How Coronavirus Impacts People with Diabetes

How Coronavirus Impacts People with Diabetes

How does coronavirus impact people with diabetes and other chronic medical conditions differently? What should people with diabetes do to prepare themselves for a long period of “social distancing”? What if a person with diabetes or a member of their household gets infected with coronavirus?

People with Diabetes are (Rightfully) Anxious about Coronavirus and their Health

If those of us who are healthy are experiencing fear and anxiety, what’s happening to others who are already dealing with a chronic condition day in and day out? A friend posted this statement on her Facebook page recently, “I am disheartened. Many of my friends and colleagues have chosen to practice “selective social distancing”… still hanging out with buddies, a few neighborhood happy hours, letting their kids see a couple of close friends. This is not ok. In fact, as someone who is immunosuppressed, I find it terrifying….While you may only experience this virus as a cold, some of us could die from it. Please stay home and please keep your kids home.”

This friend is right, of course. When any of us chooses to ignore the CDC’s guidance for social distancing, we choose to put others in harm’s way. I’m a Dietitian and a Diabetes Care Specialist, and I moved all my clients to telehealth appointments this week. A few chose to reschedule their appointments to a time when I can hopefully see them in person, but the majority were grateful to have the option to stay at home and avoid possible exposure to coronavirus.

My clients with diabetes fear for their health and safety, and rightfully so. Here are my best answers to some of their most frequently asked questions:

Are People with Diabetes More Likely to Get Coronavirus?

The American Diabetes Association says that while people with diabetes are not any more likely to become infected with coronavirus, they are more likely to have “serious complications and death.” Any time a person with diabetes gets an infection, whether it’s viral or bacterial, blood sugars tend to rise as a consequence of the inflammatory process. When blood sugars rise excessively, a serious complication called diabetic ketoacidosis can occur, especially in people with type 1 diabetes.

What Supplies Should People with Diabetes Have on Hand During the Coronavirus Pandemic?

As always, people with diabetes need to be prepared to take care of it at home. This means keeping a supply of:

  • Insulin

  • Oral medications

  • Glucose testing strips or supplies for your continuous glucose monitor

  • Ketone testing strips, especially for people with type 1 diabetes

  • Juice boxes, glucose tabs, or hard candy in case of low blood sugar

  • Water, in case your blood sugar is high and you need to push fluids

  • Soap & hand sanitizer to prevent the spread of infection

What Should I do If I Have Diabetes and I Think I Might Have Coronavirus?

If you develop symptoms such as fever, dry cough, or shortness of breath, call your doctor right away. Whether you feel sick or not, if you get a blood sugar reading of 240 mg/dl or higher twice, check your urine for ketones. If you have ketones in your urine, call your doctor.

Visit the Emergency Room if you develop these symptoms of Coronavirus:

  • Difficulty Breathing

  • Blue lips

  • Chest pain or pressure

  • Confusion

Are my Family Members a Danger to Me During the Coronavirus Pandemic?

The American Diabetes Association recommends that people with diabetes separate themselves from other family members inside the house if possible. For example, if you can confine yourself to your room most of the time, that would be best. Your family members should assume that they are contagious and could pass the coronavirus on to you at any time, even if they feel fine. They should wash their hands frequently. All households, whether they have a family member with diabetes or not, should be sanitizing doorknobs, handrails, tables, kitchen counters, and light switches regularly.

What if Someone in My House Has the Coronavirus?

If at all possible, give the sick person his or her own room, and keep the door shut. Have someone who is under 65 and who doesn’t have diabetes or another medical condition take care of the sick person.

I’m Worried That We’ll Run out of Insulin due to Coronavirus

Major insulin manufacturers report that they are running on schedule as usual and that they don’t expect Coronavirus to slow their production of insulin. Some pharmacies, including CVS, has started delivering medications to patients’ homes. If the pandemic has affected your income and you are concerned about the cost of your insulin, try

I’m Feeling Overwhelmed

When we’re overwhelmed, we tend to stop taking care of ourselves. Maybe we stop exercising, stop eating as well, and spend a little (or a lot) more time on the couch. Many friends and clients have mentioned recently that they feel like they’re in a period of mourning. It’s OK to feel however you feel, and it’s also important to remember that at times like these, we need to take better care of ourselves than we ever have, for our mental health as well as our physical health. Maintain your regular diet, keep up with your regular physical activity schedule, and adjust your insulin as required with the help of your health care team.

What’s the Best Kind of Milk for People with Diabetes?

What’s the Best Kind of Milk for People with Diabetes?

Have you been to the dairy aisle lately? There are a lot more choices than there used to be. We’ve come to the point where choosing milk requires a not-insignificant amount of thought. If you’re overwhelmed in the dairy aisle, I’ve put together some information that might make picking up a carton of milk a little easier.

Cow’s Milk

Regular, whole cow’s milk has 150 calories and 8 grams of fat per cup. That’s a lot. Whole milk is a good choice for 1-year-old children who need lots of fat for their growing brains. It’s also a good choice for people who are trying to gain weight…but that’s not most of us.

Believe it or not, 2% milk is still considered a high-fat food. So, it works for people who are working their way down from whole milk to low-fat milk, and for people who need extra calories.

Skim and 1% cow’s milk are the best cow’s milk choices for most of us, including people with diabetes and heart disease. When milk is skimmed, the cream is removed from the top. This takes away most of the heart-clogging saturated fat and cholesterol. Since people with diabetes are prone to heart disease, those who prefer cow’s milk should definitely choose skim or 1%.

Lactose-free milk is still a cow’s milk product. It can be found in whole and lower-fat varieties. The sugar, or lactose, in lactose-free milk has already been broken down into its components, glucose and galactose. This doesn’t mean that lactose-free milk is a better choice for people with diabetes. Lactose-free milk contains the same amount of carbohydrate as regular cow’s milk, and it will still cause a rise in your blood sugar like any other milk.

Soy Milk

Soy milk is comparable to cow’s milk when it comes to protein content. The fat is soy milk is unsaturated, which is heart-healthy. Soy milk is a good choice for people who don’t tolerate cow’s milk or who prefer not to consume animal products.

Almond, Rice, Cashew, & Oat Milk

Need something to wet your cereal? Any of these will do. But…they have limited protein, so they are not a good choice for small children, people with poor appetites, or others who struggle to take in enough protein from other sources like meat, eggs, and beans.

Pea Milk

Pea milk is made from flour made from yellow peas. (It doesn’t taste like peas or milk, if you ask me.) Like soy milk, pea milk is a good alternative to cow’s milk. In some cases, pea milk has more protein than cow’s milk. This is a great choice for someone who is allergic to both dairy and soy as well as for people with diabetes who want vegan alternative milk.

How to Choose the Best Milk for You

As the number of choices at the supermarket continues to expand, remember what to look for in your milk:

  • Does this milk have at least 7 grams of protein per cup?

  • Is this milk fortified with vitamin D?

  • Is the amount of saturated fat in this milk 2 grams or less per cup?

  • Do I need low-calorie milk or high-calorie milk?

How Time in the Chair Affects Your Blood Sugar

I’m sitting as I write this, but maybe I shouldn’t be.  This week, I want to tell you about a new study published on Monday in The Journal of the American Heart Association.  Researchers studied more than 500 older (post-menopausal), women.  The women wore devices to measure their activity during the study.  They had an average age of 63 years and an average sitting time of 9 hours each day.  The researchers found that insulin resistance increased by about 6% for each hour of sitting and that every 15 minutes of uninterrupted sitting increased insulin resistance by about 9%.  This was true regardless of the person’s weight.

What’s the bottom line?  Sitting increases your risk of diabetes.  If you already have diabetes, sitting makes it worse. 

What can you do?  Here are a few tricks to help you get moving:

  • The high-tech option is to wear a Fitbit or a similar device.  If you haven’t taken your desired number steps in an hour, you’ll get a little buzz on your wrist that reminds you to get up and move.

  • If you don’t want to wear a Fitbit, you can get the same effect by setting a timer on your cellphone to go off every hour.

  • Even more low-tech:  use the timer on your microwave oven.  Set it for an hour.  When it beeps, you’ll need to go turn it off and then you can set it to go off again in another hour.

  • When you’re watching TV, stand up and take a lap down the hall every time there’s a commercial break.

Speaking of standing up, I’d better do that now!

8 Places to Find Heart-Healthy Recipes for People with Diabetes

8 Places to Find Heart-Healthy Recipes for People with Diabetes

If you have diabetes, you must protect your heart. Did you know that it’s heart disease, not high blood sugar, that is the number 1 killer of people with diabetes? Heart disease kills more women every year than all types of cancers combined!  

In honor of National Heart Health Month, I’ve put together a list of resources where you can find recipes that will benefit your heart and keep your carb count in check.

  1. American Heart Association has numerous recipes. Find a few heart-healthy recipe ideas here.  

  2.  offers recipes from home cooks and expert chefs alike. Make an account & set your preferences to “Diabetic” and “Heart-healthy.” You can sign up to receive new recipes delivered to your inbox.

  3. Cooking Light has recipes from super-simple to gourmet.  

  4. When you hear “Food Network,” you may think of Man vs. Food or Diners, Drive-ins, and Dives.  Those shows feature some of the most unhealthy food around, but Food Network offers heart-healthy recipes too.

  5. Try for some new takes on quick and easy dinners.

  6. My Recipes offers recipes for healthier versions of family meals and comfort food.

  7. If you’re feeling fancy, try the “healthy-ish” recipes at Half Baked Harvest.

  8. Taste of Home has back-to-basics cooking, with recipes like Grandma used to make. Sign up for their “Recipe of the Day” while you visit the site.

    No matter what kind of food you’re craving, there’s a healthier version of it to be found. Why not try something new during National Heart Health Month this February?

Diabetes nutritionist Julie Cunningham works in-person in Hendersonville, NC. She also works as an online nutritionist for people with diabetes.

Can You Reverse Diabetes?

Can You Reverse Diabetes?

News & Events

Quis autem vel eum iure reprehenderit, qui in ea voluptate velit esse, quam nihil molestiae. 

Our Blog

Vestibulum mattis consectetur ligula, id suscipit quam dapibus vel. Maecenas molestie, enim sit amet suscipit imperdiet, justo diam semper leo.

Managing Type 2 Diabetes

Managing Type 2 Diabetes

Does it feel like you manage your diabetes, or like your diabetes handles you? So often, I find that clients with newly diagnosed type 2 diabetes feel overwhelmed when it comes to their condition. This article will give you all the information you need about type 2 diabetes, from signs and symptoms to the best ways to get better blood sugars.

Can Drinking Coffee Lower the Risk of Type 2 Diabetes?

Can Drinking Coffee Lower the Risk of Type 2 Diabetes?

I didn’t drink coffee until I was about thirty five years old, when my youngest just wouldn’t sleep through the night and I was desperate for a pick-me-up first thing in the morning. Thankfully, those sleepless nights are over, but I developed a love for coffee during those early years. It may seem too good to be true that coffee can be good for you. So, is coffee a guilty pleasure or natural superfood?

 You’ll be glad to know that there is science to support the idea that coffee is good for you, but as with most things, quality matters.

Diabetes Update

Diabetes Update

The Expanding Access to Diabetes Self-Management Training ActThere are good things happening in diabetes right now! If you’ve seen me on facebook this week, you already know that there is legislation before Congress that, if approved, will expand Medicare coverage of...


1235 Divi Theme St.
San Francisco, CA 92335


(333) 394-2342
[email protected]


M – F : 8am–5pm

Sat : 11am–6pm

Sun : Closed

What NOT to Eat (and Drink) if You Have Type 2 Diabetes

What NOT to Eat (and Drink) if You Have Type 2 Diabetes

Nobody wants to have someone else tell them what to eat. At the same time, some things are almost guaranteed to bring your blood sugar soaring to new heights. I’ve put together a list of the worst offenders, just for you.

What Not to Drink if Have Type 2 Diabetes

1.    Sweet tea. I live and work in the south, where sweet tea is consumed just as readily as ice water. I grew up drinking sweet tea at almost every lunch and supper. My mother recently reported that she hadn’t fixed sweet tea in eight days straight–a record! So, I know the pain of letting go of this caffeinated nectar. And yet, few things will raise blood sugar like a glass of sweet tea. Liquid sugar is very easily absorbed. It just passes right on through your gut and into your bloodstream, making your blood sugar rise quickly.

2.    Regular soft drinks. For all the same reasons listed above, non-diet soft drinks are a great way to raise your blood sugar and a poor choice for someone who wants to keep their blood sugar under control. If you’re concerned about the effect of artificial sweeteners, read this post.

3.    Juice. Most people know that orange juice that will raise your blood sugar in a jiffy, but that’s also true of any flavor of fruit juice. When a person with diabetes has low blood sugar, we give them fruit juice to bring it up quickly. The same thing happens when a person without low blood sugar drinks juice: their blood sugar comes up quickly. So, it’s better to reserve the fruit juice for times when you need to bring your blood sugar up.

4.    Rice milk. I know, it sounds healthy, and you can find it at the co-op and the health food store. It’s sold right beside the soy milk, so it must be good for us, right? Not so much. Rice milk has virtually no nutrition. It can be useful for people with dairy, nut, and soy allergies who need something to wet their cereal, but it’s not at all beneficial for people with type 2 diabetes. A cup of unsweetened rice milk has 22 grams of carbohydrate and no protein. Compare that to a cup of cow’s milk, which has 12 grams of carbohydrate and 8 grams of protein. If you’re dairy-free, soy and pea milk are the best alternatives.

What Not to Eat if You Have Type 2 Diabetes

1.    White rice. The difference between white rice and brown rice is that white rice has had its fibrous outer hull removed. You probably know that a high fiber diet is beneficial for people with type 2 diabetes. Because white rice has no fiber, it gets digested quickly, and its carbohydrate hits the bloodstream rapidly. White rice will raise your blood sugar in a flash. There is also the small portion size to consider: 1/3 cup of cooked white rice has about 15 grams of carbohydrate, and that’s hardly enough to taste.

2.    Instant potatoes. Instant potatoes are made from peeled, cooked, dehydrated potato flakes. About half the fiber gets lost when a potato is peeled. The peel of the potato also contains potassium and vitamin C. Instead of instant potatoes, try putting a small potato (about the size of a tennis ball) in the microwave, and eating the whole thing, including the skin.

3.    Cornflakes. It goes without saying the sugary cereals aimed at kids are not good choices for people with diabetes. (They’re not a fabulous choice for kids, either!) But you could do a lot better than cornflakes, too. Cornflakes have less than 1 gram of fiber and 24 grams of carbohydrate per cup. Take a trip down the cereal aisle –there is no lack of choice. You can do so much better than cornflakes — one good alternative is Special K Protein Cereal.

I could go on and on about what to eat & what not to eat for diabetes type 2, but I’ll let the subject rest right here for now. If you have a question you’d like me to answer in a post, feel free to message me.

Julie Cunningham is a Registered Dietitian and Certified Diabetes Care and Education Specialist. Julie is the owner of a nutrition counseling service in Hendersonville, NC. She works as both an in-person and an online nutritionist.

5 Easy, Healthy Breakfast Ideas for Diabetes Type 2

5 Easy, Healthy Breakfast Ideas for Diabetes Type 2

It’s been said that breakfast is the most important meal of the day. If you have diabetes, it can also be the most challenging. Breakfast is typically heavy on the carbs and light on veggies. That can make it hard to get full without going over your carbohydrate budget in the morning. Here are five yummy breakfast ideas to mix and match. They’re quick, they’re nutritious, and they’re filling. Best of all, they won’t load you up with too much sugar.

Overnight oats. Oatmeal is full of soluble fiber, which slows your digestion. As a bonus, oatmeal helps lower cholesterol. Since many people with type 2 diabetes also have high cholesterol, that’s a nice benefit. As the name implies, overnight oats are prepared ahead of time and ready when you get up in the morning. Try this simple recipe for strawberry overnight oats:

Strawberry Overnight Oats

·     6 ounces low-fat Greek yogurt

·     1⁄3 cup rolled oats uncooked

·     1⁄4 cup sliced almonds

·     1⁄3 cup strawberries

·     1 teaspoon vanilla extract

In a small bowl, combine ingredients. Add the ingredients to a sterilized mason jar. Cover and store in the refrigerator overnight. (42 grams carbohydrate).

Who can resist peanut butter, bananas, and granola all rolled into one? This recipe takes less than a minute to put together, and it tastes delicious!

Blueberry Peanut Butter Yogurt Bowl

·     3/4 cup plain Greek yogurt

·     1 tablespoon peanut butter

·     1/2 banana sliced

·     1⁄4 cup blueberries

·     1 tablespoon granola

Scoop yogurt from the container into a serving bowl.  Top yogurt with fruit, then nut butter, and lastly with granola.  Bon appetit! (22 grams carbohydrate).


Have a few minutes in the morning? Homemade breakfast tacos just might hit the spot. These Mexican-inspired breakfast goodies are chock-full of veggies to start your day off right!

Veggie Breakfast Tacos

·     2 corn tortillas

·     cooking spray

·     1⁄8 onion chopped

·     1⁄4 summer squash chopped

·     2 cups Swiss chard chopped

·     2 eggs

·     2 teaspoon cilantro

·     1-ounce queso fresco

·     1⁄8 cup salsa

1.    Warm the tortillas in the oven or microwave and wrap in a towel until ready to serve.

2.    Heat a pan with cooking spray and sauté the onion until translucent.

3.    Then add the summer squash until cooked throughout.

4.    Stir in the greens and continue to cook until tender, about 2 minutes.

5.    Meanwhile, beat the eggs in a small mixing bowl.

6.    In a non-stick pan, scramble eggs and cook throughout.

7.    Spoon eggs and vegetable sauté onto warm tortillas and sprinkle with cheese and cilantro. Serve with salsa.

8.    Suggested serving size: 2 tacos per person. (2 tacos have 31 grams carbohydrate).


Another yummy egg-based recipe: One-pan BLT skillet frittata. This one takes a few minutes to bake, but you can put it in the oven and come back in 15 minutes to find a mouth-watering breakfast.

One Pan BLT Skillet Frittata

·     5 eggs

·     1⁄2 cup milk

·     1⁄2 teaspoon dried basil

·     1⁄2 teaspoon dried oregano

·     1 dash salt to taste

·     1 dash pepper to taste

·     2 slices bacon chopped

·     1tablespoon olive oil

·     2 cloves garlic diced

·     15 ounces diced tomatoes drained

·     2 cups raw spinach

·     1handful fresh basil chopped

1.    Preheat oven to 425 degrees.

2.    Whisk together your eggs, milk, basil, oregano, and salt and pepper to taste. Set aside.

3.    Cook your chopped bacon until crispy.

4.    Add olive oil, garlic, and spinach to the skillet and cook until the spinach is wilted, about 3 minutes. Add in the tomatoes and stir to combine.

5.    Pour the egg mixture over the spinach and then stir in the bacon. Stir the entire skillet once or until well combined. Let sit (without stirring) for about 2 minutes, just until the edges are set.

6.    Place the entire skillet in the oven and cook for 15 minutes, or until the eggs are set and slightly golden.

7.    Top with some freshly chopped basil if desired.

8.    Slice and serve. (1/2 the frittata has 14 grams carbohydrate).


Do you have less than two minutes to deal with breakfast, but still want to take care of your diabetes? Make a smoothie and drink it in the car on the way to work or school. I guarantee it’s faster than going through the drive-through and much healthier too! The avocado in this Green Machine Smoothie lends a smooth, creamy texture.

Green Machine Smoothie

·     1 cup of frozen spinach

·     1⁄2 banana frozen

·     1 1⁄2 cups milk

·     1⁄2 avocado

·     2 tablespoons chia seeds

Combine everything into a blender and blend until well combined, about 30 to 60 seconds. Makes 2 servings. (1 serving has 30 grams carbohydrate).


Do you have a favorite breakfast that’s moderate in carbohydrates and keeps you full all morning? Leave a comment and let everyone know what works for you! For more information on diet and diabetes, subscribe to my newsletter, and read about the best diet for diabetes.

Julie Cunningham is a Registered Dietitian and Certified Diabetes Care and Education Specialist. Julie is the owner of a nutrition counseling service in Hendersonville, NC. She works as both an in-person and an online nutritionist.




5 Appointments to Schedule Now if You Have Diabetes

5 Appointments to Schedule Now if You Have Diabetes

Diabetes can feel overwhelming. It helps to have a team on your side. Here’s a rundown of the experts you need to visit at least once a year to make sure you’re on track with taking great care of your diabetes.

  1. Schedule a checkup with your family physician, internist, or mid-level provider (physician assistant or nurse practitioner).

    This person serves as your primary care provider (PCP). He or she can help you coordinate your healthcare with other providers. Your PCP can also order labs or other tests that need to happen on an annual basis, like your Hemoglobin A1C. If you have health insurance, the Affordable Care Act allows for a yearly checkup with your primary doctor at no cost. If you’ve had Medicare Part B for more than a year, you can get an annual “Wellness” exam once every 12 months. The Part B deductible does not apply to the Wellness exam, so there should be no cost to you.

  2. Arrange for an eye exam.

    An eye exam is recommended every year for those with diabetes. Your eye doctor isn’t just checking to see if you need glasses. He or she is checking for diabetic retinopathy, which is damage to your eyes from poorly controlled blood sugars. Medicare will cover an annual eye exam every 12 months if you have diabetes.

  3. Find time for a foot exam.

    Your primary care provider may do a foot exam during your annual checkup. If not, you’ll need to see a podiatrist for a foot exam every year. A foot exam includes a visual inspection of your feet as well as the use of a monofilament. A monofilament is a very thin, flexible probe that your doctor will touch to different parts of your skin. This painless process is used to make sure that you have adequate sensation in your feet.

  4. See your Registered Dietitian (RD).

    Your RD will help you determine whether you need to adjust your eating plan to make sure that your blood sugars stay in range. Most private insurance companies cover Medical Nutrition Therapy (MNT), which is the name of the service provided by a Registered Dietitian. Medicare covers three hours of MNT initially and two more hours every year after that. Medical Nutrition Therapy is fully covered under Medicare; there is no 20% copay.

  5. Don’t delay on Diabetes Self Management Education & Support (DSMES).

    DSMES is a program designed to help people with diabetes to understand their condition and to make choices that better their health. DSMES is proven to help improve the health of people with diabetes. DSMES consists of ten hours of group or individual education the first year, followed by two hours of additional training every year after that. DSMES is covered by most major insurance carriers as well as Medicare.

Does this list seem overwhelming? Don’t worry, you’ve got all year to spread out your appointments. Consider making just one phone call a day until you’ve scheduled all your health care visits. If you need a handy guide to hang on your fridge and help you keep track of your progress, you can get one here. You’ll be well on your way to staying well in no time at all.

p.s. Wondering about artificial sweeteners? Read this article.

Julie Cunningham is a Registered Dietitian and Certified Diabetes Care and Education Specialist. Julie is the owner of a nutrition counseling service in Hendersonville, NC. She works as both an in-person and an online nutritionist.

What is the Absolute Best Diet for Type 2 Diabetes?

What is the Absolute Best Diet for Type 2 Diabetes?

There is no particular food that will prevent or cause diabetes, but diet is an essential part of diabetes management. Find out how diet affects type 2 diabetes and which diets work best to prevent or reverse it.

Can food cause diabetes?

Your body has only a few distinct inputs to regulate its health: the air you breathe, the fluid you drink, and the food you eat. So, good food and clean water are integral components of good health. But, the world has many different cultures, and each culture has different customs around food. Many times, locale and climate dictate food choices. There is no perfect diet, and there is no specific set of foods that you are required to eat to help you manage diabetes. Anyone who tells you that they have a “miracle food” for diabetes is not being truthful. The body is resilient, and it can adapt to get its nutrients from various food sources.

Why does the Western diet promote the development of type 2 diabetes?

Think about your local supermarket. The fresher, unprocessed foods are usually on the perimeter of the store. Almost all the items on the inner aisles are processed. There’s a lot more space dedicated to processed food than there is to fresh food in most supermarkets. Sometimes, food processing serves a purpose. For example, the ability to freeze food means that we can enjoy summer produce all year round.

Other times, food processing does more harm than good. Imagine a box of cereal aimed at young children. Let’s pretend this product is made from wheat. When wheat grows in the field, it has an outer husk commonly referred to as bran. The bran contains fiber and protein, as well as lots of minerals. After harvesting, the wheat goes to the factory for processing into cereal. In the factory, the bran gets removed, and so does the fiber and many nutrients.

Next, the soft wheat flour gets formed into the shape of the cereal. The manufacturer adds food dye to make the product more attractive to children. Salt and sugar get added to make the taste more appealing too. Finally, some of the vitamins and minerals removed in processing get added back to the breakfast cereal. Eating this one processed sugary cereal product is not going to cause diabetes, but it’s not going to improve anyone’s health, either.

Imagine all the other products on the supermarket shelves. Now imagine the processing all of those foods go through before they get to the grocery store, and you’ll have an idea of the magnitude of our consumption of processed food.

There are areas around the world known as Blue Zones. The blue zones are places where people tend to have excellent health and where people also live significantly longer lives than they do in other areas. What do eating patterns in the blue zones have in common? A very high intake of fresh fruits and vegetables and little use of meat and dairy in the diet.

What’s the Best Diet for Diabetes?

A whole foods plant-based diet may prevent or reverse diabetes. What is a whole food plant-based diet, exactly? It’s lots of raw or lightly cooked vegetables and fruits, whole grains, and nuts and seeds along with minimal meat and dairy products. Processed foods like cakes, cookies, pies, and chips don’t cut it on this eating plan. If you have been eating a typical American diet your whole life, changing to a whole food plant-based diet may seem like a big challenge. A change is your eating habits isn’t something that has to happen cold-turkey or all at once. Any improvement in the quality of your diet is a step in the right direction.

There is some evidence that a vegan whole-foods plant-based diet (as mentioned above) can reverse diabetes. A 2018 review in Current Diabetes Reports concluded that “Vegetarian diets may be more beneficial than medication for diabetes management.” (Please don’t stop your medication without a discussion with your health care provider!)

Carbohydrate Counting

If you’re not quite ready for the whole foods plant-based approach, counting carbohydrates is the alternative. Fruits, starchy vegetables, dairy products, and food made from grains (and of course, sugar) all contain carbohydrates. You can still have these foods in moderation. Learning to count carbs is crucial for managing diabetes. Use this link to find a free trial of a diabetes meal plan that is moderate in carbohydrates.

What about Probiotics for Diabetes?

Probiotics are good bacteria that live in the gut, and they can help control blood sugar. You can also get probiotics naturally by eating yogurt, kefir, and other fermented foods like kimchee. You can buy probiotic supplements as well. Different strains of good bacteria are better at helping people with different conditions. For people with diabetes, the probiotics I recommend are B. animalis ssp. Lactis 420 (B420) and L. reuteri NCIMB 30242. You can find B. animalis under the brand Floravantage Control and Ultraflora Control. The probiotic L. reuteri can be found under the brand name Microbiome Plus Gastrointestinal. B. animalis ssp. Lactis 420 (B420) has been shown to help with weight management, and L. reuteri can help to manage cholesterol levels.

Can Type 2 Diabetes Be Reversed with a Change in Diet?

Maybe. It depends on how long a person has had diabetes and how much their pancreas is still functioning. In the early stages of type 2 diabetes (or in pre-diabetes), a person’s pancreas still has some ability to produce insulin. Around six years after diagnosis, most people have lost about 75% of their pancreas’ ability to make insulin. For people with pre-diabetes, the US National Diabetes Prevention Program encourages a weight loss of about 5% of body weight and at least 150 minutes of physical activity per week. This small weight loss combined with regular physical activity has been shown to prevent full-blown type 2 diabetes in many prediabetic patients.

The Bottom Line

Eating well won’t prevent type 1, but it goes a long way toward the prevention and reversal of type 2 diabetes. A whole foods plant-based diet combined with the addition of fermented foods or probiotics is the best way to prevent and manage diabetes.

p.s. Want to read a comprehensive review of type 2 diabetes? Click here.

Julie Cunningham is a Registered Dietitian and Certified Diabetes Care and Education Specialist. Julie is the owner of a nutrition counseling service in Hendersonville, NC. She works as both an in-person and an online nutritionist.

My Grandma’s Dying Wish was To Be Thin

My Grandma’s Dying Wish was To Be Thin

She held up her arms like a prizefighter and looked at me expectantly. I wasn’t sure if I should shake one of her hands, embrace her, or notice a ring or bracelet that only she could see. “What beautiful nail polish!” I ventured, hoping my response would fit her hallucination that day. “Is that all you have to say?” she asked. Nodding at her wrists, she said hoarsely, “Only two inches around!” Enlightenment dawned. There was no imagined jewelry that day, no search for affection. She sought praise for her shriveled body size.

After six months in a skilled nursing facility, Grandma had lost nearly one hundred pounds. While losing her battle with a trifecta of heart disease, diabetes, and kidney failure, she talked to dead relatives. Grandma shooed imaginary children out of her way day and night. She believed that there was a factory in the bath attached to her room. She no longer recognized her own family, but this one thing she knew: thin was good, and she had finally achieved it.

Grandma had been heavy for at least the last forty years of her life. She loved food, and she loved with food. When I was a child, Grandma delightedly served me cake and Pepsi for breakfast. She dedicated wide kitchen drawer to the storage of full-sized candy bars. For as long as I could remember, she fed anyone she could as much as she could.

I only heard her say the words “I love you” a handful of times; she preferred to show love with her special Hershey Bar cake. In return, it was my job to praise her generosity and confectionery skills. In her eighty-four years, nothing made my grandmother happier than for someone to tell her that her cakes or pies were the best they had ever tasted.

Grandma grew up poor during the Great Depression. She and my grandfather became financially secure later in life, but she never lost her fear of hunger. While eating one meal, Grandma planned the next. At restaurants, she would encourage me to take the extra rolls and put them in my purse. We might be hungry later, she said.

Paradoxically, she despised her body weight, and she disliked overweight in anyone else. The size of her body and everyone else’s was a continual topic of conversation. The message was mixed: Food is love, eat it up in large portions, but stay thin to be lovable.

At the end of her life, my grandmother lost touch with reality, but the desire to be thin was so firmly embedded that she was dispensing dietary advice from her deathbed. “I’ve figured it out,” she told her nurses, “Eat three peanuts when you’re hungry and go to bed and forget about it. See? Just look at my arms! Everybody’s jealous of how skinny I am!”

It overjoyed my grandmother to be thin while she was dying. Her pleasure in her emaciated body was bitter evidence of her lifelong body shame. It saddens me to think she spent her whole life feeling like her body was unacceptable. It also makes me more certain that we need to think and talk about women’s bodies in a way that makes space for people of all sizes to feel good in their skin.

Before she died, I prayed that God would take Grandma swiftly so she would not suffer. Instead, she endured a slow and painful death. Today, I pray that we can find a place of acceptance for women of all sizes, so no one else suffers a lifetime of body shame and dies with her weight on her mind.

Read these similar stories, Why Self-Care Isn’t Selfish and Fear of Flying.

Julie Cunningham is a Registered Dietitian and Certified Diabetes Care and Education Specialist. Julie is the owner of a nutrition counseling service in Hendersonville, NC. She works as both an in-person and an online nutritionist.