 1, (also known as juvenile-onset or insulin-dependent diabetes), type 2, (also known as adult-onset diabetes), gestational (diagnosed during pregnancy), and pre-diabetes. Diabetes should be managed with a combination of diet and regular exercise and, when necessary, medication. Each of these components plays a major role in a person’s overall health and well-being.

Type 1 diabetes—People with type 1 diabetes must take insulin every day in order to process the food they eat and use it for energy. You will work closely with your doctor to determine the right doses and timing for your insulin. The most important things you can do with your diet are:

• eat at consistent times that match the timing of your insulin doses
• monitor your blood sugar levels
• adjust your insulin doses for the amount of food you eat and the amount of physical activity in which you engage

Type 2 diabetes—People with type 2 diabetes may not need to take insulin to manage their disease, but often will take other medication to help control their blood sugar. Your main goals for your diet are:

• achieve and maintain normal blood sugar levels
• achieve and maintain normal cholesterol and triglyceride levels
• achieve and maintain normal blood pressure levels
• achieve and maintain ideal body weight

Gestational diabetes—Women with gestational diabetes have the added responsibility of “eating for two”. What you eat, and how well you control your blood sugar will impact the growth and development of your fetus. Therefore, the most important part of your diet is:

• eat enough calories during pregnancy to support adequate growth and development of your baby without causing hyperglycemia (high blood sugar)
• follow the diet prescribed by your doctor or healthcare professional
• limit carbohydrate intake at breakfast—some women can only handle 1 or 2 servings (15 to 30g) of carbohydrates at this meal

Pre-diabetes—Although this is not true diabetes, having pre-diabetes puts you at high risk for type 2 diabetes if you don’t make important lifestyle changes. The recommendations are similar to those with type 2 diabetes, and following these can prevent or delay the onset of type 2 diabetes.

• achieve and maintain normal cholesterol, triglyceride, and blood pressure levels
• work to achieve a normal weight
• if overweight, losing as little as 10 pounds can help improve blood sugar control
• exercise regularly
• follow your doctor’s advice about how much alcohol you should drink

More about this diet

Carbohydrates are found in grains and cereals, fruits and fruit juices, dairy products, most snack foods, and in small quantities in vegetables. Diabetes is a disease that makes the body unable to process sugars or starches from these foods either due to a lack of the hormone insulin, or an inability to properly use the insulin that is present.

People with diabetes can learn to match the amount of carbohydrates they eat at each meal or snack with their prescribed insulin or other medication so that their body can process that carbohydrate correctly. This is known as “carbohydrate counting.” It does not necessarily mean that you have to restrict the amount of sugar, bread, or fruit you usually eat. It does mean that you will probably learn a lot about reading the labels on food that you buy in the store, what your best choices are when you eat out, and how to healthfully prepare foods at home. Work with your physician or a registered dietitian to create a meal plan or diet pattern that works for you.

Having diabetes puts you at higher risk of developing cardiovascular disease. So although managing your blood sugars is important, improving your overall health with smart diet and exercise choices will be very important. If you can keep your blood pressure, cholesterol, and triglycerides within or as close as possible to the normal ranges, you will reduce your risk of heart problems, and possibly feel better as well.

Most people with diabetes will need to take medications in order to keep their blood sugar under control. Whether you are taking insulin several times a day or an oral glucose-lowering medication such as metformin, or a combination of medications, you will need to work with your physician and consistently follow the instructions you are given. Consult with your physician before changing your medications.

Just like everyone else, people with diabetes need to exercise regularly. Exercise helps the body use the insulin it has, control weight, reduce cardiovascular risk factors, and make you feel better about yourself. Everyone needs to make an exercise plan that works for them, and everyone’s plan will be different. You may find that you need to change your plan often to keep your interest so that you stick with exercising. Work with your physician or healthcare professional to develop a plan that works for your age, ability, interest, and schedule. Because exercise increases the body’s ability to use insulin, hypoglycemia (low blood sugar) can occur during or after exercise, so it will be important for you to monitor your blood sugar. Do not start or change an exercise plan without consulting your doctor.

Having diabetes can be overwhelming, especially at first. Make sure you find and work with dietitians, nurses, doctors, and other healthcare professionals who provide their expertise, and teach you what you need to know to manage your diabetes. Although it is important for you to work with experts, you are ultimately in charge of your overall health and well-being. It is up to you follow their advice, and regularly check in with them to get answers to your questions, learn more about managing diabetes, and stay on track with your healthy diet and exercise choices.