Diabetes Information Center
Comprehensive guide to understanding and managing diabetes
Diabetes Overview
Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. Most of the food you eat is broken down into sugar (glucose) and released into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin.
What Happens in Diabetes?
In diabetes, your body either doesn't make enough insulin or can't use the insulin it makes as well as it should. When there isn't enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream, which can lead to serious health problems over time.
Main Types of Diabetes
- Type 1 Diabetes: An autoimmune condition where the body attacks insulin-producing cells in the pancreas.
- Type 2 Diabetes: A condition where the body becomes resistant to insulin or doesn't produce enough insulin.
- Gestational Diabetes: Diabetes that develops during pregnancy in women who didn't previously have diabetes.
- Prediabetes: A condition where blood sugar levels are higher than normal but not high enough to be classified as diabetes.
Type 1 Diabetes
Type 1 diabetes is a chronic autoimmune condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy.
Key Facts
- Previously known as juvenile diabetes or insulin-dependent diabetes
- Can develop at any age but most commonly appears in childhood or adolescence
- Accounts for about 5-10% of all diabetes cases
- Requires lifelong insulin therapy
- Currently no known way to prevent type 1 diabetes
Type 1 Diabetes: Symptoms & Causes
Symptoms
- Increased thirst
- Frequent urination
- Extreme hunger
- Unintended weight loss
- Irritability and other mood changes
- Fatigue and weakness
- Blurred vision
- Bed-wetting in children who previously didn't wet the bed
Causes
The exact cause of type 1 diabetes is unknown. In most people with type 1 diabetes, the body's immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet) cells in the pancreas. Genetics and environmental factors appear to play a role in this process.
Type 1 Diabetes: Diagnosis
Several blood tests can be used to diagnose type 1 diabetes:
Common Tests
- Glycated hemoglobin (A1C) test: Measures average blood sugar level over the past 2-3 months.
- Random blood sugar test: Blood sample taken at a random time.
- Fasting blood sugar test: Blood sample taken after an overnight fast.
- Autoantibody tests: To distinguish between type 1 and type 2 diabetes.
Diagnostic Criteria
- A1C level of 6.5% or higher on two separate tests
- Fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher
- Random blood sugar of 200 mg/dL (11.1 mmol/L) or higher with symptoms
Type 1 Diabetes: Management & Treatment
Treatment for type 1 diabetes involves insulin therapy, blood sugar monitoring, carbohydrate counting, and maintaining a healthy diet and exercise routine.
Insulin Therapy
All people with type 1 diabetes need insulin therapy to survive. Types of insulin include:
- Rapid-acting insulin: Begins working in about 15 minutes (e.g., insulin lispro, insulin aspart)
- Short-acting insulin: Reaches bloodstream in 30 minutes (e.g., regular insulin)
- Intermediate-acting insulin: Works in 2-4 hours (e.g., NPH insulin)
- Long-acting insulin: Works over 24 hours (e.g., insulin glargine, insulin detemir)
Other Treatments
- Continuous glucose monitoring (CGM)
- Insulin pumps
- Artificial pancreas systems
- Pancreas or islet cell transplantation (in rare cases)
Type 1 Diabetes: Food Guidelines
People with type 1 diabetes need to balance their insulin doses with the carbohydrates they eat. The focus is on consistent carbohydrate intake and matching insulin to food.
Recommended Foods
| Food Category | Examples | Notes |
|---|---|---|
| Non-starchy vegetables | Spinach, broccoli, carrots, peppers, tomatoes | Low in carbs, high in nutrients |
| Lean proteins | Chicken, turkey, fish, eggs, tofu | Help maintain muscle mass |
| Healthy fats | Avocados, nuts, seeds, olive oil | Help with satiety and nutrient absorption |
| Whole grains | Quinoa, brown rice, whole wheat bread | Higher fiber content slows glucose absorption |
| Low-sugar fruits | Berries, apples, pears, citrus fruits | Contain fiber and important nutrients |
Foods to Limit
| Food Category | Examples | Notes |
|---|---|---|
| Refined carbohydrates | White bread, white rice, regular pasta | Can cause rapid blood sugar spikes |
| Sugary foods | Candy, cookies, cakes, soda | Require careful insulin dosing |
| Processed foods | Packaged snacks, frozen meals | Often high in hidden sugars and unhealthy fats |
| High-fat meats | Bacon, sausage, ribs | Can contribute to insulin resistance |
Foods to Avoid
| Food Category | Examples | Notes |
|---|---|---|
| Sugary drinks | Regular soda, fruit juice, sweet tea | Cause rapid blood sugar spikes |
| Trans fats | Fried foods, margarine, shortening | Increase heart disease risk |
| High-sodium foods | Processed meats, canned soups, fast food | Can raise blood pressure |
Meal Planning Tips
- Count carbohydrates carefully to match insulin doses
- Eat at consistent times each day
- Balance meals with protein, healthy fats, and fiber
- Monitor blood sugar before and after meals
- Stay hydrated with water and unsweetened beverages
- Work with a dietitian to create a personalized meal plan
Type 1 Diabetes: Living With
Daily Management
- Check blood sugar levels frequently (4-10 times daily)
- Administer insulin as prescribed
- Count carbohydrates in meals and snacks
- Maintain a balanced diet
- Exercise regularly
- Manage stress levels
Complications Prevention
Keeping blood sugar levels as close to normal as possible can help prevent or delay complications:
- Heart and blood vessel disease
- Nerve damage (neuropathy)
- Kidney damage (nephropathy)
- Eye damage (retinopathy)
- Foot damage
- Skin and mouth conditions
- Pregnancy complications
Type 2 Diabetes
Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin or doesn't produce enough insulin to maintain normal glucose levels.
Key Facts
- Previously known as adult-onset diabetes
- Most common form of diabetes (90-95% of cases)
- Can develop at any age, though more common in middle-aged and older adults
- Often associated with obesity and physical inactivity
- Can sometimes be managed with lifestyle changes alone
Type 2 Diabetes: Symptoms & Causes
Symptoms
- Increased thirst
- Frequent urination
- Increased hunger
- Unintended weight loss
- Fatigue
- Blurred vision
- Slow-healing sores
- Frequent infections
- Areas of darkened skin (acanthosis nigricans)
- Tingling or numbness in hands or feet
Causes
Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Exactly why this happens is unknown, although genetics and environmental factors, such as excess weight and inactivity, seem to be contributing factors.
Type 2 Diabetes: Diagnosis
Type 2 diabetes is usually diagnosed using the same blood tests as type 1 diabetes:
Common Tests
- Glycated hemoglobin (A1C) test: Measures average blood sugar level over the past 2-3 months.
- Random blood sugar test: Blood sample taken at a random time.
- Fasting blood sugar test: Blood sample taken after an overnight fast.
- Oral glucose tolerance test: Measures blood sugar before and after drinking a sugary liquid.
Diagnostic Criteria
- A1C level of 6.5% or higher on two separate tests
- Fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher
- Random blood sugar of 200 mg/dL (11.1 mmol/L) or higher with symptoms
- 2-hour blood sugar of 200 mg/dL (11.1 mmol/L) or higher during OGTT
Type 2 Diabetes: Management & Treatment
Management of type 2 diabetes includes healthy eating, regular exercise, blood sugar monitoring, and possibly diabetes medication or insulin therapy.
Lifestyle Changes
- Healthy eating: Focus on fruits, vegetables, whole grains, and lean proteins
- Physical activity: Aim for at least 150 minutes of moderate aerobic activity per week
- Weight loss: Losing even 5-10% of body weight can make a difference
- Blood sugar monitoring: Regular checks to ensure levels stay in target range
Medications
Common diabetes medications include:
- Metformin: First-line medication that improves insulin sensitivity
- Sulfonylureas: Help the body secrete more insulin
- GLP-1 receptor agonists: Injectable medications that slow digestion and lower blood sugar
- SGLT2 inhibitors: Help the kidneys remove sugar from the body
- Insulin therapy: May be needed as the disease progresses
Type 2 Diabetes: Food Guidelines
For type 2 diabetes, the focus is on foods that help control blood sugar, support weight management, and prevent complications.
Recommended Foods
| Food Category | Examples | Notes |
|---|---|---|
| Non-starchy vegetables | Leafy greens, broccoli, cauliflower, zucchini | Low in calories and carbs, high in fiber |
| Lean proteins | Fish, skinless poultry, eggs, legumes | Help with satiety and blood sugar control |
| Healthy fats | Olive oil, avocados, nuts, seeds | Improve insulin sensitivity |
| High-fiber foods | Whole grains, beans, lentils, berries | Slow glucose absorption |
| Low-fat dairy | Greek yogurt, cottage cheese, skim milk | Good source of protein and calcium |
Foods to Limit
| Food Category | Examples | Notes |
|---|---|---|
| Refined grains | White bread, white rice, regular pasta | Can spike blood sugar levels |
| Sweetened beverages | Soda, fruit juice, sweet tea | High in sugar and calories |
| Processed snacks | Chips, crackers, cookies | Often high in unhealthy fats and refined carbs |
| High-fat meats | Bacon, sausage, hot dogs | Can contribute to insulin resistance |
Foods to Avoid
| Food Category | Examples | Notes |
|---|---|---|
| Trans fats | Fried foods, margarine, shortening | Increase heart disease risk |
| High-sugar foods | Candy, pastries, ice cream | Cause blood sugar spikes |
| Processed meats | Deli meats, sausages, bacon | Linked to increased diabetes complications |
Meal Planning Tips
- Use the plate method: ½ non-starchy vegetables, ¼ protein, ¼ whole grains
- Choose high-fiber carbohydrates
- Limit portion sizes to manage calorie intake
- Eat at regular intervals throughout the day
- Stay hydrated with water and unsweetened beverages
- Read food labels carefully for hidden sugars
- Cook at home more often to control ingredients
Type 2 Diabetes: Living With
Daily Management
- Monitor blood sugar levels as recommended by your doctor
- Take medications as prescribed
- Follow a healthy meal plan
- Engage in regular physical activity
- Manage stress effectively
- Get regular check-ups (eyes, feet, kidneys, etc.)
Complications Prevention
Good diabetes management can help prevent or delay complications:
- Cardiovascular disease
- Nerve damage (neuropathy)
- Kidney damage (nephropathy)
- Eye damage (retinopathy)
- Foot damage
- Skin conditions
- Hearing impairment
- Alzheimer's disease
Common Diabetes Symptoms
While symptoms can vary between type 1 and type 2 diabetes, there are several common warning signs:
- Increased thirst (Polydipsia): Excess sugar building up in your bloodstream causes fluid to be pulled from your tissues.
- Frequent urination (Polyuria): As a result of increased thirst, you may drink and urinate more than usual.
- Extreme hunger (Polyphagia): Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy.
- Unexplained weight loss: Despite eating more than usual to relieve hunger, you may lose weight.
- Fatigue: If your cells are deprived of sugar, you may become tired and irritable.
- Blurred vision: High blood sugar levels can cause the lens of your eye to swell, changing your ability to focus.
- Slow-healing sores or frequent infections: Diabetes affects your ability to heal and resist infections.
- Tingling or numbness in hands or feet: High blood sugar can affect circulation and nerve function.
- Red, swollen, tender gums: Diabetes may weaken your ability to fight germs.
- Areas of darkened skin: Some people with type 2 diabetes have patches of dark, velvety skin.
Emergency Symptoms
Seek immediate medical attention if you experience:
- Nausea and vomiting
- Abdominal pain
- Deep, rapid breathing
- Fruity-smelling breath
- Confusion or drowsiness
Diabetes Prevention
While type 1 diabetes can't be prevented, you can take steps to prevent or delay type 2 diabetes:
Lifestyle Changes for Prevention
- Lose extra weight: Losing 7-10% of your body weight can cut your risk in half.
- Be physically active: Aim for at least 30 minutes of moderate exercise most days.
- Eat healthy plant foods: Focus on fruits, vegetables, whole grains, and legumes.
- Choose healthy fats: Opt for polyunsaturated fats found in nuts, seeds, and vegetable oils.
- Skip fad diets: Make sustainable, long-term changes instead.
- Get regular check-ups: Especially if you're over 45 or have other risk factors.
Specific Recommendations
- Diet: Choose foods low in fat and calories and high in fiber.
- Exercise: Combine aerobic exercise with resistance training.
- Smoking: Quit smoking to improve your overall health.
- Alcohol: If you drink, do so in moderation.
- Sleep: Aim for 7-8 hours of quality sleep each night.
- Stress management: Practice relaxation techniques like meditation or yoga.
For People with Prediabetes
The Diabetes Prevention Program (DPP) study showed that people with prediabetes who lost 5-7% of their body weight and added 150 minutes of exercise per week cut their risk of developing diabetes by 58%.
General Diabetes Food Guidelines
While individual needs may vary, these general guidelines can help people with diabetes make healthy food choices:
Basic Principles of Diabetes Nutrition
- Focus on non-starchy vegetables
- Include lean protein in each meal
- Choose healthy fats
- Select high-fiber carbohydrates
- Limit added sugars and refined grains
- Control portion sizes
- Stay hydrated with water
Diabetes Superfoods
- Fatty fish: Salmon, mackerel, sardines (rich in omega-3s)
- Leafy greens: Spinach, kale, collards (low in calories and carbs)
- Avocados: Healthy fats that improve insulin sensitivity
- Eggs: Improve insulin sensitivity and reduce inflammation
- Chia seeds: High in fiber and omega-3 fatty acids
- Beans: Excellent source of plant-based protein and fiber
- Greek yogurt: Probiotics may help with blood sugar control
- Nuts: Almonds, walnuts, pistachios (healthy fats and fiber)
- Broccoli: Low in carbs and high in nutrients
- Extra-virgin olive oil: Reduces heart disease risk
Sample Meal Plan
| Meal | Option 1 | Option 2 |
|---|---|---|
| Breakfast | Greek yogurt with berries and nuts | Vegetable omelet with whole grain toast |
| Morning Snack | Apple slices with almond butter | Handful of mixed nuts |
| Lunch | Grilled chicken salad with olive oil dressing | Lentil soup with whole grain crackers |
| Afternoon Snack | Carrot and celery sticks with hummus | Cottage cheese with cucumber slices |
| Dinner | Baked salmon with quinoa and roasted vegetables | Grilled turkey burger with sweet potato and steamed broccoli |
| Evening Snack | Handful of walnuts | Small pear with cheese slices |
Tips for Eating Out
- Check the menu online before going
- Ask about preparation methods
- Request substitutions (extra vegetables instead of fries)
- Ask for dressings and sauces on the side
- Share entrees or take half home
- Limit alcoholic beverages
- Don't be afraid to ask questions about ingredients
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