Wellness

Find all our posts on wellness here! Read about topics on medical news, medications and supplements, and diabetes self-care.

Prediabetes FAQ

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Prediabetes is the early onset of type 2 diabetes, which is a health condition where the body can’t control blood sugar levels. Whether you’re newly diagnosed or know someone with this prediabetes, we go over the basics and other key facts to help answer your questions about this condition.

What is Prediabetes?

Prediabetes is the early stage of type 2 diabetes, which is a condition where blood sugar (glucose) levels exceed normal or healthy range – which is called hyperglycemia.

What Causes Prediabetes?

Similar to type 2 diabetes, high blood sugar levels is caused by the body not producing enough insulin or early stages of insulin resistance.

Insulin is an important hormone released by the pancreas into the blood and absorbs sugar into the cells. But when there isn’t enough insulin, glucose stays in the blood and over time leads to several disorders and complications.

What are warning signs of prediabetes?

There are no obvious symptoms of this condition so you may have it without knowing . This is why it’s important to talk to your care provider and get screened for prediabetes. Especially if you have risk factors for prediabetes including obesity, family history of or had gestational diabetes.

What is the prediabetes range?

There’s a few ways to test measure blood glucose. One way is to measure Hemoglobin A1C, which reflects the blood sugar average from the last 2-3 months.  Another way is measuring fasting glucose which tests the amount of glucose in the blood at that specific time.  And the glucose tolerance test involves drinking a special sugar solution followed by a blood test to see how much blood sugar increases and decreases over certain times.

These test results are then compared to normal or average blood sugar levels like the table below based on the American Diabetes Association (ADA) guidelines:

Stage Hemoglobin A1C Fasting Plasma Glucose (FPG) Oral Glucose Tolerance Test
Normal A1C < 5.7% FPG < 100 mg/dl 2-hour Plasma Glucose (2hPG) < 140 mg/dl
Prediabetes A1C = 5.7% – 6.4% FPG = 100-125 mg/dl 2hPG = 140 -199 mg/dl
Diabetes A1C ≥ 6.5% FPG ≥ 126 mg/dl 2hPG ≥ 200 mg/dl
Source: ADA 2021 Standards of Care

What Happens if You’re Prediabetic?

As shown in the table above, prediabetes is diagnosed if your fasting blood glucose is between 100-125 mg/dl or your A1C is 5.7% – 6.4%.

Being diagnosed with this condition means that the beta cells in the pancreas are damaged and not functioning as well. Beta cells are responsible for the pancreas creating, storing and releasing insulin so damage to these cells negatively affects how well sugar is absorbed from the blood.

What Percentage of Prediabetics Develop Diabetes?

According to research, anywhere from 5%-10% of prediabetic people will develop diabetes annually but will vary based on certain populations. And the research also notes that up to 70% of prediabetic people will eventually develop diabetes.

How to Treat Prediabetes?

Medication can be used to treat prediabetes and Metformin is one of the most common medications prescribed for diabetes.

But there’s different opinions on whether it should be used for prediabetes. Some research does not recommend Metformin for treating this condition because it may not be needed, while others believe it should be used for higher risk individuals.

How to Reverse Prediabetes Naturally?

Fortunately, this condition is fully reversible by lowering glucose through a combination of lifestyle diet and exercise. In fact, research on lifestyle interventions – like diet and exercise – shows they’re actually more effective at reducing the incidence of Type 2 diabetes than Metformin.

With diet, reducing carbohydrate intake is key so stick with eating low-starch vegetables, protein and complex carbs. Exercise also helps lower glucose levels by using glucose for energy and improves insulin sensitivity.

Stress is another big factor of prediabetes and should be kept low. When your stress increases, hormones and chemicals tell your body to release more glucose in the blood, which can cause blood sugar levels to spike!

How Long Does it Take to Reverse Prediabetes?

There is no standard time frame and will depend on the lifestyle changes you make (diet, exercise and stress) and genetics. The more aggressive lifestyle changes you make will help reverse the condition faster, while modest lifestyle changes may mean a longer period. And people with risk factors of diabetes may have to work harder to reverse this condition.

When to Check Blood Sugar for Prediabetics?

Care providers usually don’t regularly checking glucose levels for prediabetes and will screen for Type 2 diabetes once a year. But if you’re making lifestyle change to reverse this condition, then it’s actually good idea to regularly check glucose to see your progress.

There are a lot of simple and inexpensive glucometers, which you’d use two hours after the first bite of a meal. This will give you instant feedback on whether you need to adjust your meals to control blood sugar.

What to eat with prediabetes?

Like with diabetes, the goal is to keep blood sugar levels to normal or healthy range. So this usually means lowering daily carbohydrate intake.

It’s also recommended to avoid highly refined, processed carbs that can often cause blood sugar levels to spike. Instead, try to choose more complex carbs that break down slower and are less likely to spike glucose levels like the examples below.

How Many Carbs a day for Prediabetes?

There is no set amount of carbohydrates allowed for prediabetes because it’s still in the early stages of the condition. This is different than gestational or type 2 diabetes, where you need stricter limits on carb intake because they’re more serious conditions and are much harder to reverse with diet.

But you still want to control your carb intake. A simple way to do this is using the diabetes plate method to portion meals to help minimize glucose spikes.

What is the Best Diet for Prediabetics?

There is good research showing that Mediterranean-style and low carbohydrate can help prevent prediabetes or type 2 diabetes . A large study compared a Mediterranean-style to a low-fat diet and the Mediterranean diet showed a lower relative risk for diabetes.

Another study showed remission of prediabetes to normal glucose tolerance levels with participants on a high-protein diet but only about 30% remission for those on a high-carb diet.

Diabetes Basics

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Diabetes is a common, long-term health condition that occurs when the body cannot control blood sugar levels. Whether you’re newly diagnosed or know someone with diabetes, we go over the basics of diabetes and other key facts so you can understand more about this condition.

What is Diabetes?

Diabetes mellitus is a condition where glucose (or sugar) in the blood exceeds normal or healthy levels. This is due to inadequate insulin production by the pancreas (“organ dysfunction”) and/or the body’s inability to use insulin effectively (“insulin resistance”).

Insulin is a vital hormone released by the pancreas and absorbs blood glucose into the cells. But when there isn’t enough insulin, glucose stays in the blood and over time leads to several disorders and complications.

Type 1 and Type 2 Diabetes

There are actually four classes of diabetes: Type 1, Type 2, gestational and diabetes caused by specific conditions.

  • Type 1: the pancreas is affected by an autoimmune condition that impairs the production of insulin.  Type 1 diabetes can occur in children as well as later into adulthood.
  • Type 2: the pancreas can’t produce adequate insulin because it’s been overworked after years of high blood glucose levels.  The pancreas has been stressed from continually producing insulin while the cells become more insulin resistant. Lifestyle choices are highly associated with pancreatic dysfunction.
  • Gestational diabetes occurs in pregnant women, when hormonal changes during pregnancy causes insulin resistance.
  • Diabetes can also be caused by specific conditions but isn’t as common as the other types. The conditions could be diseases affecting the pancreas (such as pancreatitis) or drug- or chemical-induced diabetes (such as using glucocorticoid after organ transplantation).

How is it Diagnosed?

Diabetes is diagnosed if measured blood glucose levels is outside of the normal or healthy range (charted below).

A common measurement is Hemoglobin A1C, which generally reflects a blood sugar average from the last 2-3 months.  Other common measurements are fasting glucose and glucose tolerance tests done through blood tests at a lab.

Stage Hemoglobin A1C Fasting Plasma Glucose (FPG) Oral Glucose Tolerance Test
Normal A1C < 5.7% FPG < 100 mg/dl 2-hour Plasma Glucose (2hPG) < 140 mg/dl
Prediabetes A1C = 5.7% – 6.4% FPG = 100-125 mg/dl 2hPG = 140 -199 mg/dl
Diabetes A1C ≥ 6.5% FPG ≥ 126 mg/dl 2hPG ≥ 200 mg/dl
Source: ADA 2021 Standards of Care

Diabetes in the U.S.

According to the CDC’s 2020 Diabetes Statistics Report, over 34 million Americans have diabetes (1 out of 10 people) and 88 million have pre-diabetes (1 out of 3 people).

The rate of this condition among adolescents (under 20 years old) also significantly increased the past several years.  This is concerning as the CDC’s report showed that diabetes was the 7th leading cause of death in 2017.

Complications

High blood glucose levels over time can restrict blood flow, damage blood vessels and reduce blood supply needed throughout the body. This can lead to serious health complications such as microvascular and macrovascular diseases.

Microvascular Disease

Diabetes can cause microvascular diseases which are caused by damaging small blood vessels located in the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy).

Retinopathy is caused by damaged blood vessels in the back lining of the eye and is the leading cause of blindness.

Nephropathy occurs when damaged blood vessels prevent the kidney from functioning properly and can lead to kidney failure. Neuropathy is caused by damage to the nerves, which can disrupt how your nerves communicate to different limbs and organs.

Macrovascular Disease

Diabetes also increases the risk of macrovascular diseases, which are caused by damage to the large blood vessels and include coronary artery disease and stroke.

Coronary artery disease is caused by damaged blood vessels that supply the heart and can cause heart attacks, heart failure or irregular heartbeats. Strokes occur when the blood supply to the brain suddenly stops – this is worsened when there is damage to the blood vessels that supply the brain.

Treatment and Management

While there is no complete cure for diabetes, medications and lifestyle changes can control diabetes to a manageable level in order to prevent complications.

Medication

Insulin is the most common medication prescribed for diabetes as it lowers blood glucose to normal/healthy ranges. Metformin is another common medication that is used to prevent the liver from releasing sugar and increase insulin sensitivity.

There are several other medications generally designed to lower blood sugar but target different organs such as  glipizide, jardiance and victoza.

Lifestyle

Lifestyle choices are also effective for controlling diabetes, particularly a combination of diet and active living.

Diet is important because the amount of sugar (or carbohydrates) in the foods you eat impacts your blood glucose levels. Generally speaking, lowering carbohydrate intake will help lower blood glucose levels.

Staying active is equally important because exercise uses carbs for energy, thus removing glucose in the blood. Staying active also helps with insulin sensitivity, weight and fat loss, and increasing muscles – all of which can reduce the risk of other diseases.

Fast Facts on Lyumjev Insulin

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Lyumjev insulin lispro-aabc is a new, rapid acting mealtime insulin with impressive onset times. We talk about this new insulin, how it compares to other insulins, and the benefits of a fast acting insulin for diabetes self care.

What is Lyumjev?

Lyumjev (insulin lispro-aabc) is made by Eli Lilly and Company and was approved by the FDA in 2020 for the treatment of Type 1 and 2 diabetes.

Lyumjev is taken via injection using either with a syringe and vial, or their insulin pen “KwikPen.” And in 2021, the FDA approved Lyumjev for use in insulin pumps for people with Type 1 diabetes.

Lyumjev is a Bolus Insulin

Lyumjev is a bolus type insulin. Bolus insulins are fast acting and are meant to lower or prevent high blood glucose spikes. Bolus insulins are taken before meals and is why they’re sometimes called “mealtime insulins.”

The other type of insulin is called basal. Basal insulins work over a long period of time and is meant to keep blood sugar levels to a healthy or baseline level.

What Makes Lyumjev Stand Out

It’s Newer Than Other Lispro Insulins

Lyumjev contains lispro-aabc insulin, which is the newest type of lispro insulin. The other lispro insulins are Humalog, which was approved in 1996 and Ademolog approved in 2017.

And for some quick history, the oldest bolus insulin (Humulin R) was approved in 1983. That’s nearly 40 years ago!

It’s Rapid Acting

When compared to other insulin lispro brands, Lyumjev stands out when it comes to how quickly it takes effect (or “onset time”).

Humalog and Admelog are lispro insulins have an onset time of between 5 to 15 minutes after injection. On the other hand, Lyumjev has on onset time of 1 minute after injection. That’s over 10x faster compared to Humalog and Admelog!

It Acts Like Natural Insulin

This study compared the developmental version Lyumjev with Humalog and other rapid insulins. And not only did the study find that Lyumjev was the fastest acting, it also found that it closely matches the body’s glucose response found in people without diabetes.

Benefits of Lyumjev

A faster acting meal time insulin like Lyumjev can provide a lot of convenience in your daily diabetes self care.

Less Planning

waiting for food

You don’t have to wait 15 to 30 minus after taking insulin before you can eat. Timing meals and insulins can be a hassle and keep people from proper diabetes self care. Just imagine the headache at being a restaurant and not being sure when your food will arrive.

Lower Chances of Low Blood Sugar

The other benefit is Lyumjev’s fast onset and fast peak time, which allows it to pass through the body faster. This can help lower the chances of hypoglycemia (low blood sugar), especially during sleeping hours.

More Efficient with Basal and Bolus Insulins

And if you’re only taking a basal insulin, adding a bolus insulin (like Lyumjev) gives you a more efficient blood glucose control regimen. This means taking less insulin overall which can lessen the amount of weight gain while on insulin (which is a common side effect).

Lyumjev Insulin Costs

Like many other prescription medications, the cost of Lyumjev will vary based on your medical insurance, pharmacy and other factors. But based on estimates from GoodRx.com, Lyumjev costs about $300. That’s a lot higher than Humalog (lispro insulin) which is about $50 – $ 80.

Summary

Lyumjev contains insulin lispro-aabc – the newest and fastest bolus insulin commercially available to help control blood sugar spikes for Type1 and Type 2 diabetes. Compared to Humalog and Admelog lispro insulin, Lyumjev takes effect in just one minute which is over 10x faster.

You can take Lyumjev at the beginning of your meal, rather than having to time meals and insulin injections with slower acting insulins. And because Lyumjev clears your body faster than other insulins, this can help reduce the chances of hypoglycemia.

The costs of Lyumjev are a lot higher than Humalog and other lispro insulins. But if you’re looking for rapid acting insulin and the added convenience to your diabetes self care, then Lyumjev is definitely one to look into.

Glucocil: What’s It All About?

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Glucocil is an over-the-counter dietary supplement that calls itself to be the “total blood sugar optimizer.” If you have Type 2 diabetes then you may have heard of Glucocil and its claims to control blood sugar.

But what exactly is it? And how does it work? We take a quick look at Glucocil and why people use it to treat diabetes.

What Glucocil Claims To Do

Made by Neuliven Health, Glucocil is marketed as the “total blood sugar optimizer.” It’s a dietary supplement for adults over 18 but not recommended if you’re pregnant or nursing.

According to Glucocil.com, it targets “3 essentials for normal blood sugar:” reducing sugar from being absorbed, reducing the liver’s sugar production, and increasing the use of sugar for energy.

It also boasts benefits of:

  • Promoting healthy blood sugar levels
  • Promotes heart, blood vessel & circulatory health
  • Promotes healthy weight loss
  • Reduces absorption of sugars and other carbohydrates
  • Promotes healthy energy

Glucocil Ingredients

Glucocil contains 14 ingredients including vitamins and minerals that you’ve heard of like D3, B1, B6, B12 and Chromium picolinate.

It also has a proprietary “blood glucose management blend” that includes:

  • Mulberry leaf extract
  • Phellodendron extract (Berberine)
  • Alpha lipoic acid
  • Gymnema sylvestre extract
  • Veld grape extract
  • Banaba leaf extract
  • Inlulina (cissus sicyoides leaf)
  • Cinnamon bark powder

The ingredients in their special blend have some benefits or functions in controlling blood glucose level. But two ingredients – alpha lipoic acid (ALA) and berberine – are noteworthy compounds that we take a closer look at.

Alpha Lipoic Acid (ALA)

ALA is a naturally occurring fatty acid found in foods and created by the body. It’s an antioxidant that helps regulate or control “free radicals.”

When cells create energy from glucose and oxygen, a byproduct is created called reactive oxygen species or “free radicals.”

These free radicals are unstable molecules that can cause oxidative stress and can lead to cell damage.

ALA is known to be a powerful antioxidant that can counter many free radicals. And ALA can even create other antioxidant substances like Vitamin C and E.

ALA and insulin sensitivity

Because antioxidants help prevent cell damage, ALA and its antioxidant properties have been shown to reverse nerve damage.

Nerve damage (neuropathy) is a microvascular disease that is commonly associated with diabetes.

Chronically high blood glucose levels – a main factor for being diagnosed with diabetes – can lead to poor blood circulation and eventually damage blood vessels.

Examples includes diabetic eye disease and kidney disease which occur due the small blood vessels to these organs being damaged due to high blood sugar levels.

ALA can also improve weight

Studies have also shown that ALA can also help with weight loss. This review of clinical trials of ALA supplementing found decreases in body weight and this review saw reductions in weight and BMI.

The reason for this could be because ALA is known to increase AMPK (AMP-activated protein kinase) activity. AMPK is an enzyme that acts like a fuel sensor and is activated when cells need more energy.

Similarly, increased AMPK activity by ALA can also increase insulin sensitivity according to this study.

Phellodendron extract (Berberine)

Phellodendron is a type of plant and has been used in traditional Chinese medicine for centuries. Berberine – one chemical found in Phellondendron – is known as a potent supplement to reduce blood sugar in people with Type 2 diabetes.

This study on berberine treatment found significant reductions in Hemoglobin A1C, fasting blood glucose and post-meal blood sugar. In fact the study saw that the berberine was just as effective as metformin, which is a common and effective medication prescribed for people with diabetes.

Other Key Glucocil Ingredients

Banaba Leaf Extract

The banaba plant is found in Southeast Asia. It’s been used as a natural treatment for diabetes for years because of its hypoglycemic effects.

Banaba leaf contains corosolic acid, which has been credited for the blood sugar lowering effects of taking Banaba leaf extract.

Specifically, corosolic acid has been shown to lower blood sugar levels within 60 minutes of consumption and has antioxidant properties.

Mulberry Leaf Extract

Mulberry leaves contain many beneficial vitamins, minerals and antioxidants. And it’s why mulberry leaves have been used in natural remedies across the world for centuries.

Mulberry leaves can also help with healthier blood sugar levels. A study had participants take mulberry leaf extract with meals and saw a reduction in blood sugar increases.

This suggests that mulberry leaf extract could be a helpful mealtime supplement by minimizing blood sugar spikes.

Chromium Picolonate

Chromium is a naturally occurring earth mineral and comes in different forms.

Some forms are used in industry (like hexavalent chromium) and can be carcinogenic. And other forms – specifically trivalent chromium – is found in very small amounts in our bodies and is considered essential.

Chromium picolonate is the supplement version and is easier for the body to absorb.

While some studies have shown improved insulin sensitivity with chromium supplementing, other studies have shown no long term improvement or inconsistent results.

Fish Oil

fish oil capsule

Omega-3 fatty acids in fish oil is an essential nutrient and has many benefits for heart health. It’s long been established that Omega-3 can help prevent or manage heart disease, lower blood pressure and lower triglycerides.

Cissus Sicyoides

Cissus Sicyoides (princess vine) is another leaf extract and is a popular natural medicine for diabetes in Brazil.

This study found cissus sicyoides showed hypoglycemic effects on diabetic rats. However, data on its effectiveness on treating diabetes condition seem limited.

Side Effects

Every supplement and medication can have side effects. Individually, the 14 ingredients in Glucocil generally seem to be well tolerated and are likely safe for adults when taken as instructed.

But each of those ingredients can react to other medications, which is why you should talk to your doctor before taking any supplement or medication.

Summary: Does Glucocil Work?

Many of the individual ingredients in Glucocil’s proprietary blend has shown benefits for people with Type 2 diabetes – especially alpha lipoic acid and berberine.

These ingredients can help better regulate blood sugars, improve insulin sensitivity and/or have antioxidant properties to prevent nerve damage.

Some of the ingredients have also shown weight loss benefits but don’t expect it to be a weight loss diet pill.

It’s important to note that Glucocil is a dietary supplement and not an FDA-approved treatment for diabetes. There’s also very little clinical studies or Glucocil medical reviews on the products claims and effectiveness.

The product has been available for years so take the time to research customer reviews and experiences. And more importantly talk with your doctor and see if Glucocil is an option for you.

Tresiba Vs Lantus

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We break down two popular, long acting insulins: Lantus vs Tresiba. They’re both used to treat people with Type 1 diabetes or Type 2 diabetes and have a lot in common. But they also have some key differences you may want to be aware of. We go over what they have in common, how they differ, and why you may want to choose one over the other.

What is Insulin?

Insulin is an important hormone your body produces to control blood sugar levels. When you eat, the body breaks down carbohydrates in the food into sugar, which then enters the blood.

The pancreas releases insulin into the blood to absorb the sugar (or glucose) into cells. The body then either uses that glucose as energy or stores it in muscles or the liver as glycogen for later use.

The more sugar or carbs you eat, the more insulin the pancreas releases. So it’s a constant feedback loop between the pancreas and the amount of glucose in the blood.

How Insulin is Made

The history of injected insulin actually dates back over 100 years. Researchers in 1921 discovered how to extract and refine insulin from the pancreas of animals, and the first successful use of insulin on a person happened in 1922. It wasn’t until the 1980s that an engineered, synthetic insulin was developed that didn’t depend on animals (“human insulin”).

Today, human insulin is made mostly from common bacteria. The processes may differ but generally the bacteria is used to create protein, which is then modified to create the human protein that produces insulin.

Insulins are also designed to meet basal or bolus requirements. Basal type insulins are effective over long period of time to keep blood glucose levels at baseline. Bolus type insulins are effective within 1-2 hours of ingestion are meant to be taken before meals to minimize blood sugar spikes.

Insulin and Diabetes

But problems happen when the pancreas can’t produce enough insulin or the body is not using insulin effectively. This is the case with diabetes , which is a condition when blood glucose exceeds normal or healthy levels. The most common are Type 1 and Type 2 diabetes:

  • Type 1 occurs when the pancreas’ ability to create insulin is impaired because of an autoimmune condition.
  • Type 2 occurs when the pancreas can’t produce enough insulin because it’s been overworked after years of high blood glucose.  The cells also aren’t able to use insulin effectively, which is called “insulin resistance.”

As a result, people with uncontrolled diabetes are often prescribed insulin to help control blood sugar levels.

Lantus and Tresiba Similarities

Method of Delivery

Both insulins are liquids you inject and come in vials (for syringes) or disposable prefilled insulin pens. The FlexTouch pen is Tresiba’s version and the Lantus pen is called SoloStar. And both the Tresiba FlexTouch and Lantus SoloStar come in 3ml of 100 units/mL and more concentrated doses.

Side Effects

Like most prescription drugs, Lantus and Tresiba come with side effects. Hypoglycemia (or low blood sugar) is the most common side effect of insulin including Tresiba and Lantus. But studies have found lower instances of hypoglycemia with Tresiba.

Other common side effects associated with Tresiba and Lantus are weight gain, injection site reactions, or skin issues. These reactions are actually common with most insulins and some can be minimized by changing injection sites.

How Lantus and Tresiba Differ

Active Ingredients

The active ingredient in Lantus is insulin glargine. This was actually the first, once-a-day basal insulin used in clinical practice. Lantus is made by Sanofi/Aventis and it received FDA approval in 2000.

Insulin degludec is the active ingredient in Tresiba and is relatively newer. Novo Nordisk makes Tresiba, which received FDA approval in 2015.

Duration of Effect

While both are long acting insulin, Tresiba has a much longer effect. The duration of action of Lantus is up to 24 hours, while Tresiba is up to 42 hours. Still, the duration of both insulins are impressive and can help control blood glucose levels throughout the day and night.

Adults and Children

Tresiba can be prescribed to children as young as 1 year old, while Lantus can be prescribed for children 6 years and up.

Costs

Tresiba and Lantus are brand name drugs so both generally cost more than other generic insulins. But there is a notable cost difference between the two.

According to Goodrx.com, the price of Lantus is around $200 but Tresiba can be nearly 3x higher at around $600. While actual costs will depends on different factors like location, medical coverage and pharmacy, Tresiba is clearly the costlier option.

Lantus vs Tresiba: Which to Choose?

Talk With Your Doctor

First, always discuss with your doctor about potential medication or treatment options. Your care provider can assess your condition, possible drug interactions or allergic reactions, and provide other medical advice.

This is also important if you’re already on insulin but interested in switching. Sometimes people with diabetes may feel their insulin is not helping meet blood sugar targets. Consult your care provider to asses your blood sugar trends and see if changing insulins is an appropriate option. But it may surprise you that a simple insulin dose adjustment is all that’s needed.

Tresiba Lasts Longer

Let’s face it: injecting insulin can be uncomfortable and time consuming. Which is why an insulin that lasts a long time can mean fewer injections.

With that in mind, using Tresiba may be the better option since a single dose can last up to 42 hours and may be more convenient overall.

Lantus Has Been Around Longer

As we said above, Lantus (insulin glargine) was developed over 20 years ago and is still widely used today. This means there’s more information on Lantus which can help answer questions on its effectiveness or safety. Not to say that Tresiba is less safe or effective but Lantus has been around much longer.

Tresiba Has Lower Rates of Hypoglycemia

glucometer to measure blood glucose

Tresiba has been shown to have a lower risk of hypoglycemia or low blood sugar. Hypoglycemia can be a serious event and is one reason why regularly monitoring blood sugar is important when on insulin.

An analysis of randomized clinical trials between insulin degludec (Tresiba) and insulin glargine (Lantus) showed lower rates of hypoglycemia with degludec. This reduction was also more noticeable at night and/or in people with Type 2 diabetes (than Type 1).

If you’re prone to having low blood sugar, your care provider may recommend Tresiba.

Lantus is More Affordable

Lantus is no doubt the more affordable option, which can be found at 3x lower than Tresiba. This price difference is probably because Tresiba is newer and Lantus has been around for decades. Insulin costs is an important factor for people with diabetes so this difference can limit your options.

Summary

Tresiba and Lantus are long acting insulins that are effective in controlling blood sugar levels. They have a lot of similarities like being available in disposable pens and have long lasting effects. But they’re difference in cost and duration are big enough to impact your decision.

Tresiba (insulin degludec) can last up to an impressive 42 hours! This can mean taking less injections throughout the day and overall more convenient. On the other hand, Lantus (insulin glargine) can last up to 24 hours yet is much more affordable – up to 3x less than Tresiba.

Whether you like Tresiba or Lantus, first get proper medical advice about these drugs. Hypoglycemia is a side effect of both insulins (though less cases with Tresiba) so talk with your doctor about your options.

But if you’re able to afford it, the prolonged effect of Tresiba is unmatched. A single injection of Tresiba can help control blood sugar for up to 42 hours – this means less injections and more convenient. And studies have shown that Tresiba has lower cases of hypoglycemia.

Insulin medications are a big part of diabetes self care so it’s important to choose an insulin that meets your needs.

Ceramides: The Fat Linked to Diabetes

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People with Type 2 diabetes are likely to have insulin resistance, which is when the body is not able to use insulin effectively. But studies are finding that a certain type of fat molecule, ceramides, plays a big role in the onset of diabetes. We take look at the science behind ceramides, their links to diabetes and insulin resistance, and discuss what you can do to about it.

Understanding Ceramides

Ceramides are one class of fatty acids under the sphingolipid family. A ceramide is made up of a fatty acid and a long-chain (called sphingoid) base. Ceramides can be stored in the muscles, adipose tissue, and the liver.

There are ceramides in food but diet is not the main source of ceramide. Rather, the body creates it through three major pathways.

  • First is called the sphingomyelinase pathway. This is where enzymes break down sphingomyelin (a type of sphingolipid) in cell membrane and release ceramide.
  • The second is the de novo pathway where ceramide is created from other molecules.
  • The third is called the “salvage” pathway. Here sphingolipids that are broken down are reused to form ceramide, through a process called reacylation.

Why Ceramides are Important

Ceramides, like other lipids, serve important functions in the body. They are an important part of the structure of cell membranes. They’re also signaling molecules and involved in many cell functions including cell growth, degradation, and others.

Ceramides are also found on skin tissue that, along with other fatty acids, form part of the skin barrier and helps prevent moisture loss. If you look at the label of lotion or moisturizer products, chances are it will list ceramide as an ingredient.

But Too Much Ceramides Create Problems

While they serve important bodily functions, the problem is when having high ceramide levels. Excess ceramides can be found when someone gains too much weight and a lot of bodyfat increases.

Accumulated ceramide can damage mitochondria, which are important parts of cells that create energy. The more damage to mitochondria can lead to metabolic syndrome and metabolic disease.

Many studies show that excess ceramides are linked to the onset of cardiovascular disease and diabetes.

Cardiovascular Disease

Similar to cholesterol, ceramides are sticky molecules and can cause problems on the cardiovascular system when there’s too much. Ceramides are known to play a key role in the development of cardiovascular diseases including atherosclerosis, heart failure, and stroke.

Researchers from the University of Utah found that people with high ceramide levels in their blood were at least 3-4 times as likely to have a stroke or heart attack than those with lower ceramide levels.

This scientific review explored the role of ceramides and the development of atherosclerosis. Atherosclerosis is the buildup of cholesterol, fats and other substances (called “plaque”) in the arterial walls.

Diabetes

High ceramide levels have been consistently linked with the development of diabetes. People with diabetes are likely to have accumulated ceramides in muscles and/or high plasma ceramide levels, particularly those that are overweight and have insulin resistance.

What Does Ceramides Have to do with Diabetes?

When there is excess ceramides, it affects insulin signaling and transmission. Insulin is a hormone released by the pancreas and absorbs blood glucose into the cells. Without insulin, glucose stays in the blood and increases blood glucose levels.

Accumulated ceramides inhibit a protein kinase called Akt/PKB, which is an enzyme involved in the insulin signaling pathway. This negatively affects glucose uptake and glucose metabolism, contributing to insulin resistance.

Over time this can lead to elevated blood glucose levels and the onset of Type 2 diabetes and related health disorders.

How to Reduce Ceramides

With the science clearly showing health risks of high ceramides, lowering ceramide levels is a priority for people with diabetes and insulin resistance.

So how do you lower ceramides? The tried and true approach of diet and exercise.

Exercise

It may not sound fun but exercise is very effective in lowering ceramides. And the studies on this area clearly show the benefits of exercise on ceramide.

This study looked at the impacts of endurance training on muscle fatty acid metabolism in relation to glucose tolerance. The participants were people who are overweight and went through 8 weeks moderate-intensity training. The researchers found that the training improved glucose tolerance and total ceramides were reduced by 42%!

Exercise Helps Insulin Sensitivity

It’s also been established that exercise helps improve insulin sensitivity as explored in this scientific review. This helps counter the negative affects of accumulated ceramides and can prevent insulin resistance from developing.

Quick and Easy Exercises

We know it can be hard for people with diabetes to get motivated or find the time to exercise. But whatever the reason, it’s really important to simply start exercising. The good news is that there are many simple, quick yet effective exercises you can start with.

woman walking

Walking is a great option if you’re not very active or have mobility issues. Stationary squats or rocket jumps can burn a lot of calories and can be done anywhere.

And adding resistance bands to your exercises is a great way to ease into strength training and building muscle.

Whole Foods

There aren’t many studies on specific foods to lower or control ceramides. But you want to follow a diet that can help minimize weight gain because of increased body fat.

A diet of whole foods and watching your calories can help reduce or control body weight. In fact, choosing whole foods, like fruit and vegetables, over highly refined foods helped lower certain ceramides according this study.

cabbage

Cruciferous vegetables, like broccoli, cabbage and brussels sprouts, include sulforaphane which can help lower blood sugar by increasing glucose uptake from the bloodstream.

According to this study, sulforaphane has been shown to block a certain enzyme involved in ceramide synthesis of ceramides, which helped improve insulin sensitivity.

Watch Your Carb and Calorie Intake

And of course you want to control your carbohydrates since glycemic control is critical for people with diabetes. Dealing with carbs and diabetes can be a challenge but thankfully there are plenty of low carb whole foods to choose from.

Limiting calorie intake is also important in minimizing unwanted weight gain. Portion control is an effective way to limit calories and the diabetes plate method is a simple, visual way to portion meals. And they even make portion control tools if you want an even easier option.

New Treatments

More and more studies are looking at medical treatments to lower or control ceramides directly. This 2010 study on obese mice used myriocin to slow or prevent the ceramide synthesis process as a way to improve glucose tolerance. And researchers are exploring new tools and methods to better detect ceramides, since they’re way less abundant than cholesterol.

We’re not aware of currently available treatments to lower ceramides for diabetes but research continues to explore this approach.

Summary

The research is clear that high ceramide levels is linked to developing diabetes and insulin resistance. Elevated levels of ceramides is can hinder insulin signals, which decreases glucose uptake and glucose metabolism. This contributes to high blood glucose concentrations that, over time, leads to diabetes and diabetes-related disorders.

While treatments to lower ceramide may be available in the future, diet and exercise are effective at lowering ceramides and things you can do now. Moderate intensity exercises was shown to significantly reduce ceramide and there are simple and convenient exercises that are perfect for people with diabetes. And eating a diet of whole foods, including cruciferous vegetables, is also very important for controlling blood glucose and improving overall health.

Resistance Band Squats: Get Strong the Easy Way

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Banded squats are an easy and safe way to burn calories and get stronger.

Strength training burns tons of calories, helps lose weight and is effective at lowering blood sugar.  This 2017 study on strength training and the risk of Type 2 diabetes found participants who did any strength training saw a 30% reduction of Type 2 diabetes.  But strength training can be hard if you have some aches or pains, or if you haven’t exercised in a while.  Using resistance bands can solve this and banded squats are a simple and effective way to ease into strength training.

What are resistance bands?

A resistance band is an elastic band and when under tension, creates resistance or “load.”  Using a resistance band with bodyweight exercises adds load to contract muscles and build strength.

Types of Resistance Bands

Resistance bands are made of latex, nylon or rubber and come in different levels of resistance.  The amount of resistance can be labeled “light,” “heavy,” etc. or by weight such as 20 lbs., 50 lbs. and so on.

They also come in a variety of lengths, thickness and styles.  They have loop bands, free bands (non looped), tube bands with handles, and others.  Ultimately, the type of band you need will depend on the exercise or movements you want to do.

For the banded squats we talk about below, you’ll need loop bands in both large and small sizes. But it’s good to have a combination of bands so you can try other exercises as well.

Why Use Resistance Bands

Easy, safe way to build strength

A resistance band is easier to manage than weights, which is important if you haven’t exercised in some time or have minor aches. This allows you to focus first on proper form and movements, which helps prevent injury.

In fact, resistance bands are commonly used for physical therapy to strengthen muscles and rehabilitate body movement.  You control the resistance from the band by your movements and band placement so you can workout on your own pace.

Focus on specific muscles

By simply changing the placement of a resistance band, you can target specific muscles or create more or less resistance. This is a huge advantage over using weights where you’re more limited in how you hold or place weights.

Take for example doing bicep curls with a loop resistance band.  Gripping the band with your hands workout bicep and forearm muscles.  But using the forearms for the curl actually reduces load on the forearm muscles (by not having to grip the band) and limits the curl movement to focus on the biceps.

A resistance band allows you to easily target weaker muscle groups and is a big reason why they’re widely used in fitness.

Convenience

Resistance bands are lightweight and very portable so you can exercise anywhere.  Not having time to workout is one of the most common reasons we hear that limit peoples’ diabetes self care (which we wrote about here).  We know self care is hard when you don’t have much time in your day but if you start by committing 15 minutes a day for self care, that’s a big step towards controlling diabetes.

Resistance bands work wonders for if you have limited time. Doing just 5 minutes of the bands squats we talk about below is enough to start burning blood sugar. Keep a pair of bands in your car or at work and you can easily get 15 minutes of quality exercise every day.

Adds variety to exercising

One of our favorite reasons to use a resistance band is that you can add them to any body weight exercise and even create different exercises.

With weight training, the movements are more controlled because of the added load. And changing movements usually means changing body positions, weights or even the whole exercise.

But a resistance band gives flexibility with body movements and allows you to work out different muscles at a time.  And doing a variety of exercises keeps you from getting bored to help stay motivated with working out.

In this article we only go over a few variations of banded squats but you can easily find a dozen other versions for this one exercise.

Learning How to Squat

Before doing banded squats, learning proper squat form is critical. The classic squat is an important movement that we learn as kids and use in everyday life.  It’s a compound movement that uses muscles in the legs and thighs (quads and hamstrings), bottom (glutes), as well as the core (lower back and abs).

But most of us don’t use correct form when we squat. Think of all the times we reach down to the floor but don’t bend our knees. It’s a common mistake but can lead to muscle pain and sometimes injury.

Below are steps to do a body weight squat which is used for many banded squat movements.

1. Starting position

Stand with feet shoulder width apart and weight balanced evenly.  Don’t lock your knees and tilt your chest slightly forward, like you’re getting ready to run.

2. Squat down

Squat downs slowly with knees bent and butt back, keeping your chest and head facing forward. As you move down, keep your knees outward and back straight.

3. Bottom of the squat

Squat down until your butt is level with your knees and thighs parallel to the ground.

4. Stand up

Slowly stand up back to the starting position using your leg and glute muscles. Be sure to keep feet planted, back straight and chest forward.

3 Simple Banded Squat Exercises

Now that you know how to do squat exercises, we go over three kinds of the resistance band squat. We chose  resistance band squats because they workout the larger muscles (quads, hamstrings and glutes) so you can burn the most calories in a short amount of time.

The banded squat exercises below work best with loop bands in both large and small sizes. We suggest starting with a lower resistance level to work on proper form and get comfortable with the movement, then increase resistance as you’re able to.

Banded Back Squat

This banded squat variation is similar to conventional bar squats but instead of a bar, a large loop band adds the load. Like standard squats this also works out lower body muscles along with other muscles in your core.

Place the loop band on the back of your neck (near shoulders) and step on the inside of the loop. Stand at the squat position with feet shoulder width apart or wider. Keep the band on the outside of your knees as you squat down, using the same movement as a standard squat.

You’ll notice that resistance band squats adds load at the starting position.  This differs from a standard squat where there’s more resistance at the lower part of the movement.  This is because the resistance band is under full tension at the start of the squat position then decreases as you squat down.

Quick Variation: Use a wide standing position.

This is the same as the banded back squat but take a really wide stance for the standing position. Keep about 3 feet of space between your legs. The variation puts more emphasis on the inner thigh and calf muscles.

Banded Squats with Mini Loops

This variation is basically a body squat but with mini loop bands around the thighs.  This resistance band squat isolates the glutes and hip abductors, which can be one of the weak muscle groups for many people. The band pushes the thighs inward and is countered by pushing the knees outward, which then strengthens weak glutes and hip abductors.

Place the mini loop band around your thighs or closer to the knees for additional resistance.  Use the starting position of a regular squat with feet shoulder width apart. You should feel tension from the band – if not, take a wider stance or use a heavier band. Squat down until thighs parallel to the floor.

Quick Variation: add a side step to the squat.

When you squat down, take a side step so that your knees are past hip width. Hold for a few seconds then step in with the other leg and move up to the standing position.  The side step stretches the mini loop band for even more resistance to really work the glutes and hip abductors. 

Banded Split Squat 

The banded split squat is similar to lunge exercise but you hold a resistance band to create an imbalance as you lunge down, which you need to stabilize by using the core muscles.   Aside from strengthening legs and butt muscles, the banded split squat helps improve balance and coordination.

To start the split squat position, grab the looped band (you can also use free band) with both hands and take one foot and step on the middle of the band. Step back with the other foot, slightly bend your knee, and keep your heel off the ground.

Keep your torso straight with weight mostly on the forward leg, and feet and hips pointed forward.  The band should be in full tension at the starting point – if not, the band may be too long and won’t have enough resistance.

Bend both knees to lunge down until your back knee is almost touching the ground. Slowly stand up using the front leg for power and at the same time keep balance using the back leg. Do a couple reps then switch legs for the next standing position.

The standing point and movement are the same as a banded split squat but at the end, add a bicep curl to get a quick upper body workout. The key thing here is using a loop band with the right length.  The band needs to have enough tension at the starting point but not too much that you can’t pull to a bicep curl.  Once you find the right size, this variation is an easy way to combine lower and upper body workouts to save time.

Summary

There’s no doubt strength training is effective at lowering blood sugar and weight loss – two big priorities for people with Type 2 diabetes.  Banded squats work great to ease you into training, especially if you haven’t exercised in a while or have some aches and pain.

We showed you three easy banded squat variations that are guaranteed to burn calories and help make you stronger. Best yet – bands squats only take 15 minutes of your day and can be the easiest part of your daily diabetes self care.

Gestational Diabetes FAQ

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Gestational diabetes mellitus (GDM) is a health condition caused by high blood sugar levels during pregnancy.  If you’ve been recently diagnosed with GDM or know someone who is, there’s a lot to know about the condition and how to manage it.  We answer common questions on GDM to help find the answers you need.

What is Gestational Diabetes?

Gestational diabetes occurs when the mother has very high blood glucose levels during pregnancy.  It’s one type of diabetes that can lead to problems for the mother and the baby. But GDM can be managed in most cases and blood sugar levels will usually return to normal levels after birth.

What Causes GDM?

Gestational diabetes is due to hormonal changes during pregnancy, typically in the second or third trimester, that reduces the mother’s ability to use insulin efficiently. This is called insulin resistance.

Insulin is a hormone released by the pancreas that absorbs sugar (glucose) in the blood to use for energy (or stored for later use). Insulin resistance means the body can’t absorb as much glucose leading to high blood glucose levels.

Insulin resistance during pregnancy is actually common as the mother’s body tries to reserve glucose for the develop fetus.1 But when too much glucose is in the blood (hyperglycemia), then GDM can occur.

How is Gestational Diabetes Diagnosed?

The American Diabetes Association recommends different screening methods depending on the mother’s risk for diabetes.2

If the mother is at risk for diabetes, screening for GDM may happen before 15 weeks of pregnancy. This usually includes checking blood glucose levels to see if it exceeds fasting glucose of 110–125 mg/dL or A1C 5.9–6.4% (41–47 mmol/mol).

If the mother isn’t at risk of diabetes, GDM is usually screened at 24 – 28 weeks of pregnancy using the oral glucose tolerance test. This test involves drinking a special sugar solution followed by a blood test to see how much the blood sugar increases and decreases over certain times.

What Are Symptoms of GDM?

Gestational doesn’t show many obvious symptoms, which is why screening during pregnancy is important.  More frequent urination can be a symptom of GDM but it can also just be part of the pregnancy.

What Happens if GDM is not Controlled?

The baby becomes exposed to high levels of glucose, which increases the chances of the baby having an above average birth weight. And during childhood, these kids can have reduced insulin sensitivity and are more likely to have impaired glucose tolerance.3

The mother also has a higher chance of developing type 2 diabetes after pregnancy. Studies have shown that women with GDM have are 10x more likely to develop type 2 diabetes than women without GDM.

How Common is Gestational Diabetes?

GDM affects up to 10% of pregnancies in the U.S. every year. And GDM rates are rising due to higher rates of obesity, which is a risk factor of diabetes.

How do I Prevent GDM?

You can reduce the chances of GDM by keeping your blood sugar levels within normal range. But keep in mind there’s a higher chance of GDM if you have prediabetes, are overweight or have other risk factors for diabetes.

How do I manage GDM?

Similar to Type 2 diabetes, diet plays a big role in managing GDM. Generally, you want to limit your carb intake and avoid sugary foods and  highly refined carbs.

Exercise and staying active burns glucose and helps lower blood glucose levels. Exercising during pregnancy can be hard but even regular walking can help control GDM, especially walking after meals.

Insulin can also be prescribed to reach blood sugar targets, which is generally safe for the mother and baby.

What Can I Eat with GDM?

You can eat the same foods as before but will need to limit the amount of carbs you eat per meal and spread out those carbs throughout the day. The goal is to keep your blood glucose at a steady level – not too high and not too low.

So a typical day would include eating 3 meals a day with 1-2 servings of carbs. And 3 snacks between those meals with 1 service of carbs. Each serving of carbs should be no more than 15 grams.

Dealing with Carbs and Diabetes

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Get the key facts on carbs to help you take control diabetes

Carbohydrates are an important energy source for the body. But carbs can be challenging for people with diabetes because of its impact on blood sugar level. You don’t have to stop eating carbs if you have diabetes but you do have to choose wisely.

In this article, we talk about the carbs that are better for diabetes, how lowering carbs can improve blood sugar and practical ways to reduce your daily carb intake. As always, consult with your diabetes educator or care provider before making major changes to your diet.

What are carbs?

A carbohydrate is a major source of energy and one of three macronutrients in foods (the other two are protein and fat).

When we eat food, the body breaks down carbs into sugar which enters the blood. The pancreas then releases insulin, which tells the body to either use the blood sugar for energy or store it in muscles or the liver as glycogen.

There’s two main kinds of carbohydrates: simple and complex carbs.

Simple Carbohydrates

Simple carbs have simple chemical structures that includes either one sugar (monosaccharide) or two sugars (disaccharide). Examples are fructose, table sugar and lactose.  Because of their simple chemical structure, these carbs are broken down quickly and can lead to blood sugar spikes.

Complex Carbohydrates

Complex carbs have chemical structures with at least three sugars (polysaccharides) and include starches and dietary fibers.  The complex structure means these carbs take longer to digest causing a more gradual increase in blood sugars.

Carbs and Diabetes

Carbs can be challenging for a person managing diabetes. People with diabetes have a condition where their blood sugar exceeds normal levels because the body is not producing enough insulin or isn’t using insulin effectively.

High blood sugar levels over time worsens blood circulation and damages blood vessels, leading to serious health issues. Diabetes medication used to treat this condition is often meant to provide better blood sugar control such as insulin and metformin.

This is why it’s important for people with diabetes to choose their carbs wisely. Foods with high carb content, especially added sugar and refined carbs, makes it harder to keep blood glucose levels within the normal range.

And continuing to have high blood sugar levels can worsen diabetes-related conditions such as insulin resistance, obesity and hypertension.

What are good carbs for a diabetic to eat?

If you decide to eat carbs, choose complex carbs over simple carbs to minimize any increases to your blood sugar level.

The carbs you eat should also come from whole foods as possible. Many snack foods and processed foods have refined carbohydrates that cause blood sugar levels to spike. And while mealtime insulin and other medications help control blood sugar levels, simply avoiding refined carbs is just as effective.

Below is a simple guide on choosing carbs for your meal plan.

Non-starchy Vegetables

Green, leafy or cruciferous vegetables are very low in carbs and good source of fiber. These vegetables are also packed with key nutrients and vitamins. For instance cruciferous vegetables contain glucosinolates, which studies have shown to have anticancer effects.

Broccoli, cauliflower, brussels, kale, mustard greens, and turnips are cruciferous vegetables you find in many groceries. Other non-starchy vegetable options are eggplant, leafy greens, asparagus, cabbage, and beets.

Starchy Vegetables

Starchy veggies that are lower in carbs include squashes, yams, carrots, parsnips, and peas. These are better options than other starchy veggies like potatoes and corn, which have much higher carb contents.  Butternut squash has only 10 grams of carbs per serving (100g) compared to potatoes which have 20 grams of carbs per serving.

Legumes & Beans

Legumes and beans can be high in carbs so choose wisely. Stick to lower carbs types and not highly processed (e.g. “healthy” snack chips made from bean-derived flours).

brown and yellow beans

Common legumes and beans that are under 30 grams of carbs per serving are green beans, peas, lima beans, lentils, lima beans, black eyed peas, black beans, pinto beans and chickpeas.

What carbs should diabetics avoid?

Grains & Fruit

Because many grains and fruit have high glycemic load, these should make up a small amount of your meal plan. And if you have to eat them choose whole and minimally processed grains and lower carb fruit.

Real whole grains (i.e. has all three parts of the kernel) have more nutrients and slightly lower glycemic load than processed grains. Real whole grains include whole oats, wild or brown rice, and wheat berries. Quinoa is also an option but it’s actually a seed.

Fruit with low sugar include berries, avocados, grapefruit, some apples, and kiwi.

Refined Sugars

Added sugars, sweeteners and syrups should be avoided as much as possible. These refined sugars are sure to raise blood sugar levels, making it unnecessarily harder to manage diabetes. Added sugars are found in a lot of packaged foods so pay attention to their food label.

How many carbs should a diabetic have a day?

The USDA Dietary Guidelines (found here) recommends that carbohydrates make up 45% – 65% of daily calories for adults. However these recommendations are most likely too high for people with diabetes.  These Guidelines apply to the general public – not specifically for people managing diabetes and have high blood sugar levels.

There is no ideal carb intake amount for people with diabetes because individual situations will vary. But studies continue to show that eating fewer carbs reduces hemoglobin A1C.

For instance, this 2018 review of carb restricted eating patterns found that greater carb restriction let to greater reductions in A1C, particularly within 6 months.  And this study comparing a low carb diet to a low fat diet found that low carb eating saw more improvement to A1C.

While there is no single definition for low carb diets, the studies above defined low carb as making up 26% – 45% of daily calories and very low carb makes up less than 26% daily calories.

Below is a reference table converting calories (%) into to grams of carbs.

This table gives you an idea how many carbohydrates in a day you should be eating. You’ll also need to know the total daily calories your body needs, which you can estimate using online calculators.

How do I lower my carbs?

Now that you know a low carb diet is better for diabetes disease control, there’s a few ways to start limiting carbs in your meal plan.

Carb Counting

A common and accurate way to lower daily carb intake is by carb counting.  Carb counting involves tracking the amount of carbs in each meal and making sure the total carbs consumed in a day is within your daily target.

sample nutrition label
Image source: usda.gov

But you’ll need to know how many carbs are in the foods you eat. This can be found in the nutrition food label on packaged foods (pictured right).

Or if you’re eating whole foods (which you should), you can search online food nutrition databases such as USDA’s database or MyFoodDiary.com.

When you count carbs, it does take time and effort at first. But don’t worry, it gets easier since you’ll remember the total carbohydrate of many foods you regularly eat.

Modified Plate Method

A simpler (but less accurate) way to reduce carbs is usng a modified version of the diabetes plate method. The American Diabetes Association plate method starts with a 9” plate and is filled with 50% nonstarchy vegetables, 25% proteins and 25% carbs (which includes grains, legumes and fruit).

Our modified plate method (see below) avoids grains and fruit in the carb portion since since the goal is to lower carb intake. Instead, replace with starchy vegetables, legumes or beans.

We also suggest reducing the amount of carbs (%) while increasing other portions.  A good starting point could be a plate with 50% nonstarchy veggies, 35% proteins, and 15% carbs.

We also suggest animal-based protein (over plant-based) in our plate method. Animal based proteins are more energy dense and contain a lot of essential amino acids. Lean protein is always a safe option but you can also eat proteins with moderate fat, as long as you watch the calories (higher fat = more calories).

Monitor Your Blood Sugar

Regularly monitor blood glucose when you lower carb intake. As blood sugar levels fall your medication may need to be changed and should be discussed with your care provider. For instance, mealtime insulin dose may need to be lowered to prevent blood sugar levels from falling too low.

If you experience very low blood sugar (glucometer reading below 70 mg/dL), quickly eat at least 15g of fast-absorbing carbohydrates. Recheck blood glucose after 15 minutes to see if it’s above 70 mg/dL. Repeat this until readings are above 70 mg/dL and then eat a meal or complex carb to keep blood sugar from dipping.

Don’t Forget About Your Energy

Count carbs but don’t forget about counting calories too. Lowering your calories from carbohydrates can make you feel less energetic.

Make sure you get enough calories (energy) from protein and fat, especially if you’re staying active. Remember, carbs and protein have 4 calories per gram while fat has 9 calories per gram.

Summary

Carbs are an important energy source but can be problematic for people with diabetes. because it raises blood sugar, especially added sugar found in a lot of food today.

Managing diabetes doesn’t stop you from eating carbs but you do have to choose wisely. We talked about how choosing complex carbs and lowering carb intake can greatly improve blood sugar levels. And we showed ways to reduce daily carb intake by carb counting or using a modified version of the plate method.

Keep your meal plan simple! No need to worry if your meals fit into labels like “low carb diets” or the “ketogenic diet.” Just focus on eating fewer calories from carbohydrates and whole, minimally processed foods.

Lastly, staying active and exercise is important for long-term diabetes management. A healthy diet combined with active living will promote weight loss and improve other diabetes-related conditions.