Controlling Type 2 Diabetes Through Diet - Expert's Panel

Diabetes management can be efficiently done by following the right diet, being active, getting enough sleep, perhaps, in some cases, taking medication as prescribed by your doctor. So many factors have to be taken into consideration when it comes to regulating your blood sugar levels in order to avoid the lows and the highs.

It is recommended by experts that one keep their blood sugars in control by diet, as in, eating healthy. For that, you have to make some healthy choices.

But with so many internet articles and blogs about diabetes and eating healthy out there, who do you listen to? Who should you trust? What do you eat? What should you avoid? One small mistake and you can pay with your life, in some cases.

We have compiled tips and suggestions from 29 respected experts who share with you their rules on how you can control your type 2 with diet. Read on to find out what they are.

1. Karen R. Koenig, LCSW, M.Ed

I encourage my clients with Type 2 Diabetes to do the following: stop dieting and labeling foods “good” or “bad” and, instead, think of them as having high or low health benefits. The diet mentality only promotes rebound eating. The goal is to develop an internal, rather than an external, locus of control. I also encourage them to learn how to become “normal” or intuitive eaters by connecting to appetite cues for hunger, fullness and satisfaction, and eating with awareness, which often means without distractions.

They also need to develop effective practices to manage stress and distress without turning to food. All this can be done with an eating disorders therapist or an intuitive eating coach and by reading books on any of the above topics.

2. Kelly Devine Rickert, MS, RDN, CSSD, LDN

There are two main tips I tell people to help control their type two diabetes. First of all, start the day with a breakfast with some complex carbohydrates AND some lean protein! Many people make the mistake of skipping breakfast or eating a higher sugar one which starts the day off on the wrong foot. Aim for complex carbohydrates such as oatmeal, fruit, whole grain toast or high fiber English muffins paired with lean protein such as peanut butter, eggs, or Greek yogurt.

Secondly, I recommend eating small frequent meals about every 3-4 hours starting with breakfast. This helps to stabilize sugars leading to less ups and downs throughout the day. Pair healthy carbohydrates such as fruit, whole grain crackers, rice cakes with some protein such as nuts, yogurt, string cheese sticks, or peanut butter.

Starting the day off with a healthy breakfast and adding in some small healthy snacks in between meals can help cut down portion sizes at your main meals and helps to increase your overall energy levels!

3. Martha Wilkins, MS, RD, CDE

I think the best response to a one sentence question that includes the words diet and control is Mindfulness. Get knowledgeable about this topic so that you realize that eating is a continuum. There are so many decisions that go into what and how much we eat, that if we do not elevate intention to the priority level it requires to attain control, we will flounder in reaching our goals. Food choices, eating, and time management are so complex in our lives that clarifying our specific goals related to food and our health is imperative to approach control in a positive way.

Those with diabetes should be results oriented. Find the scientist in yourself and track your numbers and push them to your goal ranges: pounds, blood glucose levels, A1c, minutes of moderate exercise every week, etc. Choose what is important to you, and identify concrete strategies to improve your numbers. A dietitian, especially one who is a diabetes educator can assist you to start slow, set goals, and identify sequential steps to reach each goal gradually. They can act as a coach to help you celebrate successes. and move on to another goal or challenge. Along with the other members of your health care them, let them be your cheerleader!

4. Peggy Harum RD, LD - Renal Dietitian

As a renal dietitian my focus can't be solely on diabetes. Although a very large percentage of our patients with chronic kidney disease are here due to unmanaged blood sugar control, that is just one of our problems. I have to prioritize my counseling in other ways - the most important being control of potassium, then sodium (fluid), protein and phosphorus.

The majority of our dialysis patients lose kidney function completely - in other words they no longer urinate. So imagine what happens when they eat salty foods (not salt) - they get thirsty and drink - Then the dialysis treatment must try (only try) to remove the fluid they accumulate. It is true that high blood sugar also causes thirst - which I must keep in mind. I have many patients who rely on their PCP for advice with their insulin. They take the same amount of insulin regardless of their blood sugar - and the A1C remains elevated - I can't change how they administer the insulin - but only recommend asking for a referral to an endocrinologist.

This sometimes takes months to achieve. So probably the best thing I can do is recommend - I can say "the secret of the diet is the size of the portion".

5. Jason Machowsky, RD, CSSD, RCEP, CSCS

Eat a Source of Protein with Breakfast: As the first meal of the day, breakfast can set the tone for your body's blood sugar balance and overall mindset on eating well (which, of course is also affected by a steady blood sugar!). Many typical breakfast foods tend to be rich in carbohydrates (fruit, cereal, oatmeal, toast, etc.) which may lead to spikes in blood sugar if eaten in large quantities alone.Add in sources of protein, fiber and/or healthy fats to create a blood-sugar steadying breakfast: pair fruit with yogurt or cottage cheese, oatmeal with a spoonful of peanut or almond butter, or a slice or two of whole grain toast with a couple of eggs or hummus.

Carry a Rescue Snack: Going too long without eating can lead to dips in blood sugar, sometimes called “lows”, which create unpleasant symptoms, including ravenous hunger. This often leads to poor food choices, since we're more focused on eating anything in sight, even if it's not healthy. Rather than getting to this point, keep a healthy snack with you throughout the day in case you get stuck somewhere you didn't plan at a mealtime. A balanced snack will combine a nutritious carb or veggie + source of protein or healthy fat.The chart below provides portable options you can mix and match to your tastes:

Fiber-Rich Carb or Veggie	Protein or Healthy Fat
Piece of fruit	String cheese
Whole-grain crackers / Melba toast / Rice cakes	Packet of nut butter
Carrots, celery, pepper, cucumber, etc.	Packet of hummus
Mini-bag of popcorn	Low sodium jerky
A couple of options that combine both would be nut-and-fruit trail mix or a food-based snack bar that has at least 3g of fiber and 5g of protein

And don't forget the fluid! Dehydration affects many aspects of both mental and physical functioning, so make sure you have water with you as well.

Eat Slower: Once we start eating, it takes about 15 to 20 minutes for our bodies to realize we are full. Eating too fast can lead to overeating, which can lead to a spike in blood sugar and/or weight gain…which can lead to greater insulin resistance. Consciously aim to eat slowly – give yourself at least 15 minutes – especially if you start a meal very hungry. If you are a fast eater or do not have a lot of time, eat 50% to 75% of your planned portion and then wait 10 to 15 minutes (call a friend, work a little, take a walk, anything). If you are still hungry, then eat half of what's left. Repeat until you are satisfied, not stuffed. Pay attention to how much food it actually takes to make you full so if you are in a pinch, you can make sure your eyes don't become bigger than your stomach.

6. Crystal Petrello MS, RDN, LD, ACE Certified Health Coach

People are missing the forest through the trees while trying to be perfect in the way they eat. It has become difficult to accept the tip "eat more fruits and vegetables". All the food "philosophers" (aka non-science based food guru) have filled our heads with lies about the types, packaging and serving of these foods. Saying things like "they are worthless if they are packaged in such-and-such a way". STOP with the "all-prefect or nothing" mentality. Just eat fruits and vegetables! Canned, fresh, frozen, cooked, raw, or pulverized; just get them in your belly.

The average American eats 2 servings of produce a day and french fries and ketchup count! These colorful earthly delights provide us with so much nutrition that we would be fools not to figure out a way to enjoy them. Start with just increasing by 1 serving a week and before you know it you will have reached the recommended 9-11 servings a day. The quickest way to get a jump on more vegetables is to fill half your lunch a dinner plate with a cooked or raw vegetable. My favorite is pre-cut, washed and shredded raw cabbage salad with carrots, cherry tomatoes, avocado and little dressing.

7. Sarah C. Lytton, MS, RDN, LDN

Find your Tribe

• Find a local diabetes support group in your area to connect with others managing diabetes
• to learn unique ways to keep healthy through diet.
• A support group also is a great way to mentor newly diagnosed individuals who need extra support from someone who knows the ropes.

Indulge Wisely

• When you want to satisfy your sweet tooth, be mindful of your choices.  A serving of berries is almost always a better choice than something with added sugars like a pastry or cookies.

Keeping Fiber in Check: Drink Water!

• When incorporating fiber rich foods in your diet, which helps with blood sugar control - remember to stay hydrated with enough daily water intake.  Drink water with meals and snacks and keep a water bottle with you to take sips throughout the day.  Staying well hydrated helps with regularity and promotes blood sugar control.  Aim for 60-100 fluid ounces per day.

8. Lemma M. Brown, MS, RDN

I recommend for my patients to eat a variety of foods when managing Diabetes Type 2 with diet. I particularly encourage patients to include protein from a variety of sources, fiber, and vegetables or fruit with each meal. Including small portions of many food groups with each meal ensures that patients' bodies are being healthfully fueled and they will often feel more satisfied with their meals preventing overeating and grazing throughout the day.

Some easy-to-follow examples I often provide are adding chopped mixed vegetables to scrambled eggs and including fresh fruit on the side; preparing a green smoothie with low-fat milk, low-fat yogurt, chopped fresh kale, and frozen fruit; preparing vegetarian jambalaya with brown rice; or choosing a hearty salad with mixed greens, nuts, beans, and light salad dressing from a salad bar. Food can be medicine and it can also be enjoyable!

9. Jennifer Flachbart, RDN

Although there is not a one size fits all diet plan for people with Type 2 Diabetes, there are a few key aspects that can provide a good foundation for a healthy diet in managing blood sugar control.

1. Eat More Fruits and Vegetables. Eating more plant based, whole foods have been shown to help manage blood sugar. Foods such as fruits and vegetables are high in fiber which can help slow sugar absorption and provide important vitamins and minerals in your diet.
2. Eat Whole Grains. Whole grains are also high in fiber and provide more nutrients than processed white carbohydrates. Switching from white bread or pasta to whole wheat can help control blood sugar. Adding in legumes and beans have also been shown to greatly help with blood sugar control.
3. Spread Carbohydrates Throughout the Day. Making sure you're eating a consistent amount of carbohydrates throughout the day can help keep your blood sugar even.
4. Limit Processed Carbohydrates. It is important to be aware of which carbohydrates will quickly increase blood sugar. Processed foods such as white bread, chips, sugary foods, and desserts are items to limit. If you are going to eat them, pair with a balanced meal high in fiber and vegetables to help avoid spikes in blood sugar.
5. Plan ahead! Meal planning can be extremely helpful in blood sugar control. Knowing when your next meal or snack is coming from eliminates the need for grab and go snacks from convenience stores which are usually processed, quick absorbing carbohydrates. Planning meals in advance will help keep you on track.
6. See a Registered Dietitian! Registered Dietitians are uniquely trained and positioned to help customize plans and provide guidance and education for people with diabetes.

10. Laura E. Wargo, RD, LDN

Living with Type 2 Diabetes does not mean you will be on a “diet” for the rest of your life. Technically, a “diabetic diet” is just healthy eating habits everyone should be following. Depending on your personal blood glucose numbers, the amount of carbohydrate you can eat might vary; but in general, we should all be mindful of our carbs.

In this country, we tend to over- do it on those. Most people do not enjoy measuring their foods or counting carbs. My favorite way to estimate portion sizes is to use the “Create Your Plate” method created by the America Diabetes Association. Simply use a disposable plate divided into three sections (one half-plate section and two quarter plate sections). The large, half plate section should be used for non-starchy vegetables, things like carrots, broccoli, or cauliflower. Place your lean meat or protein in one quarter-plate section, and your carbohydrate in the other quarter-plate section. You can practice designing your meal using this method on their website: http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/

If you are like me, going to the gym is not your favorite pass time. Physical activity with diabetes is so beneficial. Being active, however, does not mean having to work out. There are tons of ways to sneak in exercise in your everyday activities. For example, when grocery shopping, park at the end of the lot so you have to walk a longer distance to and from the store. If you enjoy watching tv, stand up and walk in place during the commercials. Take the stairs instead of the elevator as often as you can. If you enjoy dancing, instead of at- home work out videos, put on your favorite tunes and dance away! There are so many different ways to be active without “working out”!

Mindful eating combined with physical activity are important lifestyle habits every person with or without diabetes should have.

11. Corinne Goff, RD, LDN

BALANCE: Pair up a carbohydrate with protein and fat. Don't eat carbs alone. The protein and fat will help to slow the release of sugar into your bloodstream. Ex) Chicken and veggie stir fry with peanut sauce served over quinoa.

WHOLE FOOD: Eat carbohydrates in their whole state as opposed to highly processed versions. Choose a potato, sweet potato, brown rice, steel cut oats or an ear of corn for a starch rather than those made from flours like breads, pastas, crackers and baked goods. You will get more nutritional value plus they will break down slower in your body.

EAT MORE PLANTS: Make half your plate low-starch vegetables like salad greens, cooked dark leafy greens, mushrooms, peppers, onions, asparagus, broccoli, cauliflower, carrots, cabbage, etc. Plants are important for their antioxidants, phytonutrients and fiber and can fill you up for few calories.

STEADY FUEL: Eating every 3-4 hours during the day can help keep blood sugars better controlled.

PLAN AHEAD: Make the time to plan your meals and snacks. Knowing what you will be eating throughout the day will make life much easier. If you fail to plan, you plan to fail.

12. Lori Porter EdD, RDN, CAE

The goal in diabetes, when it comes to blood sugar, is to try to keep blood sugar at near normal levels as much as possible. This can be done through diet and physical activity for many people with prediabetes or type 2 diabetes. Here are some tips f.or controlling your blood sugar:

1. Eat 5 – 9 servings of fruits and vegetables per day. Focus on non-starchy vegetables especially those that don't impact the blood sugar as much as starchy vegetables. Non-starchy vegetables include foods like asparagus, green beans, beets, broccoli, brussel sprouts, cabbage, cauliflower, cucumbers, greens, and spinach. Non-starchy vegetables include foods like corn, potatoes, peas, lima beans, and black-eyed peas
2. Minimize consumption of highly processed foods. Highly processed foods often contain a lot of added sugars and fat. Eating less sugar will keep your pancreas from having to produce more insulin to cover spikes in your blood sugar. Avoid consuming highly processed foods, too much fruit juice, and check labels for carbohydrate content and source.
3. Choose lean sources of protein. Lean sources of protein include: eggs, egg whites, chicken breast, turkey breast, lean beef, pork tenderloin, fish (e.g., cod, tilapia, orange roughy), beans, or tofu. Adding protein to your daily intake helps to control spikes in blood sugar and helps with fullness to prevent unnecessary snacking on poor choices later.
4. Control portions and eat smaller meals. Consuming generous portions and large meals requires your pancreas to work harder to secrete the needed insulin to bring your blood sugar down. The extra calories consumed due to sizeable portions and large meals also makes it harder for you to lose weight which is usually necessary for better blood sugar control.
5. Commit to 30 – 60 minutes of daily exercise. Although not a diet tip, to control blood sugar individuals need to commit to adding 30 to 60 minutes of daily exercise to their routine. Adding exercise will help with weight loss and improve blood sugar since exercise, even at moderate levels, helps your muscles use glucose which ultimately helps to lower your blood sugar. Exercise such as walking, cycling, swimming, yoga or tennis can all be beneficial. What's most important is choosing an exercise/activity that you will enjoy and stick to!

13. Tracey Linneweber, RD, CLT

Low intake of Vitamin D, chromium, Vitamin C, zinc, and magnesium are some of the nutrient deficiencies associated with diabetes type 2. Adequate intake of fruits, vegetables, nuts, beans, meat, eggs, and whole grains can help meet those nutrient needs and your blood sugar. But, only if those foods help you feel well.

Elevated blood sugar can also come from the body's response to inflammation. If you feel like you're eating right but can't figure out why your blood sugar is spiking, it may be due to a food sensitivity. The diarrhea you thought was a side effect of your medication may actually be a food sensitivity. Food sensitivities can also be the root cause of headaches, arthritis, heartburn, fibromyalgia, sinus problems, and more. The stress of these ailments has the potential to elevate blood sugars.

The LEAP (Lifestyle Eating And Performance) elimination diet protocol utilizes MRT (Mediator Release Test) food sensitivity testing to customize an anti-inflammatory diet just for you. A Certified LEAP Therapist (CLT) can help you determine whether LEAP will be right for you.

14. Allison Tepper, MS, RD, LDN

While carbohydrate counting is effective, it can be hard to go from eating whatever you want to calculating and measuring and measuring food intake. Carbohydrate counting is effective in managing blood sugars and controlling diabetes, though eating a balanced, healthy diet can help clients reach their goals. One way to do this is by following the plate method put out by www.myplate.gov. In this image, the recommendation for nutrient intake is to make ½ of your plate vegetables, ¼ of your plate lean protein and ¼ of the plate starch. This allows someone to incorporate carbohydrates into the diet, but in a balanced way that manages blood sugars. Getting a balance of nutrients provides energy, increases satiety and allows for optimal vitamin and mineral intake. The plate method is approachable and easy to incorporate whether you are at a restaurant, at a party, or at home cooking for yourself.

Another area that I focus on is portion sizes. With the increase in portion sizes in our society, it can be hard to manage food intake. I recommend listening to your body and identifying your needs by being aware of your hunger and fullness. If you are feeling hungry, it is an indicator to eat, and once you start to feel satisfied, it is an indicator to stop eating, knowing that you can eat again later. This small change where someone begins to leave food on their plate or stops eating when feeling satisfied and not overly full can make a big difference in overall health.

The last tip that isn't exactly nutrition related is to incorporate exercise! Exercise helps greatly with insulin resistance and can make a big impact on the symptoms associated with Type II Diabetes

15. Debra L. Tindle, RD

We tend to hear much emphasis on calories, carbohydrate counting and the glycemic index when asking about type 2 diabetes management through diet. The most often forgotten nutrient for health is the most important: water. Many of our clients with type 2 diabetes are on the run and may remember to eat, yet do not take adequate time for drinking calorie-free, caffeine-free beverages to rehydrate. Since our bodies are comprised of nearly 70% water, it makes good sense to take in fluids daily to balance out our needs. Sometimes the recommended “8, 8 ounces of water per day” is not enough. A quick assessment of the color of urine coming out, depending on vitamin supplements and medications, can help determine what the right amount of liquid is daily. The lighter the color, the better!

Of course, carbohydrate types, amounts and frequencies still matter. Setting up a routine is best so the body can become more regulated, and medications can be more easily adjusted with medical guidance. For example, a “consistent carbohydrate diet” may include 4-5 carbohydrate servings (60-75 grams) per meal, with 3 meals spaced 4 or 5 hours apart. The inclusion of an evening snack may be recommended pending morning glucose trends. If morning sugars are running under 70 mg/dl, it may be a wise choice to have a 2-carbohydrate evening snack about 1 hour prior to retiring to bed.

And finally, behavioral changes that set up environments for success are extremely helpful. These may include daily food/beverage/activity/glucose logging, and food-proofing environments. Logging can now be completed easily with electronic applications and website support, such as www.choosemyplate.gov . Food-proofing takes more doing and family/significant other assistance. Environments to review may include home, shopping, work, driving, and social. Review foods in each environment that sabotage efforts to manage blood glucose, and develop strategies to cope. For instance, when driving, bring a planned carb-controlled snack (e.g. small apple, 3 graham cracker squares, sparkling calorie-free water), in case travels extend past expected times; and check driving patterns, since some automatic routes may go past a favorite fast food place that magically pulls the car in!

In summary, four main points of focus for successful type 2 diabetes management through diet:

1. Drink adequate calorie-free beverages daily for hydration (check urine color if appropriate).
2. Develop and follow a consistent carbohydrate diet routine.
3. Log food/beverages/activity/glucose daily
4. Food-proof environments (have safe foods available)

Wishing everyone good health through good nutrition!

16. Dr. Heather L Colleran, RDN CSSD LDN CSCS

Moderation and balance are key to help controlling type 2 diabetes. In working with my clients, we find foods they enjoy and make small changes over time to ensure success.

Here are a few dietary tips I give my type 2 diabetic clients to better control their blood sugar:

1. Always start your day off with breakfast, the first meal of the day. When you wake, your blood sugar is often low, eating a balanced meal such as Old-Fashioned Oatmeal with added toppings of fruit, nuts or even peanut butter will help break your overnight fast and start your day off right.
2. Eat every two to three hours. Spreading your energy needs throughout the day allows for healthier choices to be made and your blood sugar to stabilize. Work towards achieving a healthy meal pattern of breakfast (the first meal), followed by a small snack, then lunch (mid-day meal), another snack, dinner (last-meal of the day) and sometimes a small end of the day snack.
3. At each meal and snack pair carbohydrates with a protein and heart healthy fat. For meals make half your plate vegetables (raw, steamed or sautéed in a heart healthy oil like olive oil),a quarter lean protein (think less legs are better – choose fish, chicken, pork and have beef (aka red meat) on occasion), the remaining quarter of your plate should be from grains, preferably whole (i.e. quinoa, couscous, rice or even a baked potato- just go easy on the butter and sour cream). Some snack ideas include pairing fruit or vegetable with a protein, such as a banana or apple with peanut butter, raw vegetables (carrots, bell or sweet pepper strips, snap peas, celery) with hummus or even whole grain crackers with a low-fat cheese or plain yogurt with added fruit.
4. Stay hydrated. Carry a water bottle with you, sipping often and refill often. Aim to drink at least 1 to 2 liters a day. If you need “flavor” to your water, add in sliced citrus fruit (lemon, limes or oranges), sliced strawberries, sliced cucumbers, sliced kiwi or even try a combination of sliced oranges with basil.
5. Avoid artificial sweeteners. I have often seen blood sugar “crashes” with my clients which lead to over-eating to restore the blood sugar balance; opt for natural sweeteners like cane sugar, real maple syrup or honey (bonus if you get a local honey it may even help with seasonal allergies) and use sparingly.
6. Get active. Find an activity that you love (or at least don't mind). Aim to move at least 30 to 60 minutes a day most days of the week. It can be as simple as walking.

Finally, small positive changes in food choices and activity add up over time. Pick three things to change in your dietary habits. Once you have mastered them pick three more. Change takes time and nobody eats perfect.

17. Kali Williams, MS, RD, LDN

Controlling Type 2 Diabetes through diet starts with including consistent carbohydrate choices spread throughout the day. This looks like consuming 3 balanced meals at roughly the same time each day and not skipping meals. Each meal should contain about the same amount of carbohydrate to help control blood glucose levels.

Including a variety of carbohydrate-containing foods is important; options can include whole grains (≥ 3 grams of fiber per serving), fruits, starchy vegetables and dairy. All meals should include a carbohydrate source, protein and a fruit or a vegetable to help stabilize blood glucose levels and meet an individual's nutrient needs. An example may be grilled chicken, sweet potato and roasted asparagus.

Snacks are based on an individual's schedule—if there's more than 4 hours between meals, a snack can help to prevent hypoglycemia. Snacks should combine a carbohydrate with a protein or healthy fat source, such as Greek yogurt with granola, whole wheat pita with hummus or apple and peanut butter.

Managing diabetes through diet can include all of an individual's favorite foods; the key is portion control and how often a food is consumed. Eating is supposed to be enjoyable and it is possible to manage your blood glucose levels and include a wide variety of foods.

Diabetics should enlist the help of a Registered Dietitian to develop an individualized meal plan and determine the specific amount of carbohydrate an individual needs to meet his/her nutrient needs and help control blood glucose levels.

18. Stephanie Levinson RD, LDN

Tips to control type 2 diabetes through diet:

1. Eat regular meals and snacks. Eating within the first hour of waking up and then eating small meals/snacks every 2 to 4 hours throughout the day helps to control blood sugar, boost metabolism, and stay on top of hunger and cravings.
2. Meals and snacks should include lean protein. This can include eggs, dairy, nuts, seeds, nut butter, chicken, fish, lean meat and soy alternatives.
3. Carbohydrates should have at least 3 grams of fiber per serving and should be made with whole grains.
4. Half your plate should be filled with non- starchy vegetables. Some examples are green leafy veggies, mushrooms, peppers, carrots, green beans, summer squash, asparagus, broccoli, and tomatoes.
5. Cut back on added sugar. Read nutrition facts and ingredient lists to help with this. If sugar is one of the first 3 ingredients- the product may have too much sugar. Use fresh or frozen (without added sugar) fruit to flavor or sweetened things instead of buying things already flavored with less healthy sugars or flavorings. For example: instead of buying strawberry yogurt. Buy plain yogurt and add fresh berries. You will not only be cutting back on added sugars, but you will be adding fiber and volume which can help fill you up and control your blood sugar.

19. Suzanne Pecoraro, MPH, RD, CDE

My specific tip for controlling diabetes with diet is to maintain a healthy lifestyle which includes fresh, mostly unprocessed foods from all food groups. Maintain a reasonable weight which may mean weight loss and stay active. The key here is: MAINTAIN any change you have accomplished. In my opinion and that of at least one of my clients you accomplish maintenance by being good to yourself and liking your lifestyle. Here is a quote from a client who has done well and I asked her for 'tips' to share. We can all find inspiration in her reply: "The biggest thing to change is your attitude. Be kind to yourself.

Treat yourself as you would a good friend who is struggling with a lifestyle change. You would be supportive and encouraging - a slip is not the end of it all. Sometimes it's OK to indulge in a treat, but don't feel guilty - enjoy it to the fullest - then get back on track. It's OK to sit and read a book one day - just try to not make it the normal thing to do. I realized this morning when I had breakfast with a friend who is struggling with weight loss and I saw that the biggest difference was our attitude. She was moaning about how hard it was to lose and what she couldn't eat and how much she had to work out, instead of looking at the fact that she has lost 20 pounds! That said, it's not always easy to be positive, but all I really need to do is look back 4 months and I know I am making a difference."

Practical things:

1. Plan ahead - don't wait until you are hungry to plan what to eat. Sometimes just knowing what's for dinner makes it sound good.
2. Hot liquids fill you up better than most anything else - coffee, teas, non-fat hot chocolate. I have become a big fan of soup. I make it myself by browning onions in non-stick cooking spray (to bring out the flavor), then add whatever vegetables I have around with some broth (vegetable or chicken). When the veggies are soft, cool slightly, then blend in small batches. Season with S&P, or experiment with turmeric or cardamon. Makes a lovely thick, creamy soup without the calories. I use sweet potatoes, carrots, broccoli, cauliflower, whatever.
3. Limit beef, but enjoy it when you have it! (I do once a week)
4. Craving crunchy? 100-calorie popcorn - one piece at a time.
5. Craving sweet? Fat-free, sugar-free jello with 2T of Lite Cool Whip - eat slowly.
6. Keep easy, good snacks handy - Nature Valley Fruit&Nut Trail Mix Bars, individual fruit cups.
7. Activity - so important to keep busy - mentally as well as physically. Find an activity that you really WANT to do. I like to garden and now that I am tracking my activity, I find it gives me an excuse to go out and putter. Since I enjoy it and accomplish something good, it satisfies me. I have discovered that with some practice I can read while walking on the treadmill. If the book engrosses my mind, I will walk much longer than if I am just watching the timer.

20. Shirley Scrafford RDN CPC

The main point I tell type 2 diabetics is that you can eat most everything you want with some adjustments. That does not mean binging on M&Ms, but it also doesn't mean you can never have one again. There are a few things that help with making these adjustments.

First – When eating foods with simple sugars (high glycemic index foods) that quickly raise your blood sugar, combine them with something to slow that process down, whether it is protein, healthy fat, or fiber. For example, if you are having birthday cake and ice cream, eat it after a meal with lean protein, fiber rich vegetables and/or grains, and healthy fats. The meal will slow the digestion of the sugar in the cake and ice cream. But if you are counting carbs, be sure to count those in the cake and ice cream.

Second – I tell clients with type 2 diabetes to find simple swaps for items that they should be limiting and easy to incorporate new habits to make diabetes easier to manage. The easy swaps could be switching from sweetened coffee creamer to unsweetened vanilla almond (just 30 calories per cup and low glycemic index) and stevia, which is not an artificially sweetener, but made from the stevia plant. The fact the research is showing that stevia has a glucose lowering effect and can increase insulin production for type 2 diabetics, is a plus.

Third – I like the visual from the My Plate campaign and stress having half of your plate be non- starchy vegetables, a quarter be lean protein, and a quarter be some type of starch. If weight loss is an objective I have them switch to a smaller luncheon size plate rather than a large dinner plate for meals.

21. Felicia Porrazza, MDA, RDN, LDN

One of the biggest tips I discuss with my clients who are trying to manage their Diabetes is to focus on adding more fiber to their diet. We first start by adding fruits and veggies to the meals that they are already consuming. I find adding to the diet is usually an easier approach for most. Another tip is to focus on adding more whole foods, like apples with the skin versus juices or baked sweet potatoes versus the instant varieties. Along with more fruits and veggies, clients can also add fiber in the forms of nuts and seeds to meals or snacks to help with satiety and blood sugar control. One of the key points I stress to any client is to focus the balance and take it one step at a time. I don't expect anyone to do a complete 360 on their food intake since it takes time to build new (and healthy) habits that will last long-term.

22. Jo Bartell, MS, RDN

1. Shedishes.com

Controlling Type 2 diabetes through diet centers around 3 main ideas:

a. eating carbohydrate foods consistently throughout the day;

b. never eating carbohydrate foods alone; 3) focusing on Fiber.

1. Food sources of carbohydrates including breads, cereals, crackers, pasta, starchy vegetables (peas, corn, potatoes), fruit and sweets/desserts need to be eaten consistently throughout the day by focusing on small and frequent meals every 3-4 hours. Patients with type 2 diabetes should work with a dietitian who can prescribe a goal number of carbohydrate servings (or grams) at each meal and snack and teach appropriate portion size for each carbohydrate food. Daily carbohydrate needs will vary based on the individual.
2. Food sources of carbohydrates should always be eaten WITH a source of protein and or unsaturated ("healthy") fat. Fat and protein digest more slowly which helps prevent blood sugar spikes. Examples of balanced snacks that combine carbohydrate foods with protein/fat include, apple with peanut butter; berries with plain Greek yogurt; whole wheat toast with almond butter; baked potato with cottage cheese.
3. Fiber-filled foods such as fruits with skin, WHOLE wheat bread/pasta, brown rice, legumes/beans, and non-starchy vegetables will help prevent blood sugar spikes and increase post-meal satiety along with several other benefits. Patients should look for packaged foods with at least 3g of fiber per serving (5g is even better).

23. Beth Barnett-Boebel, MS, L/RD, CLT

I believe that individuals with and without Type 2 diabetes need to ensure they are eating at least eight servings of non-starchy vegetables like broccoli, cauliflower, dark leafy greens, bell peppers, green beans, okra, and so much more. One serving of vegetable is equal to 1cup, which is really about one handful worth. If you cook one serving of say greens, it will shrink, but it still counts!

How you prepare and serve vegetables makes a difference in enjoying them versus trying to choke down plain steamed veggies.

Some examples include:

• roasting a pan of vegetables tossed in avocado or grapeseed oil and a bit of salt and pepper
• sautéing in a skillet with some favorite spices
• or serve with a sauce like a Dijon or peanut sauce

Fruits and starchy vegetables should be enjoyed in more moderate amounts about three to four servings total from these two groups. Finally, grains and other simple carbohydrates (like pasta, rice, etc.) should be only 2 or three total servings. One serving of grains varies but it's about ⅓ cup cooked or 1 slice of bread.

Added sugars from baked goods, candy and soda are not recommended – that's where dark chocolate (70% or higher) comes in for that sweet fix. Not only does dark chocolate satisfy a sweet tooth but it also has health benefits. Bars differ in size but usually about 1-2 squares will do the trick.

As you increase your vegetables in your diet, work up to them so all the extra fiber does not cause excess wind.

Just as important as eating vegetables is to move everyday. It will take a bit to adjust to new habits, so be kind to yourself and don't give up! Consistency is the name of the game in supporting health - just be consistent with getting some movement and adding vegetables to your diet.

Recipe:

Dijon Sauce

I like ¼ cup avo oil, salt to taste, 1 tablespoon dijon, and fresh 1 tablespoon fresh chopped dill. Black pepper to taste optional

24. Maya Rams Murthy, MPH, RD

Here are 3 simple tips on how to manage type 2 diabetes through food!

1. Veggies, first: Research suggests that eating vegetables and lean proteins before carbohydrates may result in a lower rise in blood sugar levels over the next few hours (as compared to eating the same foods in the opposite order). While more research is needed on this topic, it's possible that eating protein and veggies first is delaying how fast the carbohydrates get absorbed.
2. Choose carbs wisely: The glycemic index (GI) is a value assigned to foods based on how quickly or slowly they spike your blood sugar levels. For someone with diabetes, high GI foods (like refined sugar or other simple carbohydrates like white rice and bread) can cause blood glucose levels to shoot up rapidly. Make sure that your carbs are high-fiber, whole grains – like legumes, brown rice, or quinoa – as these foods are high in nutrients and break down slowly into the bloodstream.
3. Up your soluble fiber intake: There are two types of fiber - the type that does not dissolve in water (insoluble fiber) and the kind that does (soluble fiber). Insoluble fiber can help manage weight and prevent constipation by moving quickly through the digestive tract and adding bulk to stool. Soluble fiber, on the other hand, absorbs water and turns into a gel-like consistency during digestion. This process slows down digestion and nutrient absorption. Soluble fiber can also lower blood sugar and cholesterol levels: because it isn't well absorbed, it doesn't contribute to blood sugar spikes and can help manage type 2 diabetes.

25. Cassie Barmore, MS, RD

Choose more whole grain foods. Whole grain options provide more fiber which is helpful in managing blood sugar levels.

Get plenty of produce. Aim to make half your plate veggies at meal times. Choosing a variety of veggies is helpful so they don't become boring. Also vary the cooking method to mix it up! Eat them raw, sauteed, steamed, or roasted for some variation in texture and flavor.

Have some protein with each eating occasion. Add in some protein with meals/snacks. Vary up the source of protein by choosing different animal or plant based options. This could be a mix of foods: hard boiled eggs, seeds, nuts, tofu, beans, chicken, nut butters, fish, greek yogurt...the possibilities go on and on.

26. Dawn A. Sharp, CLN, ACE, NASM

Controlling Type II Diabetes by diet is an absolute must. Eating low glycemic foods and staying away from highly processed foods that contain hidden toxins as well as hidden sugars is important. You cannot always trust food labels so I suggest eating as many foods that DO NOT have labels - fresh vegetables, lean proteins and nutrient rich complex carbohydrates. Some examples include, spinach, kale, asparagus, broccoli, brussel sprouts, sweet potatoes, quinoa, brown rice or bean pastas - and of course lots of lean proteins from chicken, turkey and fish. Eliminate high sugar vegetables such as peas, carrots and corn and stay away from white foods such as white flour, bread, pastries, cakes, dairy and milk products (eggs are ok).

​The best way to maintain healthy blood sugar levels is to eliminate high carbohydrate foods, eat only low glycemic foods, monitor your levels daily and work with a qualified healthcare practitioner. Losing weight and maintaining the weight loss are important and will prevent many other risk factors caused by obesity. I have a very so specific plan that addresses blood sugar issues and promotes a healthy lifestyle. When you live with diabetes, it does not have to be a life sentence, it can be reversed and it can be monitored wisely. I offer a FREE 15 minute consultation to anyone who is interested in learning more

27. Kim Conway, CHHC, AADP

The best way to control Type 2 Diabetes through diet is eating in a metabolic pattern (eating every 2 ½-3 hours) and eating low glycemic index/load diet (foods that break down slowly into glucose) to maintain blood sugar levels. The goal is to eat a balanced diet rich in lean animal proteins (chicken, turkey, fish), good fats (olive oil, coconut oil, avocado, seeds and nuts), fiber, fresh fruit, vegetables, and whole grains to balance the metabolism, hormones, and of course blood sugars. Fiber is key to maintain blood sugar. Most people get between 8-11 g of fiber a day and need between 35-45 g. Fresh vegetables (especially leafy greens) and fruit as well as whole grains like quinoa, whole brown rice, spelt, amaranth, buckwheat and whole oats) are filled with good fiber. It is best to avoid sugar, processed foods (packaged foods, breads), simple carbohydrates (white flours and grains), artificial sweeteners (Stevia in the Raw is ok), too much coffee, and sodas. Limit dairy which can affect blood sugars as well. Eating a variety of the above foods instead of the the same foods over and over again will also help maintain blood sugars.

28. Debbie Peterson & Wendy Bright-Fallon

Our advice to anyone trying to live healthier lifestyles is simple, including diabetics trying to manage their disease. Our mantra: Eat real food. What does that mean? Eat whole foods that grow from the ground, are picked from a bush or tree, or came from an animal. Whole vegetables, fruit (both preferably organic), and responsibly raised and fed animals are all a part of a healthy, nutrient-rich diet. If one can stick to this simple rule and minimize or avoid processed and packaged foods and food-like items, you'll find you look, feel, and perform better than ever.

That said, there are a few extra good things to eat and do to manage diabetes, if you can add them to your everyday whole-foods diet:

• Cinnamon adds a sweet flavor without the adverse effects of sugar. Use it to enhance the flavor of your oatmeal, toast, smoothies or cut up fruit.
• Onions are sulfur-rich vegetables that may help in normalizing blood sugar. Add them to soups, stews, salads and enjoy them raw or cooked.
• Cold-water fish rich in Omega-3 essential fatty acids (EFAs) may be helpful in insulin regulation. Salmon, tuna, trout, mackerel, sardines, cod, herring are all delicious cold-water fish.
• Satisfy a sweet tooth with fresh fruit. Target lower sugar fruits such as grapefruit, oranges, kiwis, strawberries, other berries and green apples.
• Concentrate on increasing a variety of leafy greens to all three meals. Leafy greens are full of energy, help ‘flush' the system and provide a super nutrition boost. Experiment with lettuces, spinach, kale, collards, Swiss chard, arugula, dandelion, and watercress.
• If you tolerate beans well, add a variety to a few meals each week for added fiber and satiety.

Use the above foods to help nourish your body. As you add in more real foods, cravings will be reduced and it will crowd out some of the food habits that have led to diabetes.

Above all, see what feels right for your body. Understanding how foods help you look, feel and perform your best is key to your success. Outside of food, these topics are a big part of overall health: Quality Sleep, Appropriate Movement, Reduced Stress and Supportive Community.

To find out more, connect with Nourish Coaches Debbie Peterson and Wendy Bright-Fallon who offer a customized approach to overall health. You can reach them at www.NourishCoaches.com where you can access their active blog and podcast series called Nourish Noshes. Debbie and Wendy are the co-authors of nourish – a community supported cookbook.

29. Jo Ann Hattner MPH, RDN

• Gutinsight.com

Type 2 diabetes is often accompanied by extra body weight.Setting a goal for weight loss is easy, but the biggest challenge is the plan you use to help reduce your weight so you can better manage your diabetes.

At Stanford Medical Center in California, while working as a clinical dietitian, I teamed up with a clinical research dietitian who specialized in diabetes.Our goal was to help women reach a weight recommended for their actual height. What resulted was a book Help! My Underwear is Shrinking: One woman's story of how to eat right, lose weight, and win the battle against diabetes.The book tells the story of one woman as she struggles with her daily routine and responsibilities while trying to follow the plan and lose weight. The character provides humorous insight and methods she used for achieving her goal.

The plan called “Carbohydrate Countdown” is a meal plan based on an easy to understand carbohydrate budget.The daily budget is based on—height. That's the key. With the Body Mass Index for normal weight, we designed eating patterns to nourish only the lean body weight.

The book is a good resource. The dietitian your primary care physician recommends is also a good resource. A 2013 revision of the book and a Spanish language edition are available for the Kindle.

Conclusion

From watching your glycemic intake to incorporating more whole foods to staying away from processed and junk food, our experts have presented you with all scenarios and what to do in such situations.

Their tips and suggestions will go a long way in your diabetes management.

These are the people who know and speak out of experience on what works for people with type 2 diabetes. We have carefully curated in one platform the list of experts who are multidisciplinary in their nature of work. If you have any questions or comments, please share in the comment’s box. We love to hear from our readers.

TheDiabetesCouncil Article | Reviewed by Dr. Christine Traxler MD on May 20, 2020