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Best Nutrition for Pre-Diabetes and Diabetes


I want to introduce to you my new associate Jackie Peterson RD, CDCES. She is a Registered Dietitian like myself but has the added credential and expertise as a Certified Diabetes Care end Education Specialist. She has extensive training in working with people living with all different types of Diabetes who are on also using insulin pumps and Continuous Glucose Monitors. These people want to learn how to use their Diabetes technology to best improve their blood sugar management along with decreasing the burden of living with Diabetes. She works closely with clients who are often referred by endocrinologists to help the patient adjust to having an insulin pump and learning what is the best food plan customized to their lifestyle and food preferences.

Yes, it is true. Minor changes in your diet with lifestyle will bring your blood sugar levels down to normal range in a very short time. This is not an exaggerated claim since we see these real-world results every day in our practice. I am working with my clients post-COVID-19 who have not been to their doctor in at least a year. They are shocked to then find out that they have been diagnosed with Type 2 Diabetes.

Close to 25 million Americans over 65 years old have Type 2 Diabetes (fasting blood of 100-125 mg/dL) while another 90 million 20 years or older have been diagnosed with Pre-Diabetes (blood sugar greater than 126 mg/dL). You should be aware of the fact that studies have shown at this time Diabetes has become a major epidemic and is a co-morbidity of cancer, heart disease, and stroke. Your physician will confirm a Diabetes diagnosis by looking at several blood sugar tests along with the results of an A1C, which should not be greater than 6.5% since then that indicates Pre-Diabetes. This test tells what your average glucose level has been over the past 3 months. I am glad to report that I am able to typically get my clients’ A1C down from 8.6% to 6.5% in approximately 3 months where doctors often express amazement telling me they were about to put my clients on a second diabetes medication.

The first reaction to a Type 2 Diabetes diagnosis is shock, fear, and even depression where most people will start taking 500-1000 mg of Metformin twice a day immediately. Clients report that for a couple of months they have diarrhea, gas, stomach pain, and flu-like symptoms until their body adjusts. I am adamant with my people that they do not have to live with these side affects if they work very closely with me and follow the dietary regimen I recommend.

A major problem with Diabetes is that blood sugar levels spike throughout the day and results in an increased need for the natural hormone insulin that is produced by the pancreas, to allow the glucose into the cells to decrease blood sugar levels. People diagnosed with Type 1 Diabetes do not have sufficient amounts of insulin produced by the pancreas, which causes high blood sugar levels. On the other side, people diagnosed with Type 2 Diabetes still have the ability to produce the hormone insulin but the body becomes resistant to it, also leading to high blood sugars.

One popular recommendation I am sure we have all heard from the personal trainers is how extremely important to eat 5 small meals a day that will prevent the blood sugar from spikes. There is some validity behind this recommendation to improve metabolic factors but these 5 meals do not have to be huge meals! Favorite small meal times can be eaten every few hours. I not only recommend eating 5 times per day if you can but also suggest balancing the amount of proteins, carbohydrates and fats in each meal or snack. For the first 4 meals, I recommend a large amount of protein (the size of your palm), a carbohydrate source and some vegetables. The evening meal can include a smaller amount of protein (harder to digest at night) to be enjoyed with at least a cup or more of whole grains and 2 cups of vegetables. With a few exceptions, I find my clients actually begin to enjoy spacing out their meals during the day where they are happy not to feel over full from heavy meals. They enjoy the variety of smaller, tasty meals and larger snacks. Clients easily improve glucose levels and report higher levels of energy during the day! This is due to the fact that you’re their body is not going through those roller coaster blood sugar spikes and dips without you even knowing it.

Then there are my clients that cannot eat the 5 meals a day because of their work schedule and I have created a meal plan for them based on their job situation. Let me tell you about a physician that I am working with that can only have lunch and takes no breaks during the day. Thank goodness she has agreed to keep some turkey jerky and some nuts in her white coat pocket. Her lunch has become the largest meal of her day such as 6 oz. of protein with 1 cup of vegetables and ½ cup of quinoa. She is finding that this is helping her get through the day since before she was hungry all day only eating the fruit available in the kitchen. She would always come home late ravenous and was eating her large meal at night along with several servings of dessert. Her blood sugars were out of control and I am glad to report that we her A1C went down from 8 to 6 in a matter of 4 months. I must say she listened to all our advice and is no longer on metformin.

We together discuss a smart and obtainable amount of enjoyable movement into your daily routine. Studies show that splitting up walking into 15 increments has a large impact on blood sugar levels. Therefore, it does not have to all be done at once if you have a hectic work schedule. It is quite common to see a 50 point reduction of blood sugar after a 15-30 min brisk walk, the best pill in town.

Yes, you can have desserts as long as it is eaten after a meal and not on an empty stomach. We can talk about combining fruit or dessert with a protein or healthy fat source to help prevent blood sugar spikes after enjoying a sweet treat. I know this all may sound too good to be true but it can be done if you choose to take the time for yourself by grabbing the horse by its reins and start taking charge of your health! Health is wealth and we can help you see how it is not as difficult as you make it out to be.

The good news is that most insurance companies pay for nutritional counseling for Diabetes. ABMG, Aetna, Blue Cross Blue Shield, Brown and Toland,CCHP, Cigna, Hill Phy, United Healthcare Sutter Select. Please feel free to call me at (925) 855-0150 or email me at and tell me about your nutrition concerns. I am happy to call your insurance and check on your coverage. Refer to my website for my services.