9 Innovations in Type 2 Diabetes Treatment

In a few short decades, type 2 diabetes research and technological breakthroughs have brought about significant advancements in how the condition is treated and managed. Here are some of the top innovations that are helping people with type 2 diabetes better manage the condition today.

1. Insulin pumps The first insulin pump came on the market in 1974, according to an article published in June 2020 in the journal Diabetes Therapy. If you have type 2 diabetes and have to inject insulin multiple times a day, a pump is an alternative to self-injection. “An insulin pump is a medical device that delivers insulin into the tissue just underneath the skin,” says Megan Porter, RD, CDCES, a certified diabetes educator in Portland, Oregon.

This computerized device, which is about the size of a deck of cards, can be worn around your waist, put in a pocket, secured with an armband, or attached to a belt or bra. “Some pumps deliver the insulin continuously, and others only deliver the insulin at meals or large snacks,” adds Porter. An insulin pump can also be more convenient if you’re out or at work, because all you may need to do is push a button to deliver the insulin instead of prepping a syringe and giving yourself a shot.

2. Continuous glucose monitors (CGMs) These devices have a tiny sensor that is placed below the surface of the skin to measure the amount of glucose in the fluid between cells every few minutes and transmit the data wirelessly to a device or your smartphone.

CGMs are a game changer: Unlike glucose meters that require a drop of blood to check what your blood glucose levels are at that moment, CGMs monitor your levels at set times throughout the day, such as every 5 minutes. This can help you and your doctor identify patterns and trends that may be helpful in fine-tuning your type 2 diabetes treatment plan to optimize management, according to the American Diabetes Association (ADA). These devices can also alert you when your glucose level is too low or too high.

The first CGM, which involved wearing a device provided by the doctor for two weeks or less and then returning it to the clinic or hospital, was approved by the Food and Drug Administration (FDA) in 1999, according to Endotext. Since then, CGMs have become increasingly accurate and much more widely available for home use. In the past 5 years, there have been even more advances in CGM therapy. In June 2018, the FDA approved the first implantable CGM device, which can be worn up to 3 months without changing the sensor, for people with type 1 or 2 diabetes.

“The benefit of using a CGM is that it can be worn for 5 or more days, which means one poke to insert the monitor [during that time frame] replaces checking blood sugars via a finger poke 3 or more times per day,” Porter notes. CGMs make it easier to check your blood sugar before and after meals, and they can help you understand how your diet, activity, and lifestyle affect your blood sugar levels.

3. Connected CGM-insulin pumps Another option available is a combination CGM-insulin pump, which enables the pump to use the data from the CGM to suggest changes in medication dosing or make necessary adjustments on its own. In June 2020, the FDA approved an integrated CGM, which allows it to be connected to other diabetes management devices, such as insulin pumps and blood glucose monitors.

This integration of devices can help improve type 2 diabetes management by quickly reducing blood sugar and minimizing the amount of time you experience unsafe and unhealthy blood sugar levels.

4. Diabetes medications Although insulin has been used in the United States since the 1920s, according to the ADA, today’s medications can be far more targeted for specific diabetes issues.

Metformin, which belongs to a class of medications called biguanides, is often the first medication prescribed for type 2 diabetes. “[Metformin] decreases glucose absorption from food and decreases liver production of insulin,” says Porter. Other options, including oral medications and non-insulin injectables:

• Sodium-glucose cotransporter-2 (SGLT2) inhibitors are oral medications that lower blood sugar levels by preventing the kidneys from absorbing glucose.
• Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are injectable medications that help you control appetite and blood sugar levels.
• DPP-4 inhibitors, also called gliptins, are oral medications that help manage diabetes in several ways, such as by enhancing insulin secretion, slowing down digestion, and decreasing appetite, which can help with weight loss.
• Thiazolidinediones, also called glitazones, are oral medications that help make your body’s tissues more sensitive to insulin.
• Sulfonylureas are oral medications that increase the release of insulin from your pancreas.
• Meglitinides are oral medications that help your body make more insulin around mealtimes.
• Alpha-glucosidase inhibitors are oral medications that help your body digest sugar more slowly.
• Combination therapies join multiple drug classes in a single medication. They may be injected or taken orally.

“And, of course, insulin is still used as a replacement when a person’s body does not create enough insulin on its own,” Porter adds.

5. Insulin innovations Insulin has come a long way since it was first discovered. It now comes in a variety of forms, including rapid-acting, long-lasting, and premixed formulas, and can be delivered via a number of methods, such as syringes, pumps, and pens. And innovations are still coming. For instance, there are now insulin pen devices that can remember the last dose and the time that it was given, which is especially helpful if you’re busy or tend to forget to take it. Smart insulin pens have many of the features of insulin pumps but cost less and don’t have to be attached to your body.

According to the ADA, smart insulin pens can connect to your smartphone or watch and diabetes data tracking platforms to help you accurately calculate each dose based on factors such as your blood sugar level, carb amounts, meal size, and other parameters prescribed by your doctor. These devices can also remind you to take your dose, keep track of the amount of each dose, and tell you when your insulin has expired.

6. Easier-to-use glucagon Glucagon is used in emergencies to treat very low blood sugar, or hypoglycemia, a dangerous condition that can lead to confusion, loss of consciousness, seizures, and even death, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Glucagon injections have been available for more than 20 years, but in the past few years, devices such as injectable pens and glucagon that can be inhaled have made it much easier for you — or your family or friends — to administer glucagon in the event of an emergency.

7. Better support for people with diabetes In the past, many people with type 2 diabetes were treated by their primary care physician — rather than an endocrinologist, who is trained to treat diabetes — who may not have had any special training in the complexities of type 2 diabetes management. Today, there are many specialists who can help. Since the 1980s, certified diabetes educators have transformed diabetes management, according to the ADA. These professionals, who are now called certified diabetes care and education specialists (CDCES), take a comprehensive approach to teaching diabetes management and specialize in educating and supporting those with diabetes to optimize their health.

Diabetes educators can also connect you to dietitians, physical therapists, and mental health experts trained to help with the condition. “Hopefully, over time, more people with chronic conditions, such as diabetes, will be referred out to other healthcare professionals who can help them manage their condition physically and mentally,” Porter says.

8. Diabetes smartphone apps Yes, there’s an app for that — many of them, in fact. Nowadays, diabetes apps can track your blood sugar levels and show trends; monitor your diet and suggest recipes; log your exercise; and provide support from other people with diabetes. “Coaching apps can also give you access to highly trained diabetes educators and fitness coaches,” Porter says.

But it’s important to check with your doctor, CDCES, or other trusted diabetes health professional before you choose an app. An article published in January 2020 in the journal Diabetes Care noted that there isn’t sufficient evidence to back up the effectiveness, accuracy, and safety of many apps, and many are plagued by technical problems. The authors noted that regulatory agencies and app companies urgently need to work with diabetes health professionals and researchers to ensure the safety and effectiveness of diabetes apps.

9. Meal delivery services While they weren’t developed specifically for diabetes, meal delivery companies that offer healthy foods and recipes have become very popular over the past several years. Now, many companies provide diabetes-friendly meal kits if you want to eat healthy but don’t want to do a lot of food shopping and planning.

Eating Millet May Lower Your Risk of Type 2 Diabetes: Study

For preventing or living well with type 2 diabetes, you may think carbohydrates are the enemy and cut them from your diet. But a new study suggests certain carbs may actually be worth adding to your plate to achieve these health goals.

Specifically, a group of grains called millets, which include sorghum and other seeded grasses grown as cereal crops, may help lower the risk of developing type 2 diabetes and lower A1C, or average blood sugar over about three months, in individuals managing diabetes, according to a study published in July 2021 in Frontiers in Nutrition. That’s because these grains have a lower glycemic index than alternatives such as white rice and refined wheat, the study authors note.

Researchers examined data from 65 small studies that, combined, had about 1,000 participants. The millets used had a mean glycemic index (GI) of 52.7, significantly lower than white rice (GI 71.7) and refined wheat (GI 74.2), the analysis found. Glycemic index scores range from 1 to 100, with higher scores indicating foods that produce bigger, and faster, spikes in blood sugar after a meal.

RELATED: How Glycemic Load Can Help You Better Manage Blood Sugar

The study looked at how eating millets influenced short-term blood sugar levels as well as A1C.

For people with diabetes, regular consumotion of millets reduced average fasting blood sugar levels by 12 percent and decreased average post-meal blood sugar levels by 15 percent. These changes were large enough that researchers no longer considered these patients diabetic, and instead classified them as having prediabetes.

When people had prediabetes, or slightly elevated blood sugar that’s not high enough for a full-blown diabetes diagnosis, millets reduced average A1C levels by 17 percent, enough for these individuals to have blood sugar in a normal, healthy range, the study also found.

“The lower the GI of a food, the lower its propensity for raising blood glucose levels,” says the lead study author, Seetha Anitha, PhD, a senior scientist at the International Crops Research Institute for the Semi-Arid Tropics in Patancheru, India.

RELATED: 5 Ways to Lower Your A1C

Millets Are Low on the Glycemic Index, Making Them Diabetes-Friendly

Millets are low glycemic index foods in part because of their high fiber content, which helps to prevent sudden spikes in blood sugar after meals, Dr. Anitha says. Millets are also packed with protein, which increases insulin sensitivity, or the body’s ability to use the hormone insulin to convert sugars from foods into energy, she says.

“All of this together make millets an effective food for managing blood glucose levels in the long run,” Anitha says.

The occasional meal with millets won’t help much, however. “Millets should become a regular part of one’s diet to have a sustainable effect on diabetes,” Anitha says.

One major limitation of this latest research on millets and diabetes is that most of the studies included in the analysis were very small — some with as few as three subjects. Another limitation is that there were only two studies in the analysis that looked specifically at people with prediabetes to assess whether millets might lower blood sugar to a normal range for these individuals.

RELATED: The Prediabetes Diet Everyone Should Follow

Previous Research Links Eating Millets to Lower Blood Sugar

Despite the limitations of the current analysis, the results mirror findings from several earlier studies of millets and blood sugar levels.

For example, a review published in August 2019 in the Journal of Food and Nutritional Disorders looked at the impact of millets on blood sugar levels in 130 healthy adults and 482 adults with type 2 diabetes. Researchers concluded that millets may reduce both fasting and post-meal blood sugar levels in healthy individuals as well as those with type 2 diabetes.

Another study, published in October 2020 in the Journal of Food Biochemistry, looked at how flatbread made from millets impacted blood sugar control in 100 people with type 2 diabetes. Half the participants were randomly selected to eat the flatbread with millets for three months; this group had significantly lower blood sugar, cholesterol, and blood pressure at the end of the trial than the control group who didn’t eat millets.

A previous study of people with prediabetes also found a link between millets and lower blood sugar. This study, published in February 2020 in the Journal of Food Science and Technology, found that people with prediabetes had lower fasting blood sugar levels and lower A1C levels after eating foods prepared with millets.

Results of the latest study add to the earlier evidence suggesting that millets may play a role in preventing or managing type 2 diabetes, says Rattan Yadav, PhD, a plant genetics researcher at Aberystwyth University in the United Kingdom.

RELATED: What Is a Type 2 Diabetes Diet? A Complete Guide

Other Grains That May Help Lower Blood Sugar

“Millets naturally have higher amounts of fiber and slowly digestible starch in their grains compared with commonly consumed cereals such as rice, wheat, maize, and corn,” says Dr. Yadav, who wasn’t involved in the latest study.

People who eat a typical Western diet tend to consume mostly unhealthy processed grains and very little millet, Yadav says. For these individuals, adding millets and cutting back on grains that are high on the glycemic index may be especially beneficial for preventing or managing type 2 diabetes, he says.

While millets are among the grains recommended by the American Diabetes Association (ADA) as part of a healthy diet for blood sugar management, other grains can also be beneficial. The ADA recommends breads, cereals, and products that list whole grains as the first ingredient on the label. Grains recommended by the ADA include:

• Whole-wheat flour
• Whole oats/oatmeal
• Whole-grain corn/cornmeal
• Popcorn
• Brown rice
• Whole-grain rye
• Whole-grain barley
• Wild rice
• Buckwheat/buckwheat flour
• Triticale
• Bulgur (cracked wheat)
• Millet
• Quinoa
• Sorghum

Foods made from these whole grains should also have at least 3 grams of fiber and less than 6 grams of sugar per serving, according to the ADA.

“To manage or avoid developing diabetes, people need to eat good food like millets and simultaneously avoid eating unhealthy foods,” Yadav says.

RELATED: The Best and Worst Foods to Eat in a Type 2 Diabetes Diet

Can You Eat Fruit If You Have Diabetes? – Cleveland Clinic

Fragrant, fuzzy peaches. Juicy watermelon. Tart berries.
There’s nothing like fresh-picked fruits available at a farmers market or
produce stand near you.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

But is fruit bad for diabetics? If you have diabetes, you might be a little wary of nature’s candy and the sugars they hold. “But don’t be scared of fruit,” says dietitian Kim Pierce, RD.

Here are 10 things to know about fruit and diabetes, including how to make them part of your healthy diet.

Fruit is healthy

Yes, fruits contain carbohydrates. And, yes, the body processes carbs into sugars. But you need healthy carbs to fuel your brain and red blood cells, Pierce says.

Plus, fruit is packed with vitamins, minerals, fiber and antioxidants. “Fruit contains nutrients that can lower your risk of cancer and heart disease,” she adds. “You should eat some every day.”

Fiber is your friend

Fruit does have natural sugars, but its high fiber content balances the sugars, Pierce explains. “Fiber slows down digestion. That helps us feel full longer and prevents spikes in blood sugar.”

Get your daily servings

Dietary guidelines recommend five servings of fruits and
vegetables every day. That’s true whether or not you have diabetes, Pierce
says. Since fruits have more calories and sugar than veggies, try to strike a
balance. She recommends breaking up your five servings into three veggie
servings and two fruit servings.

Eat whole fruit

“All fruit is fair game, but fresh is best,” Pierce says.

The best fruit for diabetics — and everyone, really — is fresh fruit. Whole fresh or frozen fruits should be your go-to, since they’re full of fiber and other nutrients.

Processed fruits like applesauce and canned fruits are the worst fruits for diabetics since they can increase blood sugar more quickly. Dried fruits can also be healthy, Pierce says, but watch your portion size. Two tablespoons of raisins contain as many grams of carbohydrates as a small apple.

Fruits to avoid for diabetics

As always, let nutrition labels be your guide. If you’re wondering what fruits to avoid in diabetes-friendly diets, skip fruits canned in syrup since that means added sugar. Some dried and frozen fruits can also have sugar added, so read the fine print.

Skip juice

“Fruit
juice has a lot of concentrated sugars without any fiber, so it can
increase blood sugars quickly,” Pierce says. If you’re really craving juice,
limit your portion to a half-cup serving. 

Pay attention to portions

Fruit is healthy, but you still have to practice moderation,
Pierce says. Try to space out your fruit throughout the day. (In other words,
don’t eat an entire bag of grapes in one sitting.)

In general, one serving is a small- to medium-sized piece of whole fruit, or ¾ to 1 cup of fruit like melon or berries.   

Choose smarter sweets

Fruit is a terrific option to satisfy a sweet tooth, says
Pierce. One word of caution: If you’re craving something super-specific, like a
brownie, it may be better to just eat a small piece of the chocolatey goodness.
Otherwise, you might be circling back to fruits and other sweet things all day
in a futile attempt to quash that craving.

What fruits are good for diabetics?

If you’re wondering what fruits are good for diabetics, it’s pretty much the same list as non-diabetics: eat the rainbow. Different colors of fruits and vegetables have different vitamins, minerals and antioxidants. To get all the good stuff, look for a ROYGBIV of fruits (and veggies) — from red strawberries to deep purple blackberries (and all the colors in between).

Ask the experts

Fruit is part of a healthy diet, but it’s always smart to
get guidance from nutrition experts before you dive into a bowl of watermelon. “Check
in with a diabetes educator or a registered dietitian to develop a healthy meal
plan,” Pierce advises.

Can I eat fruit if I have diabetes?

A very common question asked by people newly diagnosed with diabetes is, “do I need to cut fruit out of my diet?” Like other topics that discuss both food and diabetes, there is an abundance of conflicting information and opinions.  This article attempts to set the record straight and give you the facts so you can decide what is right for your diabetes management.

Firstly, what actually is fruit? 

Fruit is described as the sweet, fleshy edible part of a plant. It is often eaten raw and can come in many different colours, shapes, textures and flavours.

Fruit is one of the core food groups in the Australian diet as it comprises a number of key nutrients that promote overall health and wellbeing. It contains crucial nutrients and antioxidants such as vitamin A (beta-carotene), C and E as well as magnesium, phosphorus, zinc and folic acid.

Another important nutrient fruit provides our body is dietary fibre. The evidence for the benefits of fibre are extensive. Fibre contributes to improved bowel function, helps us to feel fuller for longer, promotes healthy gut bacteria and has links to improved weight management.

Current recommendations for people living with diabetes

In Australia, dietary recommendations for those living with diabetes are currently based on the Australian Dietary Guidelines (ADG). These guidelines are also aimed at the general population. The ADG recommends Australian adults consume two serves of fruit along with five serves of vegetables per day.

What is a standard fruit serve?

A standard serve is about 150g (350kJ) or:

• 1 medium apple, banana, orange or pear
• 2 small apricots, kiwi fruits or plums
• 1 cup diced or canned fruit (no added sugar)

Or only occasionally:

• 125ml (1/2 cup) fruit juice (no added sugar)
• 30g dried fruit (for example four dried apricot halves, one and a half tablespoons of sultanas)

Doesn’t fruit contain sugar though?

When managing diabetes, people need to be mindful of foods that contain carbohydrates as, on a short-term basis, this is what has a direct impact on increasing your blood glucose levels (BGLs). Fruit contains fructose, a type of natural sugar classed as a carbohydrate. Although it is important to ensure you don’t don’t eat too much fruit, it is still considered as a healthy snack due to its numerous beneficial nutrients.

Data from the 2017-18 National Health Survey actually shows that only half (51.3%) of Australian’s over 18 years meet the two serves recommendation of fruit and only 7.5% meet the guidelines for five to six serves of vegetables. It is also known that over one-third (35%) of an adult’s total daily energy intake comes from discretionary food choices. These are foods that usually contain high amounts of fat, added sugar and salt and are described as energy dense yet nutrient poor. This provides an interesting picture that rising rates of obesity and chronic conditions such as type 2 diabetes are likely related to the fact that a large proportion of Australians do not follow the Australian Dietary Guidelines (ADG)

Are all fruits equal?

Different varieties of fruit contain differing amounts of carbohydrates. Below is a list of common fruits where the amount of carbs have been compared per 100g. Each of these fruits has a glycaemic index (GI) that may also need to be considered. For more information on GI follow the link.

Is fruit juice a good choice?

Although fruit juices seem like a popular and healthy choice, it must be highlighted that juicing fruit removes a substantial amount of skin and pulp that contains fibre and key nutrients. By removing this part of the fruit it concentrates the amount of carbohydrate, makes it higher GI and may cause your BGLs to spike quickly. This is something people living with diabetes should be trying to reduce.

Take home message

Fruit is a healthy snack that is part of a balanced diet and provides you with important nutrients. For people living with diabetes, it is recommended to consume two serves a day alongside other key recommendations of the ADG. Spreading out your fruit serves across the day may help to keep your BGLs relatively stable. If you notice certain fruits cause spikes in BGLs look at reducing portions sizes or swapping to other fruit choices. It is recommended to visit an Accredited Practising Dietitian if you need individualised nutrition advice on what is best for your diabetes management.

Research links fruit but not fruit juice to lower type 2 diabetes risk — ScienceDaily

A new study finds people who consume two servings of fruit per day have 36 percent lower odds of developing type 2 diabetes than those who consume less than half a serving. The research was published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Diabetes is a disease where people have too much sugar in their bloodstream, and it is a huge public health burden. Approximately 463 million adults worldwide were living with diabetes in 2019, and by 2045 this number is expected to rise to 700 million. An estimated 374 million people are at increased risk of developing type 2 diabetes, the most common form of the disease. A healthy diet and lifestyle can play a major role in lowering a person’s diabetes risk.

“We found people who consumed around 2 servings of fruit per day had a 36 percent lower risk of developing type 2 diabetes over the next five years than those who consumed less than half a serving of fruit per day,” said study author Nicola Bondonno, Ph.D., of Edith Cowan University’s Institute for Nutrition Research in Perth, Australia. “We did not see the same patterns for fruit juice. These findings indicate that a healthy diet and lifestyle which includes the consumption of whole fruits is a great strategy to lower your diabetes risk. “

The researchers studied data from 7,675 participants from the Baker Heart and Diabetes Institute’s Australian Diabetes, Obesity and Lifestyle Study who provided information on their fruit and fruit juice intake through a food frequency questionnaire. They found participants who ate more whole fruits had 36 percent lower odds of having diabetes at five years. The researchers found an association between fruit intake and markers of insulin sensitivity, meaning that people who consumed more fruit had to produce less insulin to lower their blood glucose levels.

“This is important because high levels of circulating insulin (hyperinsulinemia) can damage blood vessels and are related not only to diabetes, but also to high blood pressure, obesity and heart disease,” Bondonno said.

Story Source:

Materials provided by The Endocrine Society. Note: Content may be edited for style and length.

Can Diabetics Eat Pineapple? Our Expert Tells

Diabetes diet: Diabetics should eat fruits in moderation

Highlights

• Pineapple can help in weight loss
• Eating pineapple can help boost digestion
• Pineapple juice can be used as a cough remedy

Diabetes is a chronic condition that requires constant management. A healthy diet and lifestyle play an important role in controlling blood sugars. A diabetes diet should include foods that do not affect blood sugar levels negatively and help in controlling them naturally. Fruits are extremely healthy. It is advised to east fruits daily to receive a variety of nutrients. But fruits contain natural sugar. So, diabetics are advised to eat fruits in moderation. While some fruits are healthy for diabetics whereas, it is advised to avoid a few. Pineapple is a sweet fruit loaded with multiple health benefits. Is it safe for diabetics to eat pineapple? Let’s find out.

Diabetes diet: Is it healthy for diabetics to eat pineapple?

Pineapple is loaded with nutrients. It contains enzymes known as bromelain which can help boost digestion. Pineapple can also help boost immunity and suppress inflammation. It also contains antioxidants that can help combat oxidative stress.

Pineapple may offer amazing health benefits but it is not a good choice for diabetics. Pineapple is a medium GI fruit. Foods with low GI (glycemic index) are considered best for diabetics. Carbs can also contribute to high blood sugar levels. Most diabetics count the number of carbs they consume per meal to avoid major fluctuations in blood sugars. Though, pineapple contains low amount of carbs.

Pineapple contains vitamin C which can help boost immunity
Photo Credit: iStock

Pavithra N Raj, Chief Dietician at Columbia Asia Hospital explains, “Pineapple is a powerhouse of nutrition. It is loaded with vitamin C, vitamin B12 (thiamine), iron, antioxidants, bioflavonoids, anti-inflammatory properties and is rich in magnesium and potassium. It also contains enzyme bromelain which aids digestion and acts as a diuretic. Pineapple is rich in fibre which can keep you full for longer and slow down the absorption of sugar but medium GI score makes it not-so-good for blood sugar levels.”

Also read: Diabetes Diet: Can Diabetics Eat Fruits? Know Tips To Choose The Right Fruits

How to eat pineapple if you have diabetes?

Pavithra further adds, “100 GM of fruit can be consumed for mid-morning and can be paired with 5-6 pieces of other fruits. “

Diabetics should avoid drinking pineapple juice
Photo Credit: iStock

Diabetics should avoid pineapple as much as possible. But if you want to eat pineapple pair it with foods that have a low GI score. Do not drink pineapple juice as it contains more sugar. Diabetics should avoid drinking fruit juices, to prepare one glass of juice you need more fruit which means more sugar.

Also read: Cough Home Remedies: This Fruit Juice Can Give You Relief From Cough; Know Methods To Use

(Pavithra N Raj, Chief Dietician, Columbia Asia Referral Hospital Yeshwanthpur)

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Can I Eat Fruit if I Have Prediabetes?

If you have prediabetes, it is important to take a good look at your diet to make sure you are eating in a way that best supports your health. But when deciding what foods to avoid and what foods to eat with prediabetes, it can get confusing. One area of confusion for many people is fruit. Fruit is high in nutrients, but it is also a natural source of sugar.

So is fruit good or bad for you? Is it okay to eat fruit if you have prediabetes?

It turns out that fruit can actually help you prevent diabetes, as long as you make healthy choices regarding what kinds and how much you consume.

Fruit can actually lower diabetes risk

While some people are concerned about fruit because it contains sugar, eating fruit is actually associated with better health and lower risk for disease. Fruit gives us fiber, vitamins, minerals, and other important plant-based nutrients, all of which can support optimal body function.

The health benefits of eating fruit include preventing diabetes and blood sugar concerns. In fact, people who eat more fruit in their diets are less likely to get prediabetes than those who eat less fruit. [1] If you already have prediabetes, eating healthy fruits may help you to control your blood sugars. One study, for example, found that prediabetics who ate more raspberries had lower blood sugar levels compared to those who didn’t eat raspberries at all.[2]

And the best part is that there is substantial evidence suggesting that eating fruits regularly can also help to reduce your risk of developing type 2 diabetes.[3-6] According to findings of a 2020 study published in the journal BMJ, your risk of diabetes may go down by 25% for each additional 66 g of fruits and vegetables you eat each day.[3] Higher fruit consumption can also lower the risk of serious complications in people who are already diabetic.[4]

Fruits like blueberries, grapes, and apples are particularly helpful for lowering diabetes risk. Fruit juice, on the other hand, increases your risk.[5]

But what about the sugar?

Fruit in moderation should provide you with healthy nutrients that can actually help keep your body healthy and prevent health concerns. But fruit also has its downsides. You don’t want to be fooled into thinking you can eat as much fruit as you want without any consequences.

Fruit does contain sugar, and excess sugar is problematic when it comes to regulating blood sugars and maintaining good health. The sugar content in fruit is definitely something to be aware of when adding fruit into your healthy prediabetes diet.

As with most foods, there can be too much of a good thing when it comes to fruit. If you eat a lot of fruit at once, you may consume too much sugar and spike your blood glucose levels above healthy limits

You don’t want to eat more fruit than recommended each day. For kids, that means about 1 to 1½ cups per day, and for adults it means about 2 cups. That equates to about one small apple (or ½ of a large one), one medium grapefruit, one medium pear, eight large strawberries, or 32 grapes.[7]

It is important to realize that fruits aren’t often the main culprits when it comes to spiking blood sugar levels. Most of the time, the vast majority of the problem comes in the form of sweets, processed foods, sodas, refined carbohydrate products, and more.[8] It is far more important to focus on limiting these unhealthy sources of carbohydrates and added sugars than it is to limit natural sugars from fruit.

So while you’ve got to watch your portion sizes with fruits to avoid excess sugar, if you are eating reasonable amounts you shouldn’t have to worry too much. You can enjoy fruit as a tasty, nutritious alternative to unhealthy options like candies and baked goods.

Making healthy fruit choices: what kind and how much

Do you want to take advantage of the nutrients and health benefits of fruit while staying away from too much sugar? To eat fruit responsibly, consider these tips:

• Remember your portion sizes. A healthy serving of fruit should be about the size of your palm. A small apple, a handful of berries, or a slice of watermelon are all good options.
• Opt for low-sugar fruits instead of high-sugar fruits. Fruits with higher sugar contents include melons, bananas, and pineapple. Dried fruits like raisins and fruit juices are also super high in sugar. Instead, choose berries, kiwi, apples, pear, or watermelon. Watermelon, for example, tastes surprisingly sweet for having just 10 g of sugar in one cup.[9,10]
• Focus on whole fruits, not dried or juiced fruits. Eating fruits whole means you get a lot of nutritious fiber, which helps slow down digestion and prevent blood sugar spikes. Fruits with edible skins are particularly high in fiber. Limit or avoid fruit juice and dried fruit, which are much more concentrated in terms of sugar and carbohydrate content. For example, a small piece of whole fruit has about 15 grams of carbs, whereas only 2 tablespoons of dried fruit contain about 15 grams. If you do eat dried fruit or drink juice, realize that the healthy portion sizes are quite small, so you can only have a very small amount at a time. [9]
• Eat the rainbow. The more color you can get in with your fruit selections the better. Think dark blue blueberries, green grapes, and bright red strawberries. The color will provide you with a variety of powerful nutrients and will make your food more fun and appealing.[8]
• Pair fruit with a healthy source of protein and fat. The protein and fat will slow down digestion of the carbohydrates in your fruit to reduce a blood sugar spike. For example, add nuts or feta cheese to a fruit salad or eat an apple with nut butter. Learn more about how to prevent blood sugar spikes when eating carbs here.
• Choose fruit instead of dessert. If you need something a bit sweet and tasty for dessert or a special treat, fruit is definitely a healthy alternative to cakes, cookies, pies, or candy. A bowl of mixed berries is always a delicious (and colorful) option.
• Spread fruits out throughout the day. Instead of eating a ton of fruit at once, consider spacing it out. The less fruit you eat at once, the less likely you are to spike blood sugar levels.
• Always read labels. If you are choosing products like canned fruit, read the label. Look for options that say “unsweetened” or “no sugar added.”[9]

Fruit with prediabetes: the bottom line

It’s okay to eat some fruit if you have prediabetes. In fact, fruit can actually provide you with nutrients and reduce your diabetes risk.

The key is to pay attention to how much you are eating and what kind of fruit you are eating to make sure you avoid unhealthy blood sugar spikes. Whole fruits are best, especially fruits like berries and apples, while dried fruit and fruit juice should be avoided completely.

If you are really wanting to improve your health and reduce your diabetes risk, then you’ll need to look beyond fruit and to other important diet and lifestyle factors. Make sure to focus on other risk factors like being overweight, not being physically active, or eating a diet with lots of added sugars, and make healthy changes to improve your health now.

1. Safabakhsh M, Koohdani F, Bagheri F, et al. Fruit and vegetable intake and pre-diabetes: a case-control study. Eur J Nutr. 2018;57(8):2953-2962.
2. Xiao D, Zhu L, Edirisinghe I, et al. Attenuation of Postmeal Metabolic Indices with Red Raspberries in Individuals at Risk for Diabetes: A Randomized Controlled Trial. Obesity (Silver Spring). 2019;27(4):542-550.
3. Zheng JS, Sharp SJ, Imamura F, et al. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries. BMJ. 2020;370:m2194.
4. Du H, Li L, Bennett D, et al. Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults. PLoS Med. 2017;14(4):e1002279.
5. Muraki I, Imamura F, Manson JE, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013;347:f5001.
6. Li M, Fan Y, Zhang X, Hou W, Tang Z. Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies. BMJ Open. 2014;4(11):e005497.
7. ChooseMyPlate. All About the Fruit Group. United States Department of Agriculture. https://www.choosemyplate.gov/eathealthy/fruits.
8. Prediabetes and Type 2 Diabetes: Prevention and Management. University of California, Berkeley. Updated 2017. https://uhs.berkeley.edu/sites/default/files/wellness-prediabetesanddiabetes.pdf.
9. Fruit. American Diabetes Association. https://www.diabetes.org/nutrition/healthy-food-choices-made-easy/fruit.
10. Food Data Central. Watermelon, raw. United States Department of Agriculture. https://fdc.nal.usda.gov/fdc-app.html#/food-details/1102698/nutrients.

90,000 What fruits can diabetic patients eat

Any changes in the diet of people with diabetes should be discussed with their doctor.
Photo: pixabay.com

The increased level of insulin in the blood imposes restrictions on the diet of diabetics.However, this does not mean that they should completely abandon sweet fruits.

Diabetes mellitus is one of the most common diseases in the modern world. Due to the need to constantly monitor the level of insulin in the blood, it is important for patients who are ill to carefully monitor what and in what quantities they eat. For a long time it was believed that they absolutely should not eat sweet fruits. But it turned out that this is not the case.

American scientists have found that there are several fruits that you can eat without fear of ending up in a hospital bed after that.

• Apples . One small apple contains 14 grams of carbohydrates. That’s not a lot. Therefore, it is quite possible for diabetics to have a snack with them during the break between the main meals.

• Kiwi . This fruit is also not rich in carbohydrates – 12-13 grams. However, it is very rich in vitamin C and also contributes to the establishment of the regular work of the gastrointestinal tract.

• Apricots .This is one of the most delicious and healthy fruits. Especially for people who need to monitor their blood sugar levels. And all because there are very few carbohydrates in apricots – only 4 grams per 100 grams of pulp. An additional bonus to the benefits of this fruit is its extraordinary richness in vitamin A, which is very beneficial for perfect skin and vision.

• Oranges . Despite the sweetness, their juicy pulp contains fewer carbohydrates.According to scientists, there are only 8-10 grams of these substances in one fruit. This level is not enough for significant fluctuations in sugar values, but it is quite enough to satisfy the desire to enjoy something tasty. By the way, you can replace the whole fruit with freshly squeezed juice. It contains half of carbohydrates.

90,000 Fruit for people with diabetes: benefit or harm

Diabetes is a chronic but manageable condition in which the body tries to control blood sugar levels.

It’s no secret that people with diabetes should eat a balanced diet that provides enough energy and helps maintain a healthy weight. But sometimes you really want something sweet. And it is fruits that can help those with a sweet tooth give up sweets and other foods with low nutritional value.

– Of course, everyone knows that fruit is a healthy food product. They contain vitamins, minerals, water, and sources of dietary fiber. Eating fruit every day is essential for a nutritious diet.In addition, fruits play an important role in normal digestion and metabolism, and are indispensable in dietary nutrition, – says therapist, nutritionist Elena Pogrebnyak.

But few people think about what dangers can cause uncontrolled consumption of large quantities of fruit every day. And this is due to the fact that fruits contain many natural sugars (sucrose, fructose, glucose).

– First, over-consumption of high-glycemic fruits can lead to weight gain.This is if you exceed the daily calorie content more than the energy consumption in the process of physical activity. Secondly, excessive consumption of fruits with a high glycemic index leads to a jump in insulin release, – notes the nutritionist.

And if these insulin releases are regular (in response to excessive consumption of very sweet fruits), then type 2 diabetes can develop.

Pogrebnyak clarified that the likelihood of developing diabetes will increase if a person, for example, has a tendency to this disease or other risk factors.

– The Association of Nutritionists of Ukraine recommends consuming up to 300 grams of fruit per day: it is better to eat one handful twice a day, she stressed.

At the same time, the general practitioner reminded that people who are overweight or have diabetes are advised to eat fruits and berries with a low or medium glycemic index. And it is not advisable to use – with a high glycemic index.

– It is also important to remember that the best fruit is a vegetable! – Elena Pogrebnyak summed up.

Fruits with a low GI (glycemic index): apple, avocado, kiwi, nectarines, orange, peach, plum, quince, pomegranate, apricot, currant, cherry, lemon, blueberry, raspberry, cranberry, grapefruit, strawberry.

Medium GI fruits: figs, pineapple, papaya, melon.

High GI fruits: dates, watermelon, grapes, persimmon, mango.

According to the WHO, today 422 million people worldwide suffer from diabetes.

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Liver in type 1 and type 2 diabetes

Diabetes mellitus (DM) is an endocrine disease that occurs in the absence of insulin (absolute insulin deficiency) or impaired insulin action (relative insulin deficiency and / or insulin resistance). Absolute insulin deficiency underlies the development of type 1 diabetes mellitus, relative insufficiency and / or insulin resistance, as a rule, leads to the development of type 2 diabetes mellitus.

In recent years, diabetes mellitus has consistently occupied one of the leading positions among the causes of death worldwide ¹ , and the cost of treating diabetes and its complications is constantly growing.

As of the end of 2018, type 2 diabetes is diagnosed in 92% of cases, and type 1 diabetes accounts for 6% (the remaining 2% are other types of diabetes). However, it is known that these data do not reflect the actual prevalence of the disease. According to the results of the large-scale Russian epidemiological study NATION, only 54% of cases of type 2 diabetes are diagnosed. ⁹

How overweight and diabetes mellitus are related

At the moment, the mechanisms involved in the development of insulin resistance are not fully understood. The main role is apparently played by an increase in the level of free fatty acids (FFA), chronic hyperglycemia, leading to the activation of oxidative stress and damage to b-cells of the islets of Langerhans, as well as inflammatory processes in adipose tissue. ¹²

With diabetes, liver changes are found in 35-100% patients ^5.6 .This is due to its active participation in carbohydrate and fat metabolism.

Steatosis is the initial stage of non-alcoholic fatty liver disease (NAFLD). The incidence of NAFLD in patients with type 2 diabetes and obesity is 70-100% ⁷ .
The development of steatosis is associated with insulin resistance, which in turn underlies type 2 diabetes mellitus. The lack of glycogen in the liver, which is observed with a relative lack of insulin, leads to the stimulation of gluconeogenesis from free fatty acids, as a result of which an increase in their level in the blood is observed.A diet high in fat also contributes to an increase in the level of free fatty acids. ⁶

The severity of steatosis depends on the duration and severity of diabetes. ⁶

With the progression of fatty hepatosis (fatty liver) can go to the following stages:

• steatohepatitis, which develops with the addition of inflammation
• fibrosis – replacement of liver tissue with connective tissue
• further the disease can progress to cirrhosis and hepatocellular carcinoma. ¹³

Clinical manifestations of hepatosis are rare. However, the patient may complain of a feeling of heaviness, discomfort or pain in the right hypochondrium, general weakness and fatigue. Such symptoms are not specific, and the patient may not pay attention to them for a long time ¹³ .

The goal of NAFLD treatment is to improve the functional state of the liver, prevent the progression of the disease and the formation of connective tissue, and help restore liver function.

Date of publication of the material: November 17, 2020

MAT-RU-2003445-1.00-11 / 2020

90,000 Fruits and berries. Diabetes. Eat – to live

Fruits and berries

Fruits and berries differ in their properties in terms of increasing sugar. So, for example, fruits of the same name, but of different varieties, act the same way – in the sense that sour and sweet apples of the same weight increase blood sugar levels in the same way. Apples taste sour not because they have less sugar than sweet apples, but because they have more acid.This means that sweet apples are not forbidden, they increase sugar to the same extent as sour ones. Therefore, you can eat any apples, not forgetting to count them in bread units.

Fruits contain fruit sugar (fructose), which means they contain “fast sugar” and can raise blood sugar quickly, within 15 minutes.

Grapes, which contain pure glucose, can be eaten in the amount of 4-5 berries, but more often it is used to stop hypoglycemia. Fruits with a high fructose content – persimmons and figs – are undesirable.Do not eat dried fruits – raisins, prunes, dried apricots. Dried fruits are converted into bread units (20 g = 1 XE), but it is better to replace 4–5 pieces of dried apricots with an apple or grapefruit; it is much healthier, since fresh fruit contains more vitamins.

Permitted fruits and berries: apples, pears, citrus fruits, watermelon, melon, apricots, peaches, plums, pomegranates, mangoes, cherries, cherries, strawberries, currants, gooseberries.

Less desirable, but sometimes acceptable fruits and berries: bananas and pineapples.

Fruit portion should not exceed 2 XE per day, and it must be divided into two parts: for example, eat an apple at noon, and a grapefruit at four o’clock in the afternoon, between lunch and dinner. Once again, it should be recalled that all fruits and berries contain “quick sugar”. This means that you should not eat an apple at the last snack – before bedtime, since the sugar rises quickly at first and then decreases, and signs of hypoglycemia may appear at four in the morning.

Fruit juices with sugar are undesirable, except for the relief of hypoglycemia.Let us remind you that the juices that are on sale come with sugar and without sugar, natural. But natural juices contain fructose and do not contain fiber. Fiber slows down absorption, and its absence leads to the fact that the “quick sugar” of natural fruits in their juices becomes “almost instant”.

So, we can conclude that grinding, turning into gruel or into juice of a product allowed by a patient with diabetes mellitus turns it into an undesirable product, and solid, fibrous and cool for a diabetic is preferable.

Vegetables are the most important component of the menu for patients with diabetes mellitus, as they contain almost no carbohydrates or fat, but they are high in fiber. But even here there are limitations, since certain types of vegetables are quite rich in carbohydrates – first of all, these are potatoes containing starch. Potatoes can be eaten, but with strict accounting: one small boiled potato (a little more than a chicken egg) is equal to 1 XE. It is best to eat boiled potatoes, as they raise sugar more slowly than mashed potatoes.

In addition to potatoes, corn, also containing starch (160 g = 1 XE), and legumes (beans, beans, peas at the rate of 5–7 tablespoons of boiled product per serving) must be converted into bread units.

No need for accounting: cabbage of all kinds, carrots, radishes, radishes, turnips, tomatoes, cucumbers, zucchini, eggplants, green and onions, lettuce, rhubarb, herbs (parsley, dill, etc.). Beets and carrots are sweet, but they can be eaten without restriction, as they are high in fiber.But if you prepare natural carrot juice without sugar, then, unlike whole or grated carrots, you need to convert it into bread units (1/2 cup = 1 XE).

Also, without limitation (within reasonable limits, of course), mushrooms and soybeans that contain vegetable protein are allowed.

Vegetable fats (sunflower oil, etc.) are not included; you can ignore nuts and seeds.

This text is an introductory fragment.

Continuation for liters

Diabetes mellitus and anemia – Portal

In this article we would like to talk about the causes, importance and principles of treating anemia in patients with diabetes mellitus. What is diabetes mellitus?

Diabetes mellitus is a chronic endocrine disease characterized by a violation of all types of metabolism against the background of absolute or relative insulin deficiency.

Metabolic disorders that occur in diabetes negatively affect the state of internal organs, which is why, against the background of diabetes mellitus, a condition such as diabetic nephropathy often develops.

One of the consequences of diabetic nephropathy is anemia, which occurs in most patients with this pathology.

What is diabetes mellitus? Diabetes mellitus is an endocrine disease that occurs as a result of absolute or relative insulin deficiency.What does it mean? Insulin is a hormone in our body that regulates the metabolism of carbohydrates (glucose) to fats and proteins. Insulin is produced by the pancreas in response to an increase in blood glucose (for example, after a meal). Once in the blood, insulin is carried throughout the body, reacts with cells and ensures the capture and processing of glucose. Thus, insulin provides a decrease in blood glucose levels and tissue nutrition (some tissues of our body are not able to capture glucose in the absence of insulin).

The cause of diabetes mellitus is insulin deficiency. An insulin deficiency can be absolute – that is, the pancreas makes too little or no insulin.

Absolute insulin deficiency is observed in type I diabetes mellitus. relative – when the insulin produced in normal amounts cannot provide adequate glucose metabolism. This situation is observed in type II diabetes, when physiological amounts of insulin cannot provide a decrease in blood glucose levels due to a decrease in tissue sensitivity to insulin itself (this phenomenon is called insulin resistance).

Why does diabetes mellitus lead to kidney damage? With inadequate treatment and prolonged increase in blood glucose levels, diabetes mellitus leads to significant damage to all internal organs. The first to suffer from diabetes mellitus are the small blood vessels of the arterioles and capillaries, which feed all organs and tissues of our body with blood. In diabetic patients (with prolonged preservation of elevated blood glucose levels), the walls of the arterioles are saturated with fat and carbohydrate complexes, which in turn leads to cell death in the walls of these vessels and the proliferation of connective tissue in them.

Affected arterioles close, and the organ fed by them begins to experience a lack of oxygen and nutrients.

Kidney damage in diabetes (diabetic nephropathy) develops by this mechanism. Massive destruction of kidney vessels in the presence of diabetes leads to the death of the working tissue of the kidneys and its replacement with inactive connective tissue. As nephropathy develops, the kidneys gradually lose their ability to filter blood and form urine – chronic renal failure develops.

Today, more than half of all cases of chronic renal failure are due to diabetes mellitus.

How does anemia relate to diabetes mellitus? Anemia is a disease in which the content of red blood cells and hemoglobin in the blood decreases. As you know, in our body, blood cells are formed in the red bone marrow. However, in order for the red brain to work, it must receive a specific signal in the form of the hormone Erythropoietin .

Erythropoietin is produced by special kidney cells. In diabetic nephropathy (see above), not only kidney cells involved in blood filtration die, but also cells that produce erythropoietin, therefore, simultaneously with chronic renal failure, diabetic patients develop anemia (the absence of erythropoietin leads to the termination of the red bone marrow). In addition to the lack of erythropoietin in the pathogenesis (development) of anemia in patients with diabetes mellitus, a certain role is played by iron deficiency and chronic protein loss accompanying renal failure.

What effect does anemia have on the condition of patients with diabetes mellitus? According to modern studies, the course of chronic renal failure, which developed against the background of diabetic nephropathy, is complicated by anemia in more than half of the cases. Anemia significantly reduces the quality of life of patients with diabetes mellitus. Against the background of anemia, there is a decrease in appetite, physical abilities, intellectual and sexual functions of patients. Diabetic patients with anemia are at greater risk of developing cardiovascular disease, as anemia is likely an independent factor contributing to the dysfunction of the heart and blood vessels.How is anemia treated in diabetic patients? Unlike cases of anemia caused by a lack of iron or vitamins (iron deficiency anemia, anemia with a deficiency of vitamin B12 and folic acid), anemia that occurs against the background of renal failure in patients with diabetes mellitus cannot be treated only with vitamin and mineral preparations and without adequate treatment can take a very bad shape. How is anemia treated in diabetic patients? Due to the fact that the main factor in the development of anemia in patients with diabetes mellitus is a lack of erythropoietin, drugs containing erythropoietin are used in its treatment.

Erythropoietin is a complex organic compound of carbohydrate-protein nature. The carbohydrate component of the erythropoietin molecule can be of two types: alpha and beta (hence the name of erythropoietin preparations). For the treatment of anemia, Erythropoietin is produced recombinantly, that is, it is synthesized by bacteria, which have been introduced to human genes encoding the structure of erythropoietin. In the process of preparing the drug, erythropoietin undergoes multiple purification, which makes it possible to minimize the frequency of adverse reactions as much as possible.Patients with diabetes mellitus with diabetic nephropathy are recommended to inject erythropoietin when the hemoglobin level in the blood drops below 120 g / l (that is, at the very beginning of anemia), if other methods of treatment are ineffective (for example, iron supplements). Early initiation of treatment with erythropoietin slows down the development of angiopathy (damage to small vessels), and, consequently, nephropathy, which improves the prognosis of the disease and facilitates its course.

Patients with diabetes mellitus are administered erythropoietin in two ways: intravenously and subcutaneously.The standard frequency of injections is 3 times a week. Recent studies in the treatment of anemia in diabetic patients show that subcutaneous injections of erythropoietin are no less effective than intravenous ones, which greatly simplifies the treatment process (patients can inject themselves), and the frequency of injections can be reduced to 1 time per week, provided that triple dose of the drug.

To increase the effectiveness of the treatment of anemia in patients with diabetes mellitus, injections of erythropoietin are supplemented with iron preparations.Prevention of anemia in diabetes blood glucose.

Therefore, the main measures for the prevention of anemia in patients with diabetes mellitus are:

• Earlier medical attention, at the first symptoms of diabetes or immediately after the detection of diabetes on the basis of a blood test;

• Strict adherence to prescribed treatment (antidiabetic drugs, insulin) and diet from the first days of illness;

• Systematic self-monitoring: checking the level of glucose in the blood, adjusting the treatment regimen in conjunction with the attending physician;

• Quitting bad habits – helps to significantly reduce the risk of cardiovascular disease and alleviate the course of diabetes;

• Weight loss (for obese people) – can not only alleviate the course of diabetes, but also eliminate it.In addition, weight loss has a positive effect on the course of other diseases associated with diabetes (hypertension, coronary heart disease, etc.).

In Western countries, diabetes has long ceased to be considered an “incurable disease” or “sentence”. Thanks to the modern possibilities of controlling the level of glucose in the blood (insulin preparations, antidiabetic drugs), diabetes has come to be considered a “special way of life” and not a disease. Indeed, adherence to a well-functioning treatment regimen and diet can compensate for the lack of insulin for decades, without the occurrence of any complications of diabetes.Treatment of anemia in patients with diabetes mellitus should be mandatory, since anemia not only reduces the quality of life of patients with diabetes, but also accelerates the development of the disease itself and its complications. At the moment, the main problem with the use of erythropoietin preparations for the treatment of anemia in diabetic patients is only the high cost of the drugs themselves.