This guide is our contribution to honor Diabetes Awareness Month and give you something you can act on to transform your life or support a loved one who deals with diabetes.
If you're looking for a collection of resources on how to better manage and live with diabetes, this list is for you.
We researched the most science-driven sources and gathered the latest research, terminology, resources, and actionable advice to help you achieve your peak health.
Read this in one sitting or jump to the section below you’re most interested in.
The pancreas is a gland and organ that plays a key role in the digestive system. It releases enzymes (a.k.a digestive juices) into the small intestine to help break down food once it has left the stomach. It’s about 6 inches long and sits across the back of the abdomen, behind the stomach and next to the liver. The pancreas also produces insulin and releases it into the bloodstream to regulate the body’s sugar level. A quick way of defining diabetes would be to say that diabetes is the condition you’d have if your pancreas doesn’t fulfill its function.
Insulin is an essential hormone for controlling blood sugar and energy absorption. Insulin is essential to stay alive as it enables our cells to get the energy required for them to function. If insulin levels are too high or too low continuously, serious health conditions start to develop, diabetes being the most important one.
The term metabolism usually refers to the breakdown of food and its transformation into energy. You can think of it as the whole set of chemical reactions that help maintain the living state of cells and organisms. A metabolic disorder is when something is wrong with the body's metabolism — the ability to turn food into energy and get rid of waste. Diabetes is a disruption in the channeling of energy to human cells and impedes metabolic function.
Islet cells are clusters of cells located in the pancreas. They produce hormones and contain alpha and beta cells, two essential cells in managing glucose levels in the blood.
Beta cells (β cells) are a type of cells found within islet cells in the pancreas. They synthesize and release insulin and amylin into the bloodstream. Patients with Type I or Type II diabetes have fewer beta-cells (between 50-70% of total cells in islets are beta-cells for a healthy human) and their function is diminished leading to insufficient insulin secretion and hyperglycemia.
Glucose is the main sugar that our body makes from the food in our diet. It is carried through the bloodstream to provide energy to all cells in the body. Cells cannot use glucose without the help of insulin.
Insulin resistance is a condition in which cells fail to respond normally to the insulin hormone, which leads to high blood sugar. Before being characterized as Type 2 diabetes, insulin resistance is often a consequence of being overweight and obesity (and sometimes skinny-fat).
Previously called juvenile or insulin-dependent diabetes, Type 1 diabetes is the consequence of your immune system destroying beta-cells in your pancreas.
Previously called adult-onset diabetes, Type 2 diabetes is a chronic condition that happens as a result of your body not metabolizing (a.k.a digesting, extracting and transforming into energy) food properly. Type 2 diabetes occurs when your body's cells resist the normal effect of insulin, which is to drive glucose in the blood into the inside of the cells. As a result, glucose starts to build up in the blood.
Type 1.5 is a common name for Latent Autoimmune Diabetes in the Adults (LADA). This new hybrid form of diabetes shares the same characteristics as both Type 1 and Type 2 diabetes. People with LADA tend to have a healthy weight and are usually diagnosed between the ages of 30 and 50 - older than typical for Type 1 but relatively young for Type 2 diabetes.
This is a new term characterizing diabetes-associated with Alzheimer’s disease. It occurs when neurons in the brain become unable to respond to insulin, which is essential for basic tasks, including memory and learning.
You can think of prediabetes as the corridor leading to Type 2 diabetes. It happens when blood glucose levels are higher than normal but not high enough to be categorized as Type 2 diabetes.
Gestational diabetes is high blood sugar that develops during pregnancy and could disappear after giving birth. It can happen at any stage of pregnancy but is more common in the second or third trimester.
Also called 2-hour glucose tolerance test or glucose tolerance test, it’s the gold standard test doctors use to determine whether you are prediabetic, have Type 2, or have gestational diabetes. the gold standard for Type 2 and gestational diabetes. Blood is drawn twice: first to determine a baseline blood sugar level and then a second time 2 hours after you drink a large glass of 75g of glucose diluted in 250-300 ml of water for adults. A glucose level of 200 mg/dL (11.1 mmol/L) or higher is used to diagnose diabetes.
A fasting blood sugar level, or fasting glucose level, is the result of a blood sample taken after a patient fasts for at least eight hours. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal while a fasting blood sugar level from 100-125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher, you have diabetes.
Glycated hemoglobin is a form of hemoglobin that is chemically linked to a sugar. The usual sugar is glucose. The formation of the sugar-Hb linkage indicates the presence of excessive sugar in the bloodstream, which is often indicative of diabetes. A1C is of particular interest because it is easy to detect. For people without diabetes, the normal range for the hemoglobin A1c level is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% mean you have a higher chance of getting diabetes. Levels of 6.5% or higher mean you have diabetes.
Metformin is an orally administered drug prescribed in cases of Type 2 diabetes. It is also called Glucophage (which means “eating glucose”) and is commonly prescribed as the first line of intervention.
Fast-acting, intermediate-acting and long-acting. Your doctor will assign the best type of insulin for your case depending on how fast they act and when they peak.
Hypoglycemia happens when there is too little glucose in the blood. For people with diabetes, this is what happens when there is an imbalanceusually the consequence of a lack of balance between insulin dose and, food, and exercise and/or medication. It can sometimes happen during sleep, which makes long-acting insulin advantageous for some people.so that’s one of the advantages of long-acting insulin.
While not everyone with diabetes experiences this, dark patches on the skin are the results of sugar build-ups in the blood that ends up causing discoloration to certain areas around the body (such as underarms, elbows, groin, behind the neck and knees). If you notice this on your skin, you should go see a doctor immediately as prediabetes can be easily reversed when addressed properly.
You might also feel sluggish and lethargic. Talk to your doctor to get your blood sugar level checked.
It’s usually a sign that your body is trying to eliminate the excess sugar in your blood through urination.
With excess urination, your body will be lacking fluids and pushing you to replace it, hence the thirst.
The likelihood of having diabetes and diabetes-related cardiovascular comorbidities increase with BMI regardless of physical activity. Similarly, the likelihood of having diabetes and diabetes-related cardiovascular comorbidities increased with BMI regardless of physical inactivity. Both BMI and physical activity are two separate risk factors, and it is important to pay attention to both.
According to the latest studies, a healthy waist measurement should be less than half that of a person’s height. This means a 5ft (60 inch) tall man or woman should aim to keep his or her waist less than 30 inches.
Several recent studies conducted by researchers in Australia (from over 8,000 women, and published in The Journal of Clinical Endocrinology & Metabolism) found that those who had PCOS were 4 to 8.8 times more likely to develop Type 2 diabetes than women who didn’t have PCOS. Additionally, they found that obesity was an important risk factor.
Family history of diabetes, mother’s short stature (less than 4 feet 9 inches) and age (over 35) increase risk for gestational diabetes and Type 2 diabetes after giving birth.
Obesity, oxidative stress, inflammation, and insulin resistance cause secondary chronic diseases like high blood pressure and diabetes.
People over 45 are more likely to have Type 2 diabetes. Type 1 diabetes is usually diagnosed during childhood and in teenagers.
In the United States, Caucasians are more likely to have Type 1 diabetes than African-Americans and Hispanic-Americans. However, the prevalence is completely different for Type 2 diabetes where Hispanic and Asian-American communities are more likely to develop Type 2 diabetes than non-Hispanic whites.
The impact is more prevalent among the non-obese who are sheltered from other risk factors. For example, if you compare two groups of people: one of them has no risk factors at all, and the other has no other risk factors except for family history, the second group is 26% more likely to be prediabetic.
Repeating it again: the likelihood of having diabetes and diabetes-related cardiovascular comorbidities increased with BMI regardless of physical activity and increased with physical inactivity regardless of BMI. A healthy weight does not mean you don’t need to exercise.
Oral health complications can be evidence of long-standing, poorly controlled blood glucose levels.
Vaginal dryness is the most prevalent sexual complaint in women with diabetes. Excess in blood sugar can also feed yeast and trigger vaginal infections. Also, a 2012 study found that women who took insulin for diabetes were 80% more likely to have trouble reaching orgasm than women who do not have diabetes.
When your cells burn fat instead of glucose to get energy, ketones show up in your blood and urine. This can lead to a coma and sometimes death.
Insulin resistance may prevent your muscles and tissues from getting the energy they require to function. Your brain understands that as a “hunger” message and pushes you to seek more food even after eating adequate portions that should otherwise be satiating.
Fatigue often remains a frequent symptom in the general practice management of diabetes for both Type 1 and Type 2 diabetes.
You may also get blurred vision when you start insulin treatment. This is mainly due to the pressure of blood glucose buildup on eye blood vessels which alter lens shapes.
As circulation slows down, blood moves more slowly, which makes it more difficult for the body to deliver nutrients to wounds.
Excess glucose buildup in brain blood vessels may lead to memory loss which can be both a symptom and a long-term complication of diabetes that could lead to dementia.
Depressive symptoms are associated with a significantly increased risk for incident diabetes.
Long-term complications of diabetes are often related to the damage caused to blood vessels. Most of them develop gradually and can be controlled and/or prevented with the proper combination of lifestyle improvement, medication and careful follow-up with your clinician. Here is a list of major diabetes complications:
Diabetes can damage your blood vessels and the nerves that control your heart and surrounding blood vessels. The longer you have diabetes, the higher the chances that you will develop heart disease.
Excess glucose buildups can injure the walls of the capillaries (small blood vessels) that nourish your nerves, especially in your legs. This can cause numbness, tingling, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation.
Diabetes can damage kidney blood vessels and impede their ability to filter waste from your blood.
Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Complications also include other serious vision conditions, such as cataracts and glaucoma.
Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Regular foot exams can reduce amputation rates by 45-85%.
These might be the earliest signs of diabetes and can be reversed if managed properly. A complete guide to diabetes-related skin conditions can be found here.
Hearing problems are more common in people with diabetes.
This is usually called Type 3 diabetes and is a direct consequence of poor blood sugar control. This is still an area where researchers are exploring multiple theories that have yet to be proven.
Macrosomia can be a complication of a mother’s gestational diabetes as extra glucose from gestational diabetes can cross the placenta and trigger insulin over-production in the baby’s pancreas. The size of the baby usually leads to a C-section birth.
Low blood sugar and need for an intravenous glucose solution for babies.
Baby’s hypoglycemia can be a consequence of the mother’s gestational diabetes immediately after birth.
Mothers who had gestational diabetes during their pregnancies should be extra cautious in monitoring lifestyle factors that could lead to Type 2 diabetes for their babies later in life.
The risk of a baby’s death (before or after birth) is 30% higher among babies born to women whose gestational diabetes wasn’t treated with insulin.
This comes with swelling in legs and feet as well as excess protein in urine and high blood pressure.
Gestational diabetes is a risk factor to get Type 2 diabetes when you get older as well as subsequent gestational diabetes during future pregnancies.
Surprising, we know. Yet according to this groundbreaking study by clinical researcher, Dr. Neal Barnard, a low fat plant-based diet is the gold standard to reverse and manage Type 2 diabetes. The study was later built on by the scientific community and a plant-based diet was put to the test by NutritionFacts.org. Watch the NutritionFacts.org video break down of plant-based diets and diabetes below.
Because people with diabetes have an increased risk for heart disease, it is important to limit both saturated and trans fats. Find a full list on healthy and unhealthy fats from the ADA here.
The glycemic index, or GI, measures how a carbohydrate-containing food raises blood glucose. For diabetics, it is important to maintain a GI of 55 or less. Most fruits and vegetables, beans, minimally processed grains, pasta, and nuts are considered low glycemic index foods.
According to the Mayo Clinic, “In people with diabetes, fiber — particularly soluble fiber — can slow the absorption of sugar and help improve blood sugar levels. A healthy diet that includes insoluble fiber may also reduce the risk of developing Type 2 diabetes.”
Physical activity makes your cells more sensitive to insulin so they work more effectively.
Glucose from your food is mainly absorbed by your muscle tissue, resistance training, which builds muscle mass, is particularly good at improving blood sugars absorption after meals. Additionally, resistance training uses a lot of energy, meaning calories, so it’s a great weight-management option as well.
As a mind-body practice, yoga can help attain glycaemic control and reduces the risk of complications in people with diabetes, as well as reduce psychological stress that worsen the severity of diabetes.
According to the Cleveland Clinic, “swimming stretches and relaxes your muscles and doesn't put pressure on your joints, which is great for people with diabetes. For those with diabetes or at risk for developing diabetes, studies show it improves cholesterol levels, burns calories and lowers stress levels.”
One of the important benefits of cycling for people with diabetes is it increases blood flow in the legs and burns a lot of calories.
The CDC reports that smoking causes Type 2 diabetes and people with diabetes who smoke are more likely than nonsmokers to have trouble with insulin dosing and with controlling their disease. Because nicotine hardens and narrows blood vessels, it is incredibly dangerous for diabetics.
When glucose levels are high, drinking water is important to help the kidneys flush excess sugar out of the body. Due to the fact that high levels of glucose draw out fluids, diabetics are also more prone to dehydration.
The polyphenols in green tea can help regulate glucose in the body as well as support metabolic function.
Alcohol contains a high amount of calories. Combined with the calories, it also has a high amount of sugar, so it can cause your glucose levels to spike or plummet. Avoid alcohol and make sure to speak with your doctor about what consumption you may be able to enjoy and when.
A WFPB diet coupled with insulin as prescribed by your doctor, helps boost insulin sensitivity making glucose levels more predictable. Additionally, eating lots of fruits and vegetables reduces your risk of diabetic neuropathy and kidney disease, while increasing your energy for the exercise that is also important for managing diabetes.
You'll be able to meet with lawmakers, share your story, and advocate for federal funding of TD1 research
It's for kids, adults, and those affected by diabetes.
Stay informed about the latest clinical trials and read the latest research from the Diabetes Research Institute Foundation, or participate in an online forum through the diaTribe Foundation.
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It focuses on information on policy, research, events, and data on everything from prevention, screening and detection, clinical care, education and more.
It's a professional group of people working to promote and support public policy initiatives to improve the health of people with diabetes.
Read the list here.
By helping them achieve their health goals through sustainable lifestyle change with a health coach, connected devices, lessons, online peer group, and a personalized action list.
It's a medical app combining neuroscience, lifestyle medicine, and artificial intelligence to target the behaviors that cause cardiometabolic diseases such as diabetes. Learn more for patients here.
It also sends reminders for follow-up data, and is easily shared with your doctor.
The app also syncs with the Dexcom G5 and G6 glucose monitoring systems.
The app alerts first responders of any medical condition, emergency contacts, and special needs even when the phone screen is locked.
This comprehensive app is available only by prescription and offers an impressive range of tools tailored to the individual. Only for people 21 years and older with Type 2 diabetes. It should not be used by those with Type 1 diabetes, gestational diabetes, or who use an insulin pump.
It also tracks glucagon kit locations and expiration dates as well as giving reminder notifications.
Speak to a personal diabetes assistant available 24/7, keep a diabetes log, get access to a range of healthy recipes, and other tools to help you maintain a normal blood sugar level. Due to the AI, the more you use it, the better it works for you.
It helps diabetic patients worok-out safely for better long-term habits.
What really sets this app apart are the integrations with fitness apps and blood sugar trend mapping.
You can also export and print your data to share with your doctor for more productive, actionable appointments.
You can find more information on apps that sync to your existing monitors here, from the American Diabetes Association.
Highlighting chronic illnesses like diabetes to the forefront of the national healthcare conversation.
You can also attend other events listed on their website.
This will help you get healthier, take advantage of partnerships to help with exercise and diet, get inspired, and share your story.
There are a number of ways to find community through the American Diabetes Association, both online and offline. From the online Count Me In community, to camp for families, and local chapter events, there is something for everyone.
You can check them out here.
You can also find oline events and webinars without putting your city.
According to the American Diabetes Association, that’s 1 in every 10 adults being diagnosed with diabetes and shows no signs of slowing down.
The Centers for Disease Control and Prevention report though that number is on track to double if not triple by 2050 to 1 in 3 adults. The sharp rise in prevalence and diagnosis over the next 40 years is due to an aging population with more opportunity to develop Type 2 diabetes, increases in high risks for minority groups for Type 2 diabetes, and lastly that people with diabetes are living longer.
Type 1 Diabetes is an autoimmune disorder; Type 2 is a lifestyle condition developed primarily by eating a poor diet. The costly epidemic is largely avoidable and reversible using lifestyle methods like eating a whole foods, plant-based diet and exercising regularly.
The leading cause of death in the United States is heart disease. Due to common complications of diabetes, according to the American Diabetes Association, 252,806 death certificates list diabetes as an underlying or contributing cause of death to the leading killers in America like heart disease and stroke.
Over a 10-year time span from 2002 to 2012, a report studying over 14,000 children from ages 0 to 18 funded by the CDC and NIH, found the rate of newly diagnosed cases of Type 1 increase by 1.8% each year and 4.8% each year for Type 2 diabetes. - Centers for Disease Control and Prevention
The same study as in #5, went further in understanding new diagnosis of diabetes in young children. Girls are being diagnosed at a higher rate (6.2%) with Type 2 diabetes, while boys are being diagnosed with Type 1 at a rate of 2.2%. - Centers for Disease Control and Prevention
That’s more than the average American. Women are at a higher risk and are diagnosed with diabetes slightly more often than their male counterparts. - U.S. Department of Health & Human Services, Office of Women’s Health
Women with diabetes also have a higher risk for problems getting pregnant as well as during pregnancy. Including the potential health problems for her and her baby, and repeated urinary and vaginal infections. - U.S. Department of Health & Human Services, Office of Women’s Health
Compared to men with diabetes, women with both types of diabetes have a higher risk for heart disease (the most common complication of diabetes), lower survival rates and a poorer quality of life after a heart attack. - U.S. Department of Health & Human Services, Office of Women’s Health
From difficulties such as a miscarriage or a baby born with birth defects, diabetes is critical to manage for women during their fertility years. - American Diabetes Association
Women with diabetes are also more likely to have a heart attack at a younger age than women without diabetes. - American Diabetes Association
In total, the rate of depression in people with diabetes is much higher than in the general population.
Aside from the expense of hospitalization and multiple prescription drugs to manage the complications of diabetes ($237 billion was for direct medical costs), a great deal is lost due to reduced productivity ($90 billion).
After adjusting for population age and sex differences, people with diagnosed diabetes incur average medical expenditures of $16,752 per year, of which about $9,601 is attributed to diabetes. - American Diabetes Association, Economic Costs of Diabetes in the U.S. in 2017
Since people with diabetes already spend an average of 2.3 more dollars on healthcare than people without, this adds up to a lot very quickly and could mean the difference between something as small as a movie ticket or as large as a family vacation. - American Diabetes Association
The unfortunate journey of the chronic condition if not managed properly is the loss of eyesight, amputations, and other situations requiring an inpatient hospital stay. Inpatient care makes up 30% of total medical costs, prescription medications make up another 30%, anti-diabetic agents and diabetes supplies make up another 15%, and physician office visits account for 13%. - American Diabetes Association
Even though most of the cost for diabetes care in the U.S., 67.3%, is provided by Medicare, Medicaid, and the military, those who don’t have insurance have 168% more emergency department visits. How people end up in the ER is that they aren’t able to afford the office visits or prescriptions that could have helped manage their condition. - American Diabetes Association
Two main drawbacks occur with transplants: the scarcity of compatible organ donors and the fact that patients need to stay on risky prescription drugs for the rest of their lives while still requiring insulin injections.
According to JDFR, a cure for Type 1 diabetes should not only stop the immune system from destroying the cells that make insulin but also replace the cells that have been lost.
Pancreas transplantation is already possible but comes with many drawbacks that could be solved if the beta-cells are coated or “encapsulated” to be protected from any immune attack before putting them in the patient’s body.
If successful, this research can lead to a cure of Type 1 diabetes without the need for a transplant from a donor.
This research is critical as even in case of successful results for regeneration and/or encapsulation research, beta-cells can still be attacked by the immune system. Many world-class researchers are currently working on this issue.
This research is critical as even in case of successful results for regeneration and/or encapsulation research, beta-cells can still be attacked by the immune system. Many world-class researchers are currently working on this issue.
Episode #58 with Dr. Neal Barnard, M.D., F.A.C.C. and founder of Physicians Committee for Responsible Medicine is rich with information in managing and reversing T2 diabetes as the leading pioneer of lifestyle medicine having conducted the leading clinical trials of the field.
In the Reversing Diabetes Episode, Dr. Neal Barnard explains the science behind how a low-fat, plant-based diet works to address the root cause of Type 2 diabetes by reducing fat buildup in the cells.
As the go-to resource for easy, science-backed information, there are multiple episodes on how to manage diabetes through lifestyle. Some highlights are #32: How Not to Die from Diabetes, #27: Plant-Based Diets for Diabetes, and #22: Plant-Based Diets & Diabetes.
There are several episodes about the research done on plant-based diets for managing diabetes. Some highlights are #18: Brenda Davis: Defeating Diabetes and Debunking Paleo (she is a plant-based Registered Dietitian, and co-author of eight books, including Defeating Diabetes and Becoming Vegan) and #43: Joseph Gonzalez (from Physicians Committee for Responsible Medicine), Common Supermarket Killers, and Peanut M&Ms.
Hasan Minhaj, a comedian, writer, producer, and political commentator dives deep into how insulin makers are price-fixing the life-saving insulin drug with his humorous and sometimes profane presentations.
A documentary in which researchers, scientists, and physicians explore how people changing their diets from animal-based to plant-based can help eliminate or control diseases like cancer and diabetes.
They investigate how the American food industry and its use of sugar may be responsible for the obesity epidemic and related chronic diseases like diabetes. Through interviews with top food experts like Michael Pollan, Marion Nestle, Robert Lustig, and Mark Bittman, the film investigates issues surrounding government involvement and its role in subsidizing and thereby endorsing the sale of unhealthy, sugar-laden products to adults and children.
It is a film following the stories of six people with diabetes that switch to a vegan diet, full of organic and uncooked food to reverse the disease without medication.
The film is about the emotional, social, and public perceptions of the Type 2 diabetes healthcare epidemic that statistically affects every household in the United States unnoticed.
It is a documentary film that follows former UFC fighter James Wilks while he travels the world and interviews elite athletes that follow plant-based diets such as Arnold Schwarzenegger, Patrik Baboumian, and Dotsie Bausch.
That’s nearly double globally in roughly 30 years.
It is projected to rise to 700 million by 2045.
It is related to three others in that group, such as heart disease, stroke, and Alzheimer’s.
Followed by Southeast Asia with 82 million, Europe with 58 million, North American and the Caribbean at 46 million, Middle East and North Africa at 39 million.
That’s quite a list. Instead of being overwhelmed by diabetes, this list is meant to empower you to be a happy, healthy, person with diabetes, not a diabetic person.
If there is one take-away to keep in mind it would be this one: lifestyle changes like adopting a managed plant-based diet along with regular exercise can go a long way in shaping your narrative with diabetes.