American Diabetes Association

Cheat Sheet / Updated 04-28-2022

Making healthy food choices is an essential part of successful diabetes management. Cooking diabetes-friendly meals at home is a great way to ensure that you're eating nutritious food; avoiding preservatives and excess fat, sugar, and sodium; and controlling your portion sizes. If you've just been diagnosed with diabetes, you may be wondering where to start when it comes to eating well. Understanding the best food choices for people with diabetes is an important first step. Before you begin cooking healthy recipes at home, learn how to shop for the best ingredients and prepare your kitchen.

Cheat Sheet / Updated 03-14-2022

Diabetes is a disorder in which the amount of glucose in your blood is too high. Type 2 diabetes is a serious condition that can lead to complications down the road, so it's important to take charge of your diabetes care! In addition to following a diabetes meal plan, maintaining an active lifestyle, and taking prescribed medications, you need to be able to perform certain essential tasks and skills to keep your diabetes care on track. Understanding how to prepare for doctor's appointments, checking your blood glucose, recognizing and treating low blood glucose readings, and using food labels to track the carbohydrate content of foods are all key aspects of the successful management of type 2 diabetes.

Step by Step / Updated 10-15-2020

Many people who are stuck at home for one reason or another think they can't work on staying fit, but the truth is that you can get a stronger core and stay fitter without leaving home. You'd be amazed at how easy it is to get fit. Your body core — the muscles around your trunk and pelvis — is particularly important to keep strong so that you can go about your normal daily activities and prevent falls and injuries, particularly as you age. Having a strong body core makes you better able to handle your daily life, even if that's just doing grocery shopping or playing a round of golf. Core exercises are an important part of a well-rounded fitness program, and they're easy to do at home on your own. To get started on your body core workout, you don't need to purchase anything. (Some of the advanced variations do call for equipment like a gym ball or dumbbells.) Include all 10 of these easy core exercises in your workouts, doing at least one set of 15 repetitions of each one to start (for all that are done as reps). Work up to doing two to three sets of each per workout, or even more repetitions if you can. For best results, do these exercises at least two or three nonconsecutive days per week; muscles need a day or two off to fully recover and get stronger. Just don't do them right before you do another physical activity (because a fatigued core increases your risk of injury).

Step by Step / Updated 10-15-2020

When you're trying to keep fit and manage your Diabetes, you can do many different static stretches to flex your joints. Here are a few simple ones to get you started.

Article / Updated 09-20-2020

People with type 2 diabetes have several things going on in their bodies with blood glucose, insulin, and other hormones: People with type 2 diabetes may not make as much insulin as they used to — or none at all. People with type 2 diabetes may not be as sensitive to the hormone insulin (called insulin resistance) as people who don’t have diabetes. Other hormones, called incretins, affect how much insulin the body releases and help control blood glucose. For some people with type 2 diabetes, a hormone called glucagon-like peptide-1 (GLP-1) may not work properly and may not stimulate the pancreas to make enough insulin. People with type 2 diabetes may release too much glucose from their livers, causing blood glucose to rise. All these things can cause high blood glucose, which can cause short- and long-term health problems. Medication can target these different problems to help lower your blood glucose. Some people with type 2 diabetes may need to take insulin because their bodies are no longer responsive to blood glucose–lowering medications or because their bodies don’t make any insulin at all. Your diabetes medication regimen can change over time. You may take a drug like metformin at the beginning, but then need to add or change medications to keep your blood glucose in your target range later on. (Remember: Most people are aiming for an A1C of 7 percent or less.) Or you may experience side effects that prompt medication changes. You may also need to take insulin at diagnosis or several years down the road. It totally depends on the individual! Your healthcare team is your number-one resource for medications. You’ll work with your nurse, doctor, pharmacist, physician assistant, or diabetes educator to troubleshoot problems or adjust doses. Never stop taking a medication because you think it’s not working or because of annoying side effects (an unintended effect, such as diarrhea or flatulence, of taking a certain drug). Instead, call your provider and tell her what’s going on. Don’t be shy about bringing up concerns like bowel movements, changes in mood, or any other concern. All drugs can have side effects, although some may be more severe than others. Know the names, doses, and instructions for each medication you take. If you’re like most people, you’ll probably need to write them down. Don’t be afraid to ask your provider or pharmacist for these details each time you see her.

Article / Updated 08-08-2020

Pills aren’t the only option for people to lower their blood glucose. Patients have access to injected medications (other than insulin), which are injected under the skin with a needle. This is different from a pill that you pop in your mouth. There are two non-insulin classes of injected medication for type 2 diabetes: GLP-1 agonists and amylin analogs. The table lists the injected medications for type 2 diabetes. Injected Medications for Type 2 Diabetes Drug Class How It Works Generic Name Brand Name Glucagon-like peptide-1 (GLP-1) receptor agonists Mimics the action of the incretin hormone GLP-1. Stimulates your body to produce more insulin. Slows down how quickly your stomach empties. Exenatide Byetta Extended Release Exenatide Bydureon Liraglutide Victoza Dulaglutide Trulicity Lixisenatide Adlyxin Amylin analogs Mimics the action of the hormone amylin. Slows down how quickly your stomach empties. Suppresses your liver from releasing glucagon, a hormone that moves glucose into your bloodstream. Pramlintide Symlin GLP-1 agonists Glucagon-like peptide-1 receptor agonists (wow, that’s a mouthful) are otherwise know as GLP-1 agonists. They’re also sometimes called incretin mimetics because they mimic the action of the incretin hormone GLP-1, which helps lower blood glucose. GLP-1 agonists help your body make more insulin and slow down how quickly your stomach empties so your blood glucose doesn’t rise as rapidly. They may also make you less hungry and encourage some weight loss. GLP-1 agonists include exenatide (Byetta), liraglutide (Victoza), extended-release exenatide (Bydureon), dulaglutide (Trulicity), and lixisenatide (Adlyxin). Victoza can be used to reduce the risk of heart attack, stroke, and other cardiovascular events in adults with type 2 diabetes and at high risk for cardiovascular disease. Exenatide received FDA approval in 2005. You inject GLP-1 agonists using a pre-dosed pen. Depending on the medication, you may inject twice a day, once a day, or once a week. Side effects include weight loss, nausea and vomiting (and resulting dehydration), episodes of low blood glucose, kidney problems, and inflammation of the pancreas. Tell your healthcare provider if you’ve had pancreatitis, gallstones, a history of alcoholism, high triglycerides, or kidney problems. Whether you’re starting a new medication or just can’t remember, don’t be afraid to ask your healthcare provider why you’re taking it. Knowing the reasons why you take a specific medication may help you remember to take it — or just feel more empowered about your actions. Amylin analogs Amylin analogs mimic a hormone called amylin that the body naturally produces along with insulin. Pramlintide (Symlin) is a manufactured version of this hormone. Some people with type 2 diabetes don’t make enough insulin or enough amylin. Pramlintide lowers blood glucose by slowing how fast your stomach empties and suppressing your liver from releasing a hormone called glucagon, which puts glucose into your bloodstream. It may also encourage you to eat less because you feel fuller at meals. Pramlintide received FDA approval in 2005 for people with type 1 or type 2 diabetes who use insulin. You inject pramlintide using a disposable pen during meals. It does not replace insulin. It’s helpful for people who need something beyond insulin to help control their blood glucose. Side effects include episodes of low blood glucose, nausea, vomiting, stomach pain, and headache.

Article / Updated 11-12-2019

You may have heard the terms diabetes self-management plan or diabetes care plan. Both of these terms refer to how you take care of or manage your diabetes. Your plan takes into account your big-picture goals and your nitty-gritty choices each day. On the one hand, diabetes management is not a small endeavor. You’re the person most responsible for taking care of your diabetes 24 hours a day, 7 days a week, 365 days a year. It’s not your diabetes educator or endocrinologist or even your spouse who will carry the torch. It’s you, the person with diabetes. On the other hand, it’s a well-trodden road. Many, many people just like you are learning to test their blood glucose, take new medications, and change the way they eat and exercise. There are millions of people in towns and cities across the United States managing their diabetes with successes and struggles. You can find them in your community hospital’s diabetes support group, and you can find them online on the American Diabetes Association’s message boards. You’re not alone — and there’s much to learn from your healthcare team and others with type 2 diabetes. In the following discussion, we give you an overview about putting together a healthcare team, taking medications, eating healthy foods, getting active, and finding support. Assembling a healthcare team One of the first steps you’ll take in managing your diabetes is to put together your healthcare team. At first, you may start with your diabetes care provider, who may be your family physician or nurse practitioner or an endocrinologist. You’ll probably see a certified diabetes educator (CDE), who is specially trained to help people manage their diabetes. These professionals will monitor your diabetes and any related complications, but also help you set goals and troubleshoot problems as they arise. Other specialists you may see include dietitians, ophthalmologists, podiatrists, dermatologists, and others. Taking medications You may be prescribed a medication, such as metformin, as soon as you’re diagnosed with diabetes. Or you may take a combination of medications or insulin injections. Taking your prescribed medications is an essential piece of managing your type 2 diabetes. It is a cornerstone of your care — and it’s important to do it at the correct times each day or each week. Switching a medication, adding a medication, or taking insulin is a normal part of having diabetes. Your diabetes will change over time, and your medication needs may change, too. Checking blood glucose Your healthcare provider will test your blood glucose using the A1C test during your checkups. As we explain in Chapter 1, an A1C test is a measure of your blood glucose over the previous three months. It gauges how well your medications work or whether you need to change your meals or physical activity. You may also be asked to check your blood glucose on your own using a meter. You’ll prick your skin using a lancet to draw a drop of blood, press a test strip onto the blood, and then get a reading on your meter. Checking your blood glucose will help you see how different things like food, exercise, and medications affect your blood glucose. It’s a snapshot of your diabetes that can help you make informed decisions like choosing a smaller meal at lunchtime or walking an extra 20 minutes in the evening when you get home from work. Eating healthy and staying active Learning about wholesome, nutritious foods and how to incorporate them into meals is a critical part of managing your diabetes. You may not have thought much about the nutritional benefits of certain foods before you were diagnosed with type 2 diabetes. After all, we all eat foods because they taste good. That’s the fun part! You don’t have to give up your favorite foods because you have diabetes. Instead, you may need to eat them in smaller portions or prepare them differently to reduce calories. You may also add a few new foods packed with nutritional punch like salmon, beets, and olive oil. Exercising also helps manage your diabetes by moving glucose out of the bloodstream and making your cells more sensitive to insulin. It boosts your mood and distracts you from everyday worries. Finding support Perhaps it sounds touchy-feely, but finding support is another important part of managing your diabetes. Support can mean so many different things — from chatting with online buddies on a message board to attending a diabetes education class. At some point, you may experience the very real feelings associated with diabetes distress, including fatigue, annoyance, and just plain burnout. Or you may experience more intense emotions of depression and/or an anxiety disorder. Talk to your healthcare provider about your feelings and concerns and seek support from a mental health professional or others with type 2 diabetes.

Article / Updated 07-09-2019

Cooking healthy meals is an essential skill to make good diabetes management easier. But there are days when eating at home just isn’t in the cards. Maybe you’re planning to go out to dinner with a group of friends, or you’re working late one evening and you won’t have the time or energy to cook when you get home. Or maybe you’d just like to enjoy a meal at your favorite restaurant. It’s important to know how to navigate restaurant menus for occasions like these. Dining out can be challenging for people with diabetes. When you prepare a healthy meal at home, you’re in the driver’s seat; you have complete control over the ingredients and cooking methods you use and the amount of food you serve yourself. You don’t have the same amount of control when you order food at a restaurant. But don’t worry! With a little advance planning and creative thinking, you can find a dish to fit your meal plan on almost any restaurant menu. In this chapter, we explore some tips and techniques to help you find the find the healthiest options when eating out. Research Your Restaurant Believe it or not, you can begin strategizing for your healthy restaurant meal before you even arrive at the restaurant. Take a few minutes before heading out the door to think about the restaurants in your area and select one that will make it easy for you to enjoy a healthy meal. If you’re not sure what kind of food a restaurant offers, call the restaurant or see if its menu is available online. The Internet is a helpful resource when you’re trying to plan restaurant meals — take advantage of it! Many restaurants now provide their full menu online, and most even include nutrition information. Ideally, you’ll want to look for a restaurant that offers a variety of different dishes featuring nutritious ingredients such as nonstarchy vegetables, whole grains, and lean proteins. If the restaurant you choose has nutrition information for its dishes available online, you’re one step ahead of the game! You can use this information to figure out exactly how different menu items will fit into your meal plan. It may be a good idea to identify a few options that will work for you before you leave home; that way, you’ll be less tempted to order unhealthy menu items when you get to the restaurant. Ask Your Server Even if you’re able to research the restaurant’s menu beforehand, you may have questions about the menu when you arrive. A dish may sound healthy on the menu, but there can be hidden sources of fat and calories in the dish that aren’t mentioned in the description of the item. Don’t be afraid to ask your server exactly what’s in the dish and how it’s prepared. Your server may not know all the ingredients or the cooking method offhand, but he or she can check with the chef. Knowing what goes into the dish you’re about to eat will give you a better understanding of how that dish will fit into your diabetes meal plan. If it sounds healthy on the menu, but it’s cooked in butter or has a lot of added sodium, you may want to look for another option. Communication with your server is important. If you’re having trouble finding good choices on the menu, he or she may be able to steer you in the right direction. Make Special Requests If you find a dish on the menu that sounds very appealing but has some less-than-healthy ingredients, feel free to make special requests and ask about substitutions. A few small changes to a dish can make all the difference when it comes to eating healthy, and most restaurants will be happy to accommodate your needs. If your dish comes with a choice of side items, look for the healthiest options available. That may mean choosing brown rice over white or fried rice, or steamed vegetables instead of mac and cheese. If you have more than one choice, why not double up on nonstarchy vegetables such as green beans, broccoli, cauliflower, asparagus, Brussels sprouts, or a side salad. Even if the menu doesn’t offer a choice of sides, you can request to replace starchy sides like fries, potatoes, and rice with healthier options. Many restaurant dishes are made with healthy ingredients but are cooked in a lot of fat or are topped with high-calorie sauces. Request that the chef leave any heavy sauce off your dish. Or ask the server if a dish can be steamed, grilled, or sautéed in a small amount of olive oil instead of fried or cooked in butter. If you’re watching your sodium intake, ask if your meal can be prepared without added salt. Don’t forget about condiments! Many condiments are sources of fat and carbohydrate. Request mustard on your burger instead of mayonnaise, or skip the dipping cups of barbecue sauce or ranch dressing. Ask your server if the restaurant has low-fat salad dressings that they can substitute for the full-fat version on your salad. Be respectful of your server, but don’t be shy about asking questions and making special requests. Be direct and polite and the restaurant should be able to accommodate your needs. Helpful Substitutions Swapping out some of the less-healthy ingredients in a dish for more nutritious options is a great way to enjoy the menu item you’re craving without disrupting your meal plan. There are a few common restaurant foods and ingredients that you’ll want to request substitutions for whenever you can. Here are a few common substitutions to get you started: Instead of … Try … Alfredo sauce Marinara sauce Cheese and/or bacon (on sandwiches) Extra fresh vegetables Cream-based soup Clear broth soup Flour tortillas Corn or whole-wheat tortillas Fried chicken strips Chicken kabobs or satay Fried mozzarella sticks Caprese (mozzarella and tomato) salad Fried rice Steamed brown rice Heavy sauces Sautéed mushrooms or onions Mayonnaise Mustard Meat pizza Veggie pizza Pan, deep-dish, or stuffed-crust pizza Thin-crust pizza Refried beans Black beans Sour cream Salsa Tempura meat or vegetables Steamed or grilled meat or vegetables Skip the Extras Even if you order a nutritious restaurant dish that fits into your meal plan, it can be easy to get off track when the free bread basket or chips and salsa arrive at the table. These items can contribute a significant amount of extra calories or carbohydrate to your meal. If you have the self-control to have just a bite of bread or a few chips, that’s fine. If not, you may want to skip these foods altogether and ask your server not to bring them to the table. Appetizers are another source of extra calories that you may want to avoid. If you’re really craving a certain appetizer, try to split it with others at the table so you only eat a small portion. Make sure you account for it in your meal plan. If you’re very hungry when you arrive at the restaurant, try ordering a side salad with low-fat dressing instead of ordering an appetizer or reaching for the bread basket. Don’t Drink Your Calories It can be tempting to order a regular soda, sweetened iced tea, or maybe even a cocktail with your dish, but these drinks can add a lot of calories and carbohydrate to your meal (which is likely already higher in calories than the meals you cook at home). Save those calories for the food on your plate. If you skip that 120-calorie serving of soda, you may have room in your meal plan to add an extra serving of nonstarchy vegetables to your plate; it’s the more satisfying and nutritious option. Remember that mixers in alcoholic beverages (besides diet soda) generally contain carbohydrate and calories as well. Try to stick with zero-calorie beverages when you eat out. Water is always a great choice, but you can try diet soda, sparkling water, unsweetened tea, or black coffee. Take Half Home Another key aspect of healthy restaurant eating is portion control. Restaurants today often serve customers huge portions of food, much more than the average person needs to eat. It’s up to you to make sure you don’t overeat. This is especially important if you’re indulging in a less-healthy menu item — but the calories and carbohydrate still add up if you eat a large portion of a healthier dish. If you’re concerned about the portion size of your meal, ask for a take-home container and pack up half of the food on your plate before you begin eating. You’ll be less likely to overeat if you have an appropriate portion of food in front of you. Out of sight, out of mind. Take the leftovers home and enjoy them for lunch or dinner the next day! Get Creative with the Menu When it comes to healthy restaurant eating, sometimes it’s helpful to think outside the box. Don’t feel pressure to order an entrée for yourself just because that’s what other people may be doing. Get creative with the menu! You may be able to build yourself a healthier meal using different menu options. For people trying to reduce their portion sizes, sharing an entrée (or even just an appetizer) with a friend or loved one is an option. Or you can choose a few healthy side dishes as your main dish. Believe it or not, the side dishes are sometimes the most nutritious items on a menu. Most sit-down restaurants offer at least one or two nonstarchy vegetable side dishes, and in some restaurants you may find beans, whole grains, or even lentils in the list of sides. And portion sizes for side dishes are generally small. Try selecting one or two healthy side options and maybe pairing them with a small salad or broth-based soup as your meal. Another idea for creating a healthy meal is to add extra nonstarchy vegetables to a dish. Add a side salad with light dressing to an entrée, for example, or ask to add extra fresh vegetables to a sandwich, wrap, or burger. Extra nonstarchy vegetables can add nutrients to your meal and may fill you up so you eat less of the other items on your plate. These are just a few ideas — don’t be afraid to take advantage of different menu option to create a meal that’s right for you. Order Takeout before You’re Hungry As with any restaurant meal, it’s important to make healthy food choices and watch your portions sizes when ordering takeout from a restaurant. But ordering takeout gives you added advantage: You can order your food before you’re hungry. It’s easier to choose nutritious foods and avoid overeating if you’re not starving when you order. If you know you’ll be ordering takeout, make a conscious effort to choose and order your food before you start feeling hungry. Some restaurants may even let you order a few hours in advance. Lock in your order early so you won’t be tempted by unhealthy options when you’re hungry later on. Choose Fast Foods Wisely Eating at fast-food restaurants can be particularly challenging for people with diabetes, so you may want to avoid fast-food restaurants when you can. But fast food may be a reality of your fast-paced lifestyle. There will be days when you’re extremely busy or you’re traveling and fast food seems like your only option. If you find yourself in this situation, here are a few tips that can help you make the healthiest possible choices: Order regular-size or “junior” sandwiches from the menu rather than “double” or “deluxe” items, which are often much larger. Avoid high-fat sandwich toppings like bacon, cheese, mayonnaise, and barbecue sauce. Opt instead for extra veggies and mustard. Opt for grilled or broiled fish and chicken instead of fried proteins and beef. They’re leaner. Avoid meal deals. They may seem like a bargain because you get more food for less, but what you’re really getting is large portions of fried foods and sugary beverages. Substitute a side salad or fresh fruit for fries if possible. Go bunless. Removing half or all of the bun from your sandwich can save you several grams of carbohydrate. Choose water, diet soda, unsweetened tea, or black coffee as your beverage. Remember that you can make special requests when ordering fast food, too! Don’t be afraid to ask the restaurant to accommodate your needs. Just be aware that it may take a few extra minutes for them to prepare a special order. If you find a healthy order that works for you at your favorite fast-food restaurant, remember it so you can easily order it again when you need to.

Article / Updated 11-05-2018

Some people have symptoms of diabetes or prediabetes before they're diagnosed, but many more never have any or realize that any symptoms they're having are related to diabetes. You need to recognize diabetes symptoms, both the classic and the subtle ones, to ensure that you get the necessary tests. Annual checkups— particularly when you're getting older — that measure your fasting blood glucose are important. That's only one way to diagnose it, and testing only fasting levels misses some people who experience spikes in their blood glucose after eating, although their morning levels are just fine. How to recognize diabetes symptoms The more classic symptoms of hyperglycemia, or elevated blood glucose levels, include increased thirst, excessive urination, unusual fatigue, blurred vision, unexplained hunger, rapid weight loss, and slow-healing cuts and infections. These symptoms are common in youth who develop type 1 diabetes rapidly. However, diabetes can have subtle symptoms and may go undetected for some time, particularly in adults who develop it slowly. If you or a loved one has complained recently about excessive thirst, frequent urination, or excessive hunger, schedule an appointment with your doctor or health care provider to check for diabetes. These symptoms aren't always indicative of diabetes. Sometimes elevated glucose levels can occur temporarily due to illness or medication use. Tests for diabetes and prediabetes Three main clinical methods are currently approved for diagnosing diabetes or prediabetes: fasting plasma glucose, oral glucose tolerance, and the A1C test (glycated hemoglobin). Any test that appears to indicate that you have either of these conditions should be repeated a second time (on another day) before your diagnosis is officially confirmed. Though this test isn't a usual official method, diabetes can sometimes be diagnosed when someone experiences the classic symptoms of hyperglycemia and has a random plasma glucose value of 200 mg/dL or higher. Fasting plasma glucose This simple blood test measures your blood glucose levels after an overnight fast of at least eight hours. It determines the amount of glucose in plasma, which is the clear part of the blood with all the red blood cells removed. The fasting value is reported (in the United States) in mg/dL, which is simply a measure of the amount of glucose (in milligrams, or mg) in a set amount of plasma (100 milliliters, which equals 1 deciliter, or dL). Outside of the United States or in research papers, it's reported as mmol/L (millimoles per liter, or sometimes mM). Note: To convert from mg/dL to mmol/L, divide the value in mg/dL by 18. The fasting plasma levels used for diagnosis are Normal: 70 to 99 mg/dL (3.9 to 5.5 mmol/L) Prediabetes: 100 to 125 mg/dL (5.6 to 6.9 mmol/L) Diabetes: 126 mg/dL (7.0 mmol/L) or above Prediabetes is diagnosed when your fasting glucose levels are elevated above normal (also known as impaired fasting glucose, or IFG). Diabetes is diagnosed when your fasting plasma glucose exceeds the prediabetes range. Being on the lower end of the normal range in the morning is always better, and you should take steps to lower it if it rises over time toward the high end of normal. Oral glucose tolerance An alternate testing method is the oral glucose tolerance test (OGTT), which involves drinking 75 grams of glucose and having your blood glucose monitored for two to three hours afterward. This approach tests your body's ability to respond to a large influx of sugar. If your blood glucose goes up or stays up too high for long from this oral sugar load, you're said to have impaired glucose tolerance (IGT). This test is used to diagnose diabetes, prediabetes, and gestational diabetes. Make sure to have your fasting blood glucose levels tested annually, and an A1C test (discussed in the following section) as well if you can swing it. A1C test (glycated hemoglobin) A third approved method to diagnose diabetes is to test your A1C (previously called glycated hemoglobin or hemoglobin A1C). The A1C indicates your average blood glucose over the past two or three months. Basically, the higher your blood glucose has been, the more glucose will be "stuck" to the hemoglobin part of red blood cells, and those blood cells live about 120 days. This simple blood test can also be used to diagnose prediabetes because it averages in post-meal spikes in your blood glucose that a fasting value may not detect. Finding out your risk for developing diabetes is important because complications can occur when your A1C test is still in the normal range (at the high end). How to interpret your diabetes test results The following table illustrates how the results of these tests are used to diagnose diabetes and prediabetes. Tests for Diabetes and Prediabetes Diabetes Diagnosis Fasting Plasma Glucose Oral Glucose Tolerance Test (OGTT) A1C Symptoms Type 1 ≥ 126 mg/dL (7.0 mM) 2-hour value: ≥ 200 mg/dL (11.1 mM) 6.5% or higher Classic symptoms of hyperglycemia or a random plasma glucose ≥ 200 mg/dL (11.1 mM) Type 2 ≥ 126 mg/dL (7.0 mM) 2-hour value: ≥ 200 mg/dL (11.1 mM) 6.5% or higher Classic symptoms of hyperglycemia or a random plasma glucose ≥ 200 mg/dL (11.1 mM) Gestational ≥ 92 mg/dL (5.1 mM) 1-hour value: ≥ 180 mg/dL (10.0 mM) or 2-hour value: ≥ 153 mg/dL (8.5 mM) Prediabetes 100–125 mg/dL (5.6–6.9 mM) 2-hour value: 140–199 mg/dL (7.8–11.0 mM) 5.7–6.4% Your test results can be confusing because you may not get diagnosed with diabetes with one test, but meet the criteria for another. To be considered as having diabetes, you only have to meet the criteria for one test. But then how your diabetes is managed may vary based on which category you met. For instance, if you just have elevated fasting levels but your A1C is okay, your doctor may put you on a medication that will lower your morning blood glucose. If your blood glucose shoots up after meals (as indicated by an oral glucose test), you may need a medication that makes your pancreas release more insulin when you eat but not at other times of day. Talk to your doctor or health care provider about your diagnosis and the best course of action to follow based on your test results. Test for gestational diabetes Gestational diabetes is typically tested for and diagnosed between 24 and 28 weeks of pregnancy with an oral glucose tolerance test. Managing it may involve using insulin or other medications, along with diet changes and regular exercise. All pregnant women should be screened for this condition no later than 28 weeks and possibly even earlier if it was diagnosed during previous pregnancies. Type 2 diabetes misdiagnosis Given the current diagnosis methods for diabetes, determining which kind of diabetes a person has can sometimes be difficult. In addition, diabetes can sometimes have other causes, such as pancreatic cancer or other rare conditions. Having excess body fat used to lead to an almost guaranteed diagnosis of type 2 diabetes, but that is no longer the case because people who develop type 1 are often overweight and can develop an insulin-resistant state related to weight gain, dietary choices, and physical inactivity. As many as 20 percent of adults who develop type 1 later in life may initially be misdiagnosed with type 2 due to their older age and slower onset. Being misdiagnosed because of your adult age is common, and you may initially respond well to oral diabetes medications (which further confuses the diagnosis). But you're not likely to be as insulin resistant as someone who has type 2 diabetes. If you're an extremely athletic adult (age 25 or older) and you were diagnosed with type 2 over the age of 18 while regularly active and at normal or near-normal body weight, you likely have a slow-onset form of type 1 diabetes instead. You can get antibody tests done to help make the diagnosis between type 1 and type 2. Knowing which you have can help because starting insulin therapy (rather than diabetes pills) early may help preserve your remaining beta cells for a little longer.

Article / Updated 06-14-2018

You don’t have to visit the coast to enjoy delicious seafood dishes! These recipes will help you fit rich, tasty seafood into your everyday diabetes meal plan. Fish and other kinds of seafood are a relatively lean type of protein, which makes them a good choice for people with diabetes; fish that contain omega-3 fatty acids (a “healthy” fat) are especially good options. However, when most people think of eating seafood, they probably picture battered, fried fish and shrimp or lobster soaked in melted butter. These kinds of seafood dishes are luxurious, but they can add a lot of unhealthy saturated fat to your diet. Try to avoid breaded and fried seafood and heavy sauces when choosing seafood options. Baked Garlic Scampi Preparation time: About 5 minutes Cook time: 10 minutes Servings: 4 Serving size: 3 ounces and 1/2 cup arugula Ingredients 1 tablespoon extra-virgin olive oil 1/4 teaspoon salt 7 garlic cloves, crushed 2 tablespoons chopped fresh parsley, divided 1 pound large shrimp, shelled (with tails left on) and deveined Juice and zest of 1 lemon 2 cups baby arugula Directions Preheat the oven to 350 degrees F. Grease a 13-x-9-x-2-inch baking pan with the olive oil. Add the salt, garlic, and 1 tablespoon of the parsley in a medium bowl; mix well and set aside. Arrange the shrimp in a single layer in the baking pan, and bake for 3 minutes, uncovered. Turn the shrimp, and sprinkle with the lemon peel, lemon juice, and the remaining 1 tablespoon of parsley. Continue to bake 1–2 minutes more until the shrimp are bright pink and tender. Remove the shrimp from the oven. Place the arugula on a serving platter, and top with the shrimp. Spoon the garlic mixture over the shrimp and arugula and serve. If possible, use fresh (never frozen) shrimp or shrimp that are free of preservatives — for example, shrimp that have not been treated with salt or sodium tripolyphosphate (STPP). Per serving: Choices/Exchanges 2 Lean Protein; Calories 110 (from Fat 30); Fat 3.5g (Saturated 0.5g, Trans 0.0g); Cholesterol 120mg; Sodium 220mg; Potassium 250mg; Total Carbohydrate 3g (Dietary Fiber 0g, Sugars 1g); Protein 16g; Phosphorus 165mg. Broiled Sole with Mustard Sauce Preparation time: About 5 minutes Cook time: 20 minutes Servings: 6 Serving size: 3 ounces with sauce Ingredients Nonstick cooking spray 1-1/2 pound fresh sole filets 3 tablespoons low-fat mayonnaise 2 tablespoons Dijon mustard 2 tablespoons chopped parsley 1/8 teaspoon freshly ground black pepper 1 large lemon, cut into wedges Directions Preheat broiler. Coat a baking sheet with nonstick cooking spray. Arrange the filets so they don’t overlap. In a small bowl, combine the mayonnaise, mustard, parsley, and pepper, and mix thoroughly. Spread the mixture evenly over the filets. Broil 3–4 inches from the heat for 4 minutes until the fish flakes easily with a fork. Arrange the filets on a serving platter, garnish with lemon wedges, and serve. Try this recipe over blanched broccoli or string beans. Chicken and salmon fillets work well with this recipe, too. Per serving: Exchanges 3 Lean Protein; Calories 120 (from Fat 20); Fat 2g (Saturated 0.4g, Trans 0.0g); Cholesterol 60 mg; Sodium 280mg; Potassium 330mg; Total Carbohydrate 2g (Dietary Fiber 0g, Sugars 1g); Protein 22g; Phosphorus 265mg. Flounder Parmesan Preparation time: About 5 minutes Cook time: 20 minutes Servings: 4 Serving size: 3–4 ounces Ingredients 1 tablespoon extra-virgin olive oil Four 4-ounce flounder filets 1 cup marinara sauce 1/4 cup freshly grated Parmigiano-Reggiano cheese 4 ounces skim milk mozzarella Directions Preheat the oven to 375 degrees F. Grease a baking dish with the olive oil and place the fish filets on the dish. Pour the Marina Sauce over the fish. Top with the Parmigiano-Reggiano Cheese and mozzarella. Bake for 12–15 minutes, or until the fish is cooked through and the mozzarella is bubbly. Transfer to a platter and serve. Per serving: Choices/Exchanges 1 Nonstarchy Vegetable, 4 Lean Protein, 1 Fat; Calories 250 (from Fat 100); Fat 11g (Saturated 4.7g, Trans 0.0g); Cholesterol 85mg; Sodium 310mg; Potassium 530mg; Total Carbohydrate 6g (Dietary Fiber 2g, Sugars 3g); Protein 31g; Phosphorus 450mg.