If you have type 2 or prediabetes, or have recently been diagnosed, this page is for you! In this article, we will cover:
  • What is diabetes?
  • What are risk factors for diabetes?
  • How to interpret your blood test results
  • How you can manage diabetes
You may have been told by a family doctor that you have diabetes or prediabetes, and now you have to “watch your blood sugar”. Maybe they prescribed a medication, advised you to lose some weight, and do more exercise. Going on medication for life is a huge commitment and it can be overwhelming for so many people. On top of that, you might have to invest in a glucometer, test strips, and lancets to monitor your blood sugar at home. You want to manage with lifestyle interventions such as a healthy diet and exercise, but you don’t know where to start. You have so many questions: what causes diabetes? Can it be reversed? What happens if my blood sugar stays high? Do I have to cut out all sweets, fruits, bread and pasta?
Don’t sweat. It is hard news, but you’re not alone. Here’s the good news: if managed well, diabetes doesn’t have to affect your quality of life! And yes, you can still eat the foods you love while taking care of your health. 

What is diabetes?

In short, diabetes is when your body either doesn’t produce or doesn’t properly use the insulin it produces.
  • Type 1 diabetes is the former, when your body doesn’t produce insulin at all and you need to depend on exogenous insulin. This is an autoimmune disease that affects about 10% of people with diabetes.
  • Type 2 diabetes is by far the most common diagnosis and is the focus of this article. It is when your body is no longer sensitive to the insulin it produces.
  • Prediabetes refers to impaired fasting glucose tolerance, indicated by a hemoglobin A1C of 6.0% to 6.4%. Having prediabetes does not mean that you will have type 2 diabetes. With proper management, type 2 diabetes can be prevented. 
What is insulin? Insulin is a hormone produced in the pancreas. When we eat food that contains carbohydrates, it gets digested, absorbed, and raises our blood sugar (glucose). Insulin is basically the key that opens the doors on the cells of our body to take in the glucose for our cells to use as energy. When insulin isn’t working as well anymore, the sugar level remains high in the blood and our cells have less fuel to use. This causes symptoms such as fatigue, irritability, blurred vision, excessive thirst and hunger, and frequent urination. 

​What causes diabetes?  

Many of my patients with diabetes have asked, “What have I done wrong? I never eat a lot of sweets or drink pop.” I want to let you know, many of the risk factors for diabetes are really beyond your control. These include:
  • Genetics
  • Family history
  • Age
  • Ethic background (individuals of African, Arab, Asian/South Asian, Hispanic, Indigenous descent have higher risk of developing diabetes) 
  • Certain existing health conditions
  • Certain prescribed medications  
Indeed, your lifestyle such as diet, exercise and smoking can also affect your risk of type 2 diabetes. Fortunately, these risk factors can be managed to make sure you stay healthy.

What tests can diagnose diabetes?

Several tests are used to diagnose diabetes. They are summarized in the table below.

How can I manage diabetes?

There are 4 main ways to manage blood glucose: 

1. Diet

  • The key to managing your blood glucose with nutrition is to eat regular meals at regular intervals throughout the day to maintain a steady level of blood sugar. Without insulin’s tight control of blood sugar, skipping meals or having a meal to large or small at varying time can cause unwanted fluctuations in your blood glucose levels.
  • Choose slow carbs, not low carbs. After diagnosis, a lot of my clients started cutting out rice, bread, and pasta in fear of high blood glucose, when they really shouldn’t. Choosing “slow carb” means choosing more of low-glycemic index carbohydrates and less of high-glycemic index foods. The glycemic index is a measure of how fast your blood sugar rises after eating a certain food. A slow, stead rise helps your body respond to the carbohydrate load better.
  • Instead of focusing on cutting out food, my approach is all about adding food.
    • Add more vegetables and fruits
    • Add more whole foods (instead of processed foods)
    • Add more high fibre foods (beans, legumes, lentils, chickpeas, whole grains, bran, nuts, seeds)
    • Add more healthy fats (avocado, salmon, flax seeds, olive oil, canola oil)
  • If you don’t know where to start or whether you’re on the right track, see a registered dietitian for individualized support.

2.  Exercise

  • It's recommended to get 150 minutes of aerobic exercise per week. This includes walking, running, biking, dancing. Exercising helps you bring down the blood sugar that remains high 1-2 hour after a meal. Beyond blood glucose control, there are lots of other benefits from exercise, such as lowering blood pressure, relieving stress, better sleep, improved digestive health, and lots more.
  • Resistance exercises such as lifting weights 2-3 times per week also help you boost lean muscles, burn calories, and improve blood glucose control.
  • It is important to check with a health professional before you start a new exercise program, especially if you aren’t normally active. If you’re taking insulin, you may need to monitor blood sugar, adjust insulin and diet according to your exercise regimen.  

3. Medications

Depending on your blood work and health condition, your doctor may prescribe an oral diabetes medication to help manage your blood glucose. Another type of medication is insulin which is administered through an injection. Different oral medications and insulin have different mechanism, onset, and duration that treat diabetes. 

4. Managing Stress

Stress is an inevitable part of life, especially if you have a chronic condition to manage while carrying out daily activities. Stress can affect your blood sugar as well. If you experience a lot of stress, have a plan on things you can do to manage stress levels. What would bring you joy? Who can you talk to? Remember, you’re not alone on this journey. The people around you would love to help if you let them know how. Consider seeking support from a professional who can walk with you through these challenges.