The simple meals and snacks in this 7-day meal plan feature some of the best foods for diabetes: complex carbohydrates (think whole grains and fresh fruits and vegetables), lean protein and healthy fats. We limited refined carbohydrates (like white bread, white pasta and white rice) as well as added sugars, which can spike your blood sugar quickly. We've also cut back on saturated fats and sodium, as they can negatively impact your health if you eat too much. What we definitely didn't skimp on is flavor. The meals and snacks in this diet plan feature fresh ingredients and plenty of herbs and spices that add flavor without adding extra sodium. You can plan to eat well over the course of this weekly meal plan. 
The earliest oral diabetes drugs were the sulfonylureas. These work by stimulating the pancreas to produce more insulin. The oldest of these drugs still on the market is chlorpropamide (Diabinese), which has been used for more than 50 years. The second-generation sulfonylureas are taken once or twice a day. They include glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, DiaBeta, Glynase), and glimepiride (Amaryl).

Thiazolidenediones can increase risk of heart failure and should not be used in patients with symptoms of heart failure. Liver enzymes should be checked regularly with use. Other side effects include weight gain, fatigue, swelling of the legs or ankles, increased risk for fractures in female patients. Avandia may have a potential increased risk for heart attack.
Because carbohydrates break down into glucose, they have the greatest impact on your blood glucose level. To help control your blood sugar, you may need to learn to calculate the amount of carbohydrates you are eating so that you can adjust the dose of insulin accordingly. It's important to keep track of the amount of carbohydrates in each meal or snack.

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Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 AD with type 1 associated with youth and type 2 with being overweight.[114] The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus which is also associated with frequent urination.[114] Effective treatment was not developed until the early part of the 20th century when the Canadians Frederick Banting and Charles Best discovered insulin in 1921 and 1922.[114] This was followed by the development of the long acting NPH insulin in the 1940s.[114]

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A random blood sugar of greater than 11.1 mmol/l (200 mg/dl) in association with typical symptoms[23] or a glycated hemoglobin (HbA1c) of ≥ 48 mmol/mol (≥ 6.5 DCCT %) is another method of diagnosing diabetes.[10] In 2009 an International Expert Committee that included representatives of the American Diabetes Association (ADA), the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes (EASD) recommended that a threshold of ≥ 48 mmol/mol (≥ 6.5 DCCT %) should be used to diagnose diabetes.[50] This recommendation was adopted by the American Diabetes Association in 2010.[51] Positive tests should be repeated unless the person presents with typical symptoms and blood sugars >11.1 mmol/l (>200 mg/dl).[50]

Large changes in your blood glucose levels over the past month will show up in your A1C test result, but the A1C test doesn’t show sudden, temporary increases or decreases in blood glucose levels. Even though A1C results represent a long-term average, blood glucose levels within the past 30 days have a greater effect on the A1C reading than those in previous months.
You should report any side effects that are not listed in the patient information leaflet to your doctor. In the case of type 1 diabetes this is likely unless research finds an alternative treatment. It is not so uncommon for people with type 2 diabetes to come off medication. This is particularly a possibility for people who have successfully lost a lot of weight.

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It’s important to look at all of your glucose values to get the big picture — not just a single point in time. By doing so, you can spot trends (for example, your fasting blood glucose levels are consistently above target or you tend to go low every afternoon around 4pm). Your numbers are information for both you and your health-care team to learn how your diabetes treatment plan (medication, food intake, physical activity) are working for you. Bring your logs or, at least, your meter to all of your regular provider visits and make sure your provider looks at your numbers.
Your blood glucose goals may be different, however. If you’re younger, have had diabetes for a shorter amount of time or are not taking any medicine for your diabetes, your glucose goals might be a little “tighter,” or lower. Likewise, your blood glucose goals may be higher than what ADA recommends if you’re older, have diabetes complications, or don’t get symptoms when your blood glucose is low.

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^ Schwingshackl, Lukas; Hoffmann, Georg; Lampousi, Anna-Maria; Knüppel, Sven; Iqbal, Khalid; Schwedhelm, Carolina; Bechthold, Angela; Schlesinger, Sabrina; Boeing, Heiner (2017-04-10). "Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies". European Journal of Epidemiology. 32 (5): 363–375. doi:10.1007/s10654-017-0246-y. ISSN 0393-2990. PMC 5506108. PMID 28397016.

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How it works: Helps insulin work better in muscle and fat. It lowers the amount of sugar the liver releases and makes fat cells more sensitive to insulin’s effects. It may take a few weeks for these drugs to lower blood sugar. Your doctor should talk with you about heart risks with this type of drug, which he may call “thiazolidinediones.” Side effects from this type of drug are rare but may include:

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Talk to your doctor about your child's risk for diabetes. If your child's blood sugar tests are higher than normal, but not yet at the level of diabetes (called prediabetes), your doctor may instruct you in specific diet and exercise changes to help your child avoid getting diabetes altogether. Children with type 2 diabetes or prediabetes are almost always overweight or obese.

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Nuts make an excellent snack, but only if you feel hungry in between meals. They taste great even when added to oatmeal, salads and curries. An American Society for Nutrition study from 2008 revealed that nuts have the potential to improve blood lipid profile to reduce the risk of coronary heart disease and type 2 diabete. Choose from walnuts, pine nuts, almonds, hazelnut, peanuts and pistachio. Steer clear of packaged nuts with added fats and sugars. The best kinds of nuts are the organic and least processed kinds.

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Diabetes is one of the first diseases described[21] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine."[114] The first described cases are believed to be of type 1 diabetes.[114] Indian physicians around the same time identified the disease and classified it as madhumeha or honey urine noting that the urine would attract ants.[114] The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Apollonius Of Memphis.[114] The disease was rare during the time of the Roman empire with Galen commenting that he had only seen two cases during his career.[114]

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The Mediterranean style eating pattern focuses on mostly plant-based foods like vegetables, fruit, whole grains, cereals, nuts, seeds, and beans, seasonally fresh, and locally grown foods. Olive oil is the main source of fat.  This eating pattern also includes a small amount of dairy products, such as cheese and yogurt, fish, and poultry. Red meat is limited. Wine can be consumed in small amounts (1-2 glasses of wine per day) with meals. 

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When using the A1C test for diagnosis, your doctor will send your blood sample taken from a vein to a lab that uses an NGSP-certified method. The NGSP, formerly called the National Glycohemoglobin Standardization Program, certifies that makers of A1C tests provide results that are consistent and comparable with those used in the Diabetes Control and Complications Trial.

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Oral diabetes medications may also come in combination tablets such as Metaglip (glipizide/metformin), Prandimet (repaglinide/metformin), Glucovance (glyburide/metformin), Janumet (sitagliptin/metformin), Avandamet (rosiglitazone/metformin), Avandaryl (rosiglitazone/ glimepiride), Duetact (pioglitazone/glimepiride), Actoplus Met (pioglitazone/metformin).

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Depending on your diabetes treatment plan, your doctor or diabetes educator may advise you to check once a week, once a day or up to 10 times a day (hint: if they don’t tell you, ask!). But what does it mean when you see a 67, 101 or 350 on your meter? And what is a “normal” blood sugar, anyway? Great questions! After all, if you don’t know what the numbers on your meter mean, it’s hard to know how you’re doing.

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In the short term, high blood glucose levels can make you feel downright bad. Thirst, frequent trips to the bathroom, fatigue and weight loss are all symptoms of high blood glucose (hyperglycemia). If not treated, more serious issues can occur, such as diabetic ketoacidosis. Chronic high blood glucose levels can lead to complications such as heart, kidney and eye disease, as well as nerve damage. So, it’s all about the blood glucose.

Diabetes can cause major health problems if you do not keep your blood sugar in check. However, you can stay healthy and feel good despite your diagnosis if you follow your doctor's recommended treatment plan and maintain a healthy lifestyle. By choosing foods wisely, exercising regularly, maintaining a normal weight, reducing your stress level, and making other modest lifestyle changes, living with diabetes will be easier.

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^ Jump up to: a b c Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, Stevenson B, Furness S, Iheozor-Ejiofor Z (November 2015). "Treatment of periodontal disease for glycaemic control in people with diabetes mellitus". The Cochrane Database of Systematic Reviews (11): CD004714. doi:10.1002/14651858.CD004714.pub3. PMID 26545069.

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Your doctor will check them for redness, cracks, sores, or open wounds. He'll look for weird problems (like overlapping toes); and he'll do a monofilament test. You’ll close your eyes and he'll simply press a piece of nylon to various parts of your foot. If you can’t feel it, you might have nerve damage. He may also tap on your Achilles tendon to see if the nerves on the back of your ankle are in good condition. A clue that they are? Your foot will point downward automatically.

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Ignore the fads. Give your body a break between the three main meals of the day. Let it get sensitive to insulin again. Let your body burn fat for energy between meals. No doubt, it takes a little getting used to. But, if you make sure that your diet has the good fats your body needs, it will respond by learning to use fats, instead of craving sugar.

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^ Nield L, Summerbell CD, Hooper L, Whittaker V, Moore H (July 2008). Nield L (ed.). "Dietary advice for the prevention of type 2 diabetes mellitus in adults". The Cochrane Database of Systematic Reviews (3): CD005102. doi:10.1002/14651858.CD005102.pub2. hdl:10149/92337. PMID 18646120. (Retracted, see doi:10.1002/14651858.cd005102.pub3. If this is an intentional citation to a retracted paper, please replace {{Retracted}} with {{Retracted|intentional=yes}}.)

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Because carbohydrates break down into glucose, they have the greatest impact on your blood glucose level. To help control your blood sugar, you may need to learn to calculate the amount of carbohydrates you are eating so that you can adjust the dose of insulin accordingly. It's important to keep track of the amount of carbohydrates in each meal or snack.
Eating more protein helps you to stay full for longer durations, lose weight and keep your blood sugar levels stable through the day. Since proteins are harder to digest than carbs, they offer sustained energy throughout the day and keep mindless snacking at bay. However, not all meats are the same. Choose lean cuts of meat that aren’t laden with animal fats. Completely eliminate processed meats like bacon, sausages, salami and other cold-cuts from your diet. Instead, focus on fresh chicken, turkey, fish and lean cuts of lamb. If you must eat red meat (we see no real reason to), limit it to no more than two servings a week.

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A low carbohydrate eating pattern focuses on non-starchy vegetables such as broccoli, green beans, kale, salad greens and protein foods like meat, poultry, fish, shellfish, eggs, cheese, nuts and seeds, fats (oils, butter, olives and avocado). Highly processed carbohydrate foods and grains are limited or avoided in this eating pattern.  There is no standard at this time for the grams of carbohydrate in a low-carb eating pattern and research continues to look at the effects of this eating pattern on diabetes. Work with a registered dietitian who can talk with you about your current eating habits and help you figure out the plan that will work best for you.  

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If you have diabetes, your HbA1c level may be done every 2-6 months by your doctor or nurse. This test measures your recent average blood sugar (glucose) level. Because it is an average measurement you do NOT need to fast on the day of the test. The test measures a part of the red blood cells. Glucose in the blood attaches to part of the red blood cells. This part can be measured and gives a good indication of your average blood glucose over the previous 2-3 months.
When using the A1C test for diagnosis, your doctor will send your blood sample taken from a vein to a lab that uses an NGSP-certified method. The NGSP, formerly called the National Glycohemoglobin Standardization Program, certifies that makers of A1C tests provide results that are consistent and comparable with those used in the Diabetes Control and Complications Trial.
High blood sugar (hyperglycemia). Lots of things can cause your blood sugar to rise, including eating too much, being sick or not taking enough glucose-lowering medication. Watch for signs and symptoms of high blood sugar — frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea — and check your blood sugar if necessary.

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If you have diabetes, your HbA1c level may be done every 2-6 months by your doctor or nurse. This test measures your recent average blood sugar (glucose) level. Because it is an average measurement you do NOT need to fast on the day of the test. The test measures a part of the red blood cells. Glucose in the blood attaches to part of the red blood cells. This part can be measured and gives a good indication of your average blood glucose over the previous 2-3 months.

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Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). If you're taking medication that lowers your blood sugar, including insulin, your blood sugar level can drop for many reasons, including skipping a meal and getting more physical activity than normal. Low blood sugar also occurs if you take too much insulin or an excess of a glucose-lowering medication that promotes the secretion of insulin by your pancreas.

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Another non-insulin injection for people with diabetes is exenatide (Byetta). This medication, originally derived from a compound found in the saliva of the Gila monster, triggers insulin release from the pancreas when blood glucose levels rise. Exenatide is meant to be used along with oral diabetes drugs. It is dosed twice daily and should be injected within an hour of the morning and evening meals. Recently, the FDA warned that exenatide may increase the risk of severe even fatal pancreatitis (inflammation of the pancreas) and that the drug should be discontinued and not restarted if signs and symptoms of pancreatitis develop (severe abdominal pain, for example). It is not for use in people with type 1 diabetes.

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Check your blood sugar level regularly, and watch for signs and symptoms of low blood sugar — sweating, shakiness, weakness, hunger, dizziness, headache, blurred vision, heart palpitations, irritability, slurred speech, drowsiness, confusion, fainting and seizures. Low blood sugar is treated with quickly absorbed carbohydrates, such as fruit juice or glucose tablets.

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Your blood glucose goals may be different, however. If you’re younger, have had diabetes for a shorter amount of time or are not taking any medicine for your diabetes, your glucose goals might be a little “tighter,” or lower. Likewise, your blood glucose goals may be higher than what ADA recommends if you’re older, have diabetes complications, or don’t get symptoms when your blood glucose is low.

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^ Schwingshackl, Lukas; Hoffmann, Georg; Lampousi, Anna-Maria; Knüppel, Sven; Iqbal, Khalid; Schwedhelm, Carolina; Bechthold, Angela; Schlesinger, Sabrina; Boeing, Heiner (2017-04-10). "Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies". European Journal of Epidemiology. 32 (5): 363–375. doi:10.1007/s10654-017-0246-y. ISSN 0393-2990. PMC 5506108. PMID 28397016.

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About Diabetes, Type 2:  Type 2 diabetes is characterized by "insulin resistance" as body cells do not respond appropriately when insulin is present. This is a more complex problem than type 1, but is sometimes easier to treat, since insulin is still produced, especially in the initial years. Type 2 may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder (no ketoacidosis) and can be sporadic. However, severe complications can result from unnoticed type 2 diabetes, including renal failure, and coronary artery disease. Type 2 diabetes was formerly known by a variety of partially misleading names, including "adult-onset diabetes", "obesity-related diabetes", "insulin-resistant diabetes", or "non-insulin-dependent diabetes" (NIDDM). It may be caused by a number of diseases, such as hemochromatosis and polycystic ovary syndrome, and can also be caused by certain types of medications (e.g. long-term steroid use). About 90-95% of all North American cases of diabetes are type 2, and about 20% of the population over the age of 65 is a type 2 diabetic. The fraction of type 2 diabetics in other parts of the world varies substantially, almost certainly for environmental and lifestyle reasons. There is also a strong inheritable genetic connection in type 2 diabetes: having relatives (especially first degree) with type 2 is a considerable risk factor for developing type 2 diabetes. The majority of patients with type 2 diabetes mellitus are obese - chronic obesity leads to increased insulin resistance that can develop into diabetes, most likely because adipose tissue is a (recently identified) source of chemical signals (hormones and cytokines).

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It’s estimated that almost 50% of the American population has diabetes or prediabetes – a condition where blood sugar is higher than normal levels. It is accompanied by insulin resistance, a risk factor for full-blown diabetes, and other health complications. National Health and Nutrition Examination Survey (NHANES) data estimates the recent prevalence of total diabetes, diagnosed diabetes and undiagnosed diabetes’ US trends to be 12-14% among US adults.

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Check your blood sugar level regularly, and watch for signs and symptoms of low blood sugar — sweating, shakiness, weakness, hunger, dizziness, headache, blurred vision, heart palpitations, irritability, slurred speech, drowsiness, confusion, fainting and seizures. Low blood sugar is treated with quickly absorbed carbohydrates, such as fruit juice or glucose tablets.
Tuna melt: Top 1 toasted whole grain English muffin with ¼ c tuna mixed with 1 tsp mayonnaise (or 1 Tbsp light mayonnaise), 1 Tbsp minced dill pickle and/or chopped celery and 1 oz reduced-fat cheese. Place in pre-heated oven (450ºF) for 5 to 10 minutes (or microwave for 30 seconds until cheese melts).  Serve with 8 baby carrots with 2 Tbsp reduced fat ranch dressing, and 1 c fat-free milk or calcium-enriched soy beverage.
You should report any side effects that are not listed in the patient information leaflet to your doctor. In the case of type 1 diabetes this is likely unless research finds an alternative treatment. It is not so uncommon for people with type 2 diabetes to come off medication. This is particularly a possibility for people who have successfully lost a lot of weight.
Injections of insulin may either be added to oral medication or used alone.[24] Most people do not initially need insulin.[13] When it is used, a long-acting formulation is typically added at night, with oral medications being continued.[23][24] Doses are then increased to effect (blood sugar levels being well controlled).[24] When nightly insulin is insufficient, twice daily insulin may achieve better control.[23] The long acting insulins glargine and detemir are equally safe and effective,[102] and do not appear much better than neutral protamine Hagedorn (NPH) insulin, but as they are significantly more expensive, they are not cost effective as of 2010.[103] In those who are pregnant insulin is generally the treatment of choice.[23]

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For people with diabetes, treatment aims to lower the HbA1c level to below a target level which is usually agreed between you and your doctor. Ideally, the aim is to maintain your HbA1c to less than 48 mmol/mol (6.5%). However, this may not always be possible to achieve and the target level of HbA1c should be agreed on an individual basis between you and your doctor. (For example, by increasing the dose of medication, improving your diet, etc.)

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For this test, you fast overnight. In the morning you are given a drink which contains 75 g of glucose. A blood sample is taken two hours later. Normally, your body should be able to deal with the glucose and your blood level should not go too high. A glucose level of 11.1 mmol/L or more in the blood sample taken after two hours indicates that you have diabetes. See separate leaflet called Glucose Tolerance Test for more details.

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