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Expert Q&A: A Healthy Diet for Type 2 Diabetes

An interview with Hope Warshaw, MMSc, RD.
WebMD Feature
Reviewed by Louise Chang, MD

Here's some good news: Healthy eating can have a dramatic impact on the symptoms and progression of type 2 diabetes and its frequent precursor, prediabetes. But the problem is that there's a lot of conflicting information out there. Just what does healthy eating with type 2 diabetes really mean? No sweets? Scheduled snacks? Low-fat, low-carb -- or neither?

To help guide you, WebMD turned to Hope Warshaw, MMSc, RD, CDE. She's been a dietitian and diabetes educator for almost 30 years, and is the author of numerous books on the subject, including Diabetes Meal Planning Made Easy, published by the American Diabetes Association.


How does a healthy eating plan for someone with type 2 diabetes differ from what everyone else should be eating?

It doesn't. The nutrition recommendations from the American Diabetes Association echo the healthy eating guidelines for the general public. Everyone should be eating more whole grains, fruits, and vegetables and less saturated and trans fat. Remember that the type of fat matters to your heart and blood vessels. We've moved away from recommending a strict low-fat diet and shifted toward an eating plan that allows for a moderate amount of fat, provided you choose healthier fats, like monounsaturated and polyunsaturated fats.

If you have diabetes and are trying to lose weight, don't take the drastic diet approach, like a low-carb diet. It might help you lose weight in the short-term, but there's not good evidence that it will help you keep it off. Here's my point: You're going to have diabetes for the rest of your life. You need to be thinking about minor doable changes in your eating habits that you can really maintain. Even small steps towards healthier eating result in big rewards, like lower blood glucose and improved blood pressure and lipids.

You also don't need a special diet to tell you how to eat healthy. Most people -- especially people reading WebMD -- already know. The big challenge is actually doing it day after day, year after year. 

What is the connection between diabetes and heart and blood vessel diseases?

The connection is huge. It is said that diabetes is a cardiovascular disease. But lots of people haven't realized it yet. They worry more about diabetes affecting their eyesight and kidneys. Yes, that can happen. But the fact is that people with diabetes suffer and die much more from heart and blood vessel disease. That's the real issue.

This is the key reason there's been a big change in the focus of diabetes management. It's no longer just about glucose control. It's at least -- if not more -- important for people to focus on controlling blood pressure and blood lipids, particularly LDL cholesterol. By the time someone gets diagnosed with diabetes, he or she may have already been living with serious risk factors for heart and blood vessel disease for years.

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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