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Right diet key to managing diabetes, prediabetes


One in three. That’s how many Americans have diabetes or prediabetes. But many keep their condition secret.

Celebrity chef Paula Deen, famed for butter-laden recipes, hid her diagnosis of diabetes for nearly four years before going public this year.

“No wonder she has diabetes,” was one comment that circulated the Internet. It’s no wonder Deen hid her condition, when people are so critical.

I wish we would move beyond blame toward constructive and compassionate talk about ways to enjoy life and prevent or treat diabetes.


Some cases of diabetes are detected late, after it has silently damaged a person’s heart, kidneys and eyesight.

But detecting and treating diabetes can prevent those problems. So consider getting a simple blood test from your physician. This is especially useful if you are overweight or over age 45, according to experts.

Also, if you have any of the following symptoms, it’s worth getting a quick checkup, according to the ADA: frequent urination, unusual thirst, extreme hunger, unexplained weight loss, extreme fatigue and irritability, blurred vision, cuts that are slow to heal, tingling or numbness in the hands or feet, or frequent infections.


A blood test can show whether your blood sugar is normal, or if it’s high enough to be diabetes. Sometimes blood sugar is in between the normal and high levels. This is called prediabetes. It means you can take action to help prevent developing diabetes.

If you have prediabetes, studies have shown that you can reduce your risk of diabetes and heart disease by losing a little weight (if you’re overweight) and getting active.

Just 150 minutes a week of physical activity, such as walking briskly for a half hour five days weekly, can help. Several studies have shown that modest weight loss of 5 to 10 percent can cut your risk dramatically.

You’re more likely to succeed if you join a diet and exercise program with follow-up than if you go it alone, the American Diabetes Association says.

The association also recommends teaming up with a registered dietitian to develop an eating plan that meets your preferences. Some insurance companies cover visits with a dietitian, called medical nutrition therapy.


The ADA says that for weight loss, the following diets “may be effective” at least for the short term:

  • low-carbohydrate
  • low-fat calorie restricted
  • Mediterranean.

Personally, I’m not a huge fan of deprivation diets. But most traditional eating plans, whether Mediterranean, Asian, Latin American, Hawaiian, are fine. They all tend to be high in fruits, veggies, nuts, fish, beans and whole grains and low in fast foods, sodas and chips.

A dietitian can help you plan a gentle change that you can live with forever.

Other advice for people with prediabetes:

  • You should avoid sugar-sweetened beverages such as sodas, lemonades, and the like.
  • Substituting whole grains for refined grains is also helpful, according to the ADA. Consider trying whole-grain wheat or rye bread instead of white bread, and brown rice versus white rice. People who eat the most servings of white rice have higher risks of diabetes, a Harvard study says.
  • There’s some evidence that getting more fiber can reduce your risk of developing full-blown diabetes, so try for 25 to 35 grams of fiber daily. Fruits and veggies have even more fiber than whole grains. Beans, peas and lentils are the best sources, however. People with diabetes who ate a cup of beans daily had lower blood sugar and blood pressure than folks who ate whole grains instead, according to a study just out from well-known researcher Dr. David Jenkins of Toronto.
  • People with prediabetes don’t need to count carbs. For many people, eating well and being active can prevent diabetes from developing or at least delay it by years.


Like folks with prediabetes, people with diabetes also need to be physically active, maintain a healthy weight, avoid sugary drinks and eat more fiber.

Watching carbohydrates is critical, too. That’s because foods with carbohydrates turn to sugar in the body, which can raise blood sugar, the hallmark of diabetes. Tracking your carbohydrate intake can help control your blood sugar.

There are several ways to monitor carbs. The simplest is the plate method, which involves dividing your dinner plate into sectors such as starch, protein, fruit, milk and nonstarchy vegetable. This is a variation on the MyPlate system endorsed by the federal government.

A more precise way is to use carbohydrate exchanges, in which you learn standard portion sizes of carbohydrate-rich foods—for example, how much white rice is equivalent to a piece of bread.

The third and most complex way is to track grams of carbohydrates. Your dietitian can help you decide which method would work best for you and also to experiment with how much carbohydrate your body handles best.

You don’t necessarily have to give up all sweets, according to the ADA, but it helps if you keep track of how many carbs you eat overall.

A dietitian can tailor an eating plan for you, and experts are more flexible than ever before about food.

“A variety of dietary meal patterns are likely effective in managing diabetes including Mediterranean-style, plant-based (vegan or vegetarian), low-fat and lower-carbohydrate eating patterns,” according to a statement released by the ADA this year.

The glycemic index has been in the news a lot, as it’s part of popular diets. But the glycemic index is tricky, because it can vary from person to person. So, I don’t use the index much. Instead, I recommend higher fiber foods, because fiber tends to blunt rising blood sugar.


Because diabetes can raise the risk of heart attacks and strokes, it’s also important to eat less saturated fat—no more than 15 grams a day for the average person.

Saturated fats are found in beef, bacon, egg yolks, pork and dairy products. Trans fats should be avoided altogether, so avoid stick margarines and most fried foods.

However, you can still enjoy fruits, veggies, nuts, beans, whole grains, chicken, fish, lean meats and all kinds of foods in moderation.

There’s lots more to know. For info about checking blood sugar, adjusting meals to accommodate workouts and other issues, I highly recommend seeing a certified diabetes educator.

Ask your doctor about the diabetes management programs offered at your local hospitals, or find a certified professional at Most insurance plans cover diabetes management programs.

While it can feel complicated at first, it is possible to prevent or control diabetes and to live a full, happy and delicious life. It’s time to move forward.


Jennifer Motl  is a registered  dietitian. Formerly of Fredericksburg, she now  lives  in Wisconsin. She welcomes reader questions via her website, brighteat, or by email at