Diet and Exercise

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Diet and Exercise

Diabetes Type 2
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Diet and Exercise
Diet and Exercise
Type 2 diabetes frequently can be prevented and always can be improved through healthy diet and exercise habits.
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Reviewed by the Faculty of Harvard Medical School

Diet and Exercise

Type 2 diabetes often can be prevented. It always can be improved through healthy diet and exercise habits. Both diet and exercise can reduce blood sugar and insulin resistance. They also can improve other health risks that are common in people with diabetes. These include high blood pressure and cholesterol problems.

You can get these benefits from reducing calories and increasing exercise even if you don't lose weight. Losing pounds is often a slow process for diabetics. You may prefer to measure your progress by watching your blood sugar results.

A National Institutes of Health study showed how effective lifestyle changes are at preventing diabetes. You can read the findings of the study, the Diabetes Prevention Program.

Diet Advice for Diabetics
Almost all people with type 2 diabetes can benefit from a reduced-calorie diet. The following components can help to build an effective weight-control plan:
    • Pay attention to the type and amount of carbohydrates you eat.


      • Choose the best carbohydrates. Some carbohydrates are rapidly digested. These include sugar, white bread, white rice and most pasta. Whole grain foods are digested more slowly. If your meal is loaded with rapidly digested "carbs," it creates a high peak of blood sugar shortly after your meal. This prevents good blood sugar control. Reduce your intake of refined flours and sugars. Recent research links added sugar in the diet to insulin resistance, pre-diabetes, and diabetes. Reduce added sugars in the foods you eat, particularly if you often have sweetened drinks. 
      • Limit "low-carb" diets to less than a year. Carbohydrates are important for nutrition. They provide you with vitamins, fiber and quick body fuel. Doctors do not recommend that people with diabetes change permanently to a "low-carb" diet. However, a low-carb diet is one acceptable way for you to lose weight if it is limited to a year or less. You should eat at least 130 grams of carbohydrate per day if you are not following a planned low-carb diet. During a planned low-carb diet, your doctor should do blood tests from time to time to make sure you are not having changes in your cholesterol or kidney function. These changes could occur as a result of the extra fat and protein that you may eat while you are cutting down on carbs.


    • If possible, visit a registered dietician. He or she can look at your eating patterns and suggest adjustments that fit your culture and lifestyle. Your dietician also can explain ways to keep track of the carbs you eat. For example, you may want to use food-item exchange lists or "carb counting." These tools can help minimize day-to-day variation in your glucose control. If you inject insulin before meals, you also may be able to plan extra insulin for a meal with extra carbohydrates.


    • The best total calorie count is unique for each person. Many people with diabetes should try to reduce the number of calories they eat by 250 to 500 per day. This can be helpful for people who are overweight or need medicine to control diabetes. Being overweight means having a body mass index of 25 or more. For most diabetics, the recommended daily total will fall between 1,600 and 2,800 calories. Consult a doctor before lowering your calorie intake if you are pregnant.


    • Follow a nutritionally balanced diet. If you eat the right carbohydrates and fats, both your weight and cholesterol can benefit. Try to divide your calories up in this way:
      • 45% to 65% carbohydrates — At least half of your carbohydrates should come from whole grains, fruits, vegetables and low-fat milk.
      • Abundant fresh fruits and vegetables — Juices are less healthy. That's because they do not contain fiber but they do contain natural or added sugars. Aim for two to four servings of fruit and three to five servings of vegetables per day.
      • 15% to 20% protein
      • 25% to 40% fats — Make monounsaturated fats the main fat type in your diet. Monounsaturated fats are the type of fat in olive oil or canola oil. They help raise your "good" cholesterol (HDL) to healthy levels. Remember that different types of fat can have different effects on your health. Learn to replace "bad" fats with "good" fats.
      • No more than 10% polyunsaturated fats
      • Less than 7% total of the worst two fat types: saturated fats and trans fats. Saturated fats are found in meats and dairy products. Trans fats are found in hydrogenated and partially hydrogenated oils. They are used in many processed, packaged and fried foods.


  • Limit cholesterol to no more than 300 milligrams daily. Your limit should be 200 milligrams if you also have a cholesterol problem.


  • Be sure to count the calories from alcohol you drink. If you take medicine to lower your blood sugar, alcohol can lead to hypoglycemia (low blood sugar) when you drink it without food.


  • Eat meals that are similar in size. Space them evenly apart. This is especially important if you use insulin, unless you have adjusted your insulin plan to accommodate your eating habits.


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Exercise Advice for Diabetics
The U.S. Surgeon General's office recommends at least 30 minutes of moderate physical activity on most days of the week. This should total at least 150 minutes of exercise per week.
For a person with type 2 diabetes, this amount of exercise typically lowers blood-sugar levels by about 10% to 20%.
Always drink plenty of fluids before and after exercise. Before you start a new exercise plan, consider the following:

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Exercise Cautions for Diabetics

If you have had type 2 diabetes for more than 10 years …
If you are over age 35 …
If you have high cholesterol or high blood pressure …
Or if you have complications from diabetes …
Your doctor may first recommend a treadmill test to check your heart, to be certain aerobic exercise is safe for you.
If you have eye damage (retinopathy) from diabetes …
Avoid high-impact sports or exercise that involves straining or jarring. Examples include weight lifting, racquet sports and jogging. Better choices are walking, swimming or stationary cycling.
If you have decreased sensation in your feet …
Avoid exercises with repetitive weight-bearing motion. This includes treadmill, jogging and step exercises. It's better to use exercises that don't put weight on your feet. Examples include swimming, cycling and chair exercises. Wear proper footwear. Check your feet frequently for blisters.
If you inject insulin …
You may absorb your insulin faster during exercise. Speak with your doctor about when and where on your body you should do your injections.

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Last updated October 28, 2013

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