Pregnant women advised to dim lights before bed to reduce diabetes risk

From theguardian.com

Those exposed to more light in hours before sleep appear more likely to develop gestational diabetes, researchers suggest 

While reading until the small hours or scrolling under the covers are common bedtime habits, pregnant women might want to switch off sooner to reduce their risk of developing gestational diabetes, researchers have suggested.

According to the Royal College of Obstetricians and Gynaecologists, gestational diabetes affects at least four to five in 100 women during pregnancy. If it is not well controlled it can lead to complications, including health problems for the baby. 

Now research published in the American Journal of Obstetrics and Gynecology Maternal Fetal Medicine has revealed pregnant women who are exposed to greater levels of light in the three hours before sleep appear to be more likely to develop diabetes during their pregnancy.

“Light at night may be an unrecognised risk for acquiring a serious pregnancy complication,” said Dr Minjee Kim, the lead author of the study at Northwestern University.

Among other studies, researchers have previously found people who work shifts are at greater risk of type 2 diabetes, while greater exposure to outdoor artificial light at night has also been linked to an increased risk of the condition.

Pregnant women were advised to try to put their phones away in the hours before bed. Photograph: VikaValter/Getty Images

It is thought exposure to light at night suppresses levels of a hormone called melatonin, disrupts the body’s internal clock, and impacts various metabolic processes, such as regulation of blood sugar levels.

“While we can’t prove it from this observational study, similar mechanisms may play a role in pregnant women,” said Kim.

Between 2011 and 2013, Kim and colleagues asked 741 pregnant women in the US who were in their second trimester to wear light sensors on their wrists and complete a daily sleep diary for around a week.

The researchers split the participants into three even-sized groups based on their median exposure to dim light in the three hours before sleep. The results reveal 16 of the 247 women who only spent about 1.7 hours in dim light developed gestational diabetes, compared with 12 of those who spent about 2.2 hours in dim light, and three of those who spent about 2.6 hours in dim light.

While only a small number of women developed gestational diabetes, the results revealed a trend.

“Women who spent the least time in dim light had fivefold greater odds of developing gestational diabetes compared to those who spent the most time in dim light,” said Kim.

The researchers say an association was present even when they took into account factors such as age, sleep quality and duration, body mass index and how much light participants were exposed to during the day.

However the study does have limitations, including that the light measurements were made only over one week.

The good news, Kim said, was that it was relatively easy to take action. “Starting three hours before bedtime, try to dim the lights whenever possible,” Kim said, adding that also applied to light-emitting devices such as phones. “Try to put them away if possible, but if not, at least try to dim the screen or put them on the night mode.”

Dr Faye Riley, a research communications manager at Diabetes UK, said: “The study hints at a link between artificial light exposure before sleep and increased risk of gestational diabetes but we’ve a lot more to learn before we can say with any confidence that limiting artificial light exposure could be helpful in the prevention of the condition.

“What we do know is that managing your weight, eating healthily and keeping active before pregnancy can help to reduce your risk of gestational diabetes.”

https://www.theguardian.com/lifeandstyle/2023/mar/10/pregnant-women-advised-to-dim-lights-before-bed-to-reduce-diabetes-risk

Is it possible to reverse type 2 diabetes?

From nebraskamed.com

The short answer is yes; it's possible for Type 2 diabetes to go into remission. To be in remission, your blood sugar levels must remain normal for at least three months without using glucose-lowering medications.  

"Type 2 diabetes is a chronic disease, so we don't say it's 'reversed' or 'cured.' Instead, we say it's in remission," explains endocrinologist Sydney Blount, MD. "Once your diabetes is in remission, you should see your doctor regularly to check for recurrence.

Early diagnosis and intervention are critical in managing Type 2 diabetes. Remission of Type 2 diabetes is more likely if you've been recently diagnosed with Type 2 diabetes, have lower blood sugar levels and have achieved weight loss.

How do I know if I have diabetes?

A person with diabetes has abnormally high blood glucose levels. Your doctor can determine if you have diabetes by doing a blood test to measure the glucose level in your blood. 

"Type 2 diabetes has a strong link to family history," says Dr. Blount. "But environmental factors, like lifestyle, also play a large role."

See your doctor right away if you have any of the following diabetes symptoms:

• Excessive thirst
• Excessive urination
• Excessive hunger
• Fatigue
• Blurring vision
• Numbness in the feet
• Unexplained weight loss

How is diabetes treated?

Diabetes medications aren't prescribed until you've been diagnosed with diabetes. Many classes of drugs work differently to achieve normal glucose levels. Some of these function by increasing your body's sensitivity to insulin.

"Not everyone with Type 2 diabetes needs treatment with insulin," says Dr. Blount. "Many glucose-lowering medications can be used before insulin, depending on the individual." 

While medications can be helpful, lifestyle changes can induce remission of diabetes and normalization of blood glucose levels without medications. Weight loss improves insulin resistance and glucose metabolism, lowering blood glucose levels into the normal range.

"We don't yet know how much weight a person needs to lose to induce remission," explains Dr. Blount. "It's different for every individual and depends on factors like the duration and severity of diabetes. That's why it's important to discuss weight loss with your doctor."

6 Lifestyle changes to put diabetes into remission

1. Exercise regularly. Work toward exercising 30 minutes a day, five days a week. Include a combination of light cardio and strength training.
2. Lose weight using medications, dietary changes, or bariatric (weight loss) surgery as prescribed by your doctor. 
3. Eat healthily. There's no one-size-fits-all diabetes diet. Start by reducing processed foods and foods high in sugar and carbohydrates. You can also try the Diabetes Plate Method. Or, meet with a  nutritionist or dietitian to develop an individual dietary plan.
4. Get enough sleep. Aim for at least seven to eight hours of sleep each night.
5. Quit smoking. Talk to your doctor if you need help breaking this habit.
6. Manage sleep apnoea. If you suspect you have sleep apnoea, get evaluated by your doctor and get treated.

What's the difference between insulin resistance, prediabetes and diabetes?

Insulin resistance occurs when your body doesn't respond well to insulin. It takes more insulin to lower glucose levels into the normal range. Over time, if the pancreas can't produce enough insulin to overcome the resistance, prediabetes or diabetes can develop.

Prediabetes is when you have higher than normal blood glucose levels but not high enough to be diagnosed with diabetes. Prediabetes typically has no symptoms, so it's vital to be screened with blood tests.

"Medications, like metformin, can prevent prediabetes from progressing into diabetes. However, these drugs aren't as effective as making lifestyle changes," says Dr. Blount. "You can prevent and reverse insulin resistance and prediabetes by adopting healthy lifestyle habits. The key is to start making changes early on." 

https://www.nebraskamed.com/diabetes/is-it-possible-to-reverse-diabetes 

A Guide To The Best Snacks For People With Diabetes

From forbes.com

Diabetes is a widespread condition, affecting an estimated 11.3% of Americans, according to the Centres for Disease Control and Prevention (CDC). Making modifications to your diet and choosing nutritious, diabetes-friendly snacks can help manage blood sugar levels, support overall health and prevent long-term problems associated with the disease.

Read on for more details on how what you put on your plate affects blood sugar levels, along with some healthy, expert-recommended snack selections for diabetes.

How Nutrition Affects Diabetes

A healthy and balanced diet is key to balancing blood sugar levels and managing diabetes. This is important to prevent complications related to diabetes, such as heart problems and vision loss.

Carbohydrates, which are found in foods like fruits, vegetables, grains and sweets, are especially important for diabetes management. “Carbohydrates specifically are broken down into sugars during the digestion process, so higher amounts of carbohydrates generally lead to higher blood sugar levels,” explains Jennifer Price, a registered dietitian based in Athens, Georgia.

Additionally, complex carbs (such as starchy vegetables, fruits and legumes) are digested and absorbed slower than simple carbs found in sweets and other processed foods (which can cause larger fluctuations in blood sugar levels). Price also notes that some carbohydrates may be higher in fibre, which can slow digestion and reduce their effect on blood sugar levels. Therefore, fibre-rich foods like fruits that contain natural sugars may have less of an impact on blood sugar than fruit juice, which is low in fibre.

The foods that carbohydrates are combined with can also impact blood sugar levels, she adds. “One of the easiest ways to reduce the impact of a high carbohydrate food on blood sugar is to pair it with a protein food like meat, poultry or fish and/or a fat, such as nuts, seeds, avocado or cheese,” says Price, explaining that both protein and fat can slow digestion and absorption to help release sugar into the bloodstream more gradually.

In addition to stabilizing blood sugar levels, making changes to your diet may offer other benefits. “A diet high in fibre, good fats and lean protein can improve general health by regulating blood sugar levels, encouraging feelings of fullness and lowering cholesterol,” says Pallini Winnifred, a registered dietitian in Floral Park, New York. For this reason, making smarter snack selections could even help prevent many long-term health complications of diabetes, such as heart disease. 

The Best Snacks for People With Diabetes

The following snacks are recommended by nutrition experts to support blood sugar control for people with diabetes.

Nuts or Nut Butter With Fruit

Nuts like almonds, cashews, peanuts or macadamias are a great option for people with diabetes, as they are rich in both protein and fat and don’t have a significant impact on blood sugar levels, according to Robert Iafelice, a registered dietitian based in Mentor, Ohio.

Iafelice also recommends pairing sugar-free nut butters with fresh fruit. “Though fruits have sugar, the sugar (fructose) is absorbed more slowly than carbs from grains,” says Iafelice. “Plus, the nut butter further slows the effect on blood sugar.”

Some research also suggests that nuts could also contain compounds with diabetes-fighting properties. For example, one 2017 review reported that the heart-healthy fats found in nuts could support blood sugar control and reduce appetite, while the fibre and polyphenols they contain may protect against diabetes by altering the beneficial bacteria in the gut. 

Greek Yogurt With Berries

Low-fat or non-fat Greek yogurt is another nutritious, low-carb snack option that can help maintain healthy blood sugar control. Greek yogurt is high in protein to help stabilize blood sugar levels, explains Iafelice, who recommends mixing in berries or stevia to help naturally sweeten it.

Interestingly, research links consuming 80 to 125 grams of yogurt per day to a 14% lower risk of developing type 2 diabetes. Furthermore, some types of yogurt also contain beneficial probiotics, which can help regulate the metabolism of sugar.

Whole Grain Oatmeal

Each serving of whole grain oatmeal contains a hearty dose of resistant starch. As its name implies, this type of starch resists digestion and helps feed the beneficial bacteria in the gut, according to Justine Chan, a Toronto-based registered dietitian and certified diabetes educator at YourDiabetesDietitian.com. “What’s more, these types of foods also contain soluble fibre, which can help to manage hunger [and] lower cholesterol as well as blood sugars,” she says,

Several studies confirm the beneficial effects of oatmeal. For instance, a 30-day study in 298 people with type 2 diabetes found that adding 50 or 100 grams of oats to a low-fat, high-fibre diet led to significant improvements in post-meal blood sugar levels, insulin resistance, cholesterol levels and haemoglobin A1C, a marker of long-term blood sugar control.

To make your own flavourful oatmeal at home, try topping rolled oats with fresh fruit, chia or flax seeds and nut butter. You can also add a scoop of your favourite protein powder to bump up the protein content.

Veggies With Hummus

“Most of us don’t eat enough vegetables,” says Chan. “Incorporating them at snacks can help to fill the gap.” Chan adds that vegetables are a great source of antioxidants, which can protect cells against damage and prevent certain diabetes-related complications.

Combining fresh vegetables like cucumbers, cherry tomatoes, carrots or bell peppers with hummus can be a simple way to squeeze more valuable nutrients into your diet. According to the American Diabetes Association, plant-based proteins like hummus are also particularly rich in high-quality protein, healthy fats and fibre.

Edamame

Edamame is a type of immature soybean that is often boiled or steamed and enjoyed as an appetizer or snack. In addition to being versatile and full of flavour, edamame may also be a nutritious option for people with diabetes. “Edamame is a great all-in-one diabetes snack choice, containing carbohydrates, fibre, protein and fats packaged into one nutrient powerhouse,” says Price.

Plus, some research shows that the soy protein found in edamame could be beneficial for type 2 diabetes. In fact, one meta-analysis of 11 studies concluded that soy protein could reduce fasting blood sugar and insulin levels, decrease cholesterol levels and improve markers of insulin resistance.

Though there are plenty of pre-packaged edamame snacks available at most grocery stores, you can also easily make your own at home. Try tossing unshelled, heated edamame with your favourite toppings, such as sea salt, minced garlic, lime juice or grated Parmesan.

What to Look for in a Snack If You Have Diabetes

There are a variety of delicious and nutritious snack options that can easily fit into a healthy diet for diabetes. Chan recommends looking for snacks that contain:

• Less than 15 grams of carbohydrates per serving
• At least 10 grams of protein per serving
• At least 4 grams of fibre per serving

“Having an adequate amount of protein and fibre at snacks can help to ensure you are satisfied and prevent blood sugar spikes,” explains Chan.

Iafelice also advises against eating high-carb foods alone, including chips, crackers or breads. Instead, you should pair these foods with a good source of protein or fat, such as cheese or nut butter, he says.

It’s also best to opt for whole foods-based snacks over packaged products whenever possible, adds Price, as they tend to be higher in important nutrients, including fibre, vitamins and minerals. This includes foods that are minimally processed and made using nutrient-dense ingredients, such as fruits, vegetables and whole grains.

https://www.forbes.com/health/body/best-snacks-for-diabetes/

Time to Eat? Why Timing Matters for People With Diabetes

From diatribe.org

Do people with diabetes need to eat at regular intervals? Is late night snacking ok? What about intermittent fasting? Learn more about why timing matters when eating if you have diabetes.

There is no easy answer to the question: “How many times should I eat in a day?”

Advice on when it’s best to eat can be confusing for a person without diabetes (should you eat three square meals a day, or six small meals per day? What about only eating when you’re hungry?). Add in the element of diabetes, and what is considered healthy guidance for many could become dangerous advice to people with diabetes. 

How an individual with diabetes should time their meals will vary and depend on their body’s needs, their blood glucose patterns, the type of medication they’re taking, and other factors. 

“It has to be an individualised approach,” said Dr. Henry Anhalt, paediatric endocrinologist and chief medical officer at Embecta, a diabetes supply company. 

“Depending on the person’s age, their stage in life, their occupation, their living situation, their work hours, their medication, and so on,” Anhalt said. “All of those will impact how a person should best optimize their nutrition [and timing].”

Even if someone doses insulin in the same place at the same time each day, Anhalt points out that there can be a 20-30% variation in insulin absorption. Considerations like these, and the fact that our lives and our bodies are far from robotic, mean there is no real one-size-fits-all answer to the question about meal timing. 

Here’s what to consider, as you attempt to answer the question for yourself with the hands-on involvement of your care team.

Do People With Diabetes Need to Eat at Regular Intervals?

If your circumstances enable you to eat regularly and you have consistent access to food, then Mariana Dineen, a registered dietitian based in Chicago and the founder of Elemento Health, recommends following regular eating patterns. In her treatment of patients with diabetes, she’s found that many different types of diabetes medications require certain meal requirements. 

“Skipping meals and lack of meal structure can throw off the balance between food intake and medication and this can result in poorly controlled blood glucose,” she said. “Eating at regular intervals also ensures that carbohydrates are spaced evenly throughout the day, which translates to better blood glucose control.”

Skipping a Meal: A Disaster For People With Diabetes?

Dineen’s recommendation aside, those living with diabetes know that real life does throw curveballs, like major traffic jams, long work shifts without access to food, and other complications, so eating at regular intervals every day might not always be possible. And that’s okay.

“I don't like to add stress by suggesting that people with diabetes must eat at regular intervals. Life is busy and sometimes unpredictable, and so it is not always possible to eat at the same times,” Dr. Sarah Musleh, Dallas-based endocrinologist and cofounder at Anzara Health, said. “In theory, if your basal insulin dose is right for you and if your blood sugars are within a safe range, you should be able to skip or delay a meal and be safe.”

Late-Night Snacking: Is It OK If You Have Diabetes?

The topic of night-time eating can be complicated, and like other eating questions, depends on a multitude of factors. 

Anhalt said that it’s not so much a concern of what will happen overnight, but rather the lack of information people have about night-time blood sugars. After all, it’s not likely you are waking up hourly to ensure your blood sugars are in check. For many, night-time accounts for 30% of the time in range, Anhalt adds, and can be tracked by wearing a continuous glucose monitor (CGM) sensor, which he calls “critical” to obtaining essential data on what your blood sugars are doing at night, with or without a snack.

In a 2022 review of 16 studies, researchers concluded that there was no consistent relationship between having a bedtime snack and improving blood sugar control.

If you do plan to eat before bed, Musleh recommends avoiding high-carbohydrate snacks at that time. “Going to bed with good blood sugar levels and being able to maintain that overnight sets you up for a better morning and next day,” she said.

One might ask why it really matters if you are going to be asleep, but Musleh adds that high overnight blood sugars can cause poor sleep, and waking up with high blood sugars is a less-than-ideal way to start the day. 

The Bottom Line

Overall, experts pointed to the importance of being able to eat on a schedule that works best for you and is most convenient for your life, provided you’ve worked with your healthcare provider to help you achieve desirable results. If you can eat regularly and predictably, it might be easier to control your blood sugar in some circumstances. If you can’t, then communicate with your provider about how to adapt your eating timing for the best outcomes.

Time-restricted eating and Intermittent fasting: The do’s and don’ts for people with diabetes

The polar opposite of eating at regular intervals is intermittent fasting or time-restricted eating. If you have prediabetes or are hoping to manage diabetes through weight loss, this might be something you’ve considered. 

“Intermittent fasting (IF), although not new, has recently gained attention and popularity as a means to facilitate weight loss and improve metabolic health,” Dineen said. 

There are two basic versions for a “time-restricted” eating schedule:

• The most common is 16/8, meaning eating in an 8-hour window, and not for the 16 hours following that.

• Also common is the 5/2 schedule, meaning eating normally 5 days per week, and restricting caloric intake to 500-600 calories on the remaining 2 days.

Dineen noted that research has proven IF to have similar outcomes in weight loss as daily calorie restriction. In addition, she said, “Studies on the safety and benefits of IF with diabetes are limited, but a few have shown that IF could be a good tool and non-medical treatment of diabetes.” 

For example, a 2019 review concluded that IF was helpful in weight loss for both Type 1 and Type 2 diabetes, but also warned of potential immediate risks of hypoglycaemia, which should always take precedence over potential long-term health benefits.

“Intermittent fasting per se isn’t a challenge, provided that the mechanism of action of the drugs that you’re taking permits you to be for hours without food,”  Anhalt said. “I don’t see how intermittent fasting is any worse than any other diet, or any better than any other diet.

Anhalt added that if someone doesn’t have an insulin pump or hasn't adjusted their insulin for intermittent fasting, then they’re putting themselves at risk of high or low blood sugars. Otherwise, he doesn’t see any issues with intermittent fasting or time-restricted eating. “Less food, less insulin, less glucose, less fat, less medication required,” he said. 

All of our experts agreed that changes in the timing of your food intake must be something you discuss with your diabetes care team before trying to make those changes.

“Special attention should be paid to medication adjustment, frequency of glucose monitoring and fluid intake,” Dineen said, adding it’s not safe if you are pregnant or lactating, or for young children and the elderly, especially if they have diabetes.

Overall, the experts pointed to the potential to be able to eat on a schedule that works best for you and is most convenient for your life, provided that you’ve talked with your health care provider.

https://diatribe.org/time-eat-why-timing-matters-people-diabetes 

Diabetes, obesity rising among young adults in US: study

From thehill.com

Diabetes and obesity rates are increasing in people ages 20 to 44 in the U.S., according to a study published in the Journal of the American Medical Association.

Over about a ten-year period from 2009 to 2020, diabetes prevalence among those aged 20 to 44 increased from 3 percent to just over 4 percent. Obesity rates increased from about 33 percent to about 41 percent.

Prevalence rates of hypertension, or high blood pressure, also increased from 9 percent to nearly 12 percent, although the authors note that this was not a statistically significant change.

The researchers found differences among racial and ethnic groups. Black adults had the highest rates of hypertension throughout both survey periods at about 20 percent of respondents. In comparison, the prevalence of hypertension among white adults was at about 10 percent.

There was an increase over the study period of hypertension among Mexican American and Hispanic adults, and a significant rise in diabetes in Mexican American adults.

There was no change in prevalence of smoking history and a decrease in prevalence of hyperlipidemia, a condition where there are too many fats like cholesterol present in the blood.

The researchers examined data from the National Health and Nutrition Examination Survey over several two-year survey periods from 2009 through March 2020. Nearly 13,000 people participated in the surveys, although the authors note that these patterns may have changed since the COVID-19 pandemic began.

“The national increases in diabetes and obesity among young adults in the US have major public health implications,” write the authors. “These results highlight the need for public health and clinical interventions, especially as these risk factors can affect lifetime rates of heart attack, stroke and heart failure.”

https://thehill.com/policy/healthcare/3886017-diabetes-obesity-rising-among-young-adults-in-us-study/ 

5 Supplements You Shouldn't Be Taking If You Have Diabetes, According to a Dietitian

From eatingwell.com

In addition to diet and exercise, can supplements help with diabetes? Learn more about 5 supplements you might want to reconsider taking if you have diabetes 

When it comes to managing diabetes, lifestyle plays a major role in blood sugar management and overall health. What you eat, how you move your body, your sleeping patterns and stress levels are all factors that can impact your blood sugars. Even if you are taking medications to manage your diabetes, they are to be used in conjunction with a nutritious eating plan and physical activity. But, what about supplements? Are they safe and effective?

Supplements are meant to fill nutrient gaps when you are unable to meet your needs through food alone or if you have a deficiency. Because supplements are not regulated by the Food and Drug Administration, it's important to take them cautiously. Always look for third-party certification to assure what they say is in it actually is and never begin supplementation without supervision from a registered dietitian or medical doctor. Supplements can be costly and if not taken carefully may do harm, especially if you are taking certain medications or have other health conditions.

The 5 Supplements You Shouldn't Be Taking If You Have Diabetes

There are different types of diabetes and different treatment options for each type, so it's difficult to generalize which supplements all people with diabetes should not take. That's one of the reasons it is so important to talk to a health professional. All that said, here are five supplements you may want to reconsider if you have diabetes, as they may interfere with certain medications, disrupt blood sugar levels or cause unwanted side effects.

1. Chromium

Chromium is a mineral that is found in a number of foods, such as meat, vegetables, grains, fruits and nuts. A deficiency in chromium may cause high blood sugar; however, deficiency is very rare. If you have diabetes and take insulin or other oral medications aimed to reduce blood sugar, taking chromium may increase the risk of hypoglycaemia (low blood sugar).

The American Diabetes Association cautions anyone with kidney disease against taking chromium because supplementation can worsen kidney disease. Chromium supplementation may also interfere with levothyroxine (a medication commonly used to treat hypothyroidism).

2. Bitter Melon

Bitter melon is an herbal supplement that has been studied for its use in reducing blood sugars in people with diabetes. Its components—charantin, vicine and polypeptide-p—are thought to have a similar structure to insulin (the hormone involved in blood sugar control).

In a systematic review and meta-analysis in Nature, researchers found that the data on bitter melon supplementation continues to remain inconsistent. Studies that have been done are short, and the doses of bitter melon used vary. More research is needed to determine long-term effects and safety. In addition, if you are prone to low blood sugar, bitter melon may increase your risk of low blood sugar and may not be appropriate for you.

3. Green Tea Extract

Drinking green tea has been shown to provide benefits for people with diabetes. For example, in a meta-analysis of 17 clinical trials published in The American Journal of Clinical Nutrition, researchers found that drinking green tea had favourable effects, such as decreased fasting glucose and haemoglobin A1C (three-month average of blood sugar). However, there is little research on the effectiveness of a green tea supplement outside of studies conducted on animals, and most studies have been very short in duration. Therefore, additional supplementation beyond drinking green tea is probably not necessary.

4. St John's Wort

More research is needed on the use of St. John's wort and diabetes, due its potential effects on diabetes medications, insulin sensitivity and insulin secretion. One small study in the British Journal of Clinical Pharmacology, which evaluated the use of St. John's wort and metformin in 20 healthy male subjects, found that taking it in conjunction with metformin can increase insulin secretion and lower blood sugar after a glucose tolerance test. However, another very small study, including 10 healthy male subjects, found that there were no changes in insulin sensitivity when taking St. John's wort alone. Instead, researchers noted less insulin secretion, which can increase blood sugar levels.

These very small studies had conflicting results and did not include diverse populations or people with diabetes or have a long enough duration to examine the long-term effects. Therefore, more studies are needed to explore the drug-herb interactions, as well as insulin secretion effects of St. John's wort.

In addition, if you have diabetes and heart disease and are taking blood thinners, the ADA recommends avoiding St. John's wort, as it can increase bleeding.

5. Vitamin E

Vitamin E is a powerful antioxidant that can help combat oxidative stress, a precursor and contributor to type 2 diabetes. But, vitamin E can interact with blood thinners and increase the risk for bleeding by blocking the clotting effects of vitamin K. Therefore, unsupervised supplementation is not recommended if you have diabetes and are taking blood thinners.

Tips for Healthy Eating If You Have Diabetes

Before spending lots of money on supplements that may not work or can cause harm, focus on making simple yet sustainable dietary changes. Whole foods contain a variety of macronutrients, vitamins and minerals. Aim to increase your intake of plants—fruits, vegetables, whole grains, nuts and seeds—that are rich in fibre, vitamins, minerals, antioxidants and healthy fats.

Fibre is the indigestible part of carbohydrate that can help to reduce blood sugar spikes because it is metabolized slowly. One simple way to eat more fibre is to ingest one fruit or vegetable at each meal, make half of your grains whole grains, and add one serving of unsalted nuts each day. The 2020-2025 Dietary Guidelines for Americans recommends consuming 25 to 38 grams of fibre daily. If you are not accustomed to eating fibrous foods, increase your intake slowly and drink ample amounts of fluids to reduce the risk of stomach discomfort, such as gas.

When eating carbohydrates (grains, potatoes, beans, corn), pair them with non-starchy vegetables, lean protein and healthy fats. This food combination will not only provide satiating power, but also it will help you up your intake of vitamins, minerals, essential fats and protein. A simple yet effective strategy is to use the plate method. Fill half of your plate with non-starchy vegetables, one quarter with lean protein, and the other quarter with a complex carbohydrate. For example, roasted chicken with stir-fried broccoli and baked sweet potato is a balanced and filling meal.

Frequently Asked Questions

1. Are there over-the-counter treatments for diabetes?

It is very important not to replace medical treatment with over-the-counter products that claim to treat diabetes. Treatment of diabetes is ongoing and requires daily diabetes self-management. Lifestyle changes, such as eating a nutritious diet, weight loss (when indicated), physical activity, adequate sleep and reducing stress can help you manage your diabetes. Unfortunately, there is no supplement that will cure you.

2. What supplements may help with diabetes?

If you are deficient in a vitamin, you may benefit from supplementation. And if you have complications of diabetes, some supplements—including vitamin D, B vitamins, omega-3 fatty acids and probiotics—may help with symptoms or delay the progression of complications related to diabetes.

Vitamin D: Having low levels of vitamin D is associated with the development of diabetes, metabolic syndrome and insulin resistance. Low vitamin D levels are also associated with an increased risk of foot ulcers and other infections, feelings of depression and impaired bone health, to name a few. Some studies suggest that supplementing with vitamin D and calcium, in people who are deficient, may help to improve blood sugar control. It is important for all people with diabetes to assess their vitamin D status with their health care provider to determine if supplementation is needed.

B vitamins and omega-3 fatty acids: People with diabetes, particularly those who take metformin, can be at increased risk of vitamin B12 deficiency. Metformin can reduce the absorption of B12 as well as blood concentrations. B12 deficiency and insufficiency is associated with neuropathy, so assessing B12 status is important. If levels are low, supplementation may be recommended. If you have complications of diabetes, such as neuropathy (nerve damage), you may want to discuss with your doctor the use of B vitamins or fish oil in treating pain and preventing the progression of disease. Animal studies have shown omega-3 fatty acid supplementation to be beneficial, but more research is needed.

Probiotics: There is growing evidence to support the use of probiotics for gut health, diabetes and blood sugar control. Some studies have shown that the use of probiotics like yogurt, fermented milk and capsules had a beneficial effect on blood sugar control. Keep in mind that different strains of probiotics have different functions, and your dietary patterns, along with the amount of colony units you take, can also have an impact. If you want to take a supplement, be sure to talk to a professional. A good place to start increasing your probiotic intake is by adding some fermented foods to your diet; try yogurt, kefir, kimchi, sauerkraut and miso.

The Bottom Line

While supplements can serve a purpose when you need to fill nutrient gaps or when you are deficient, they are not always safe, and oftentimes we don't know their long-term effects. Therefore, before you spend money on supplements, take a look at your lifestyle. A foods-first approach is a safer, more affordable and more realistic way to prevent and manage diabetes. Eating a variety of fruits, vegetables, whole grains, nuts, seeds and lean protein can help you to manage blood sugars and inflammation (another key factor in diabetes).

If you have diabetes, or take care of someone who does, and don't know where to start, meet with a registered dietitian or certified diabetes care and education specialist. Before taking any supplements, discuss it with your health care provider.

https://www.eatingwell.com/article/8030923/supplements-you-shouldnt-be-taking-if-you-have-diabetes/