Vital Information – Diabetes


What Is Diabetes?

The American Diabetes Association says Diabetes is a metabolic disease in which the body’s inability to produce any or enough insulin.

This causes elevated levels of glucose in the blood. The condition in which the body does not properly process food for use as energy.

Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies.

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both.

Common Signs and symptoms of diabetes:

  • Urinating often
  • Feeling very thirsty
  • Feeling very hungry – even though you are eating
  • Extreme fatigue
  • Blurry vision
  • Cuts/bruises that are slow to heal
  • Weight loss – even though you are eating more (type 1)
  • Tingling, pain, or numbness in the hands/feet (type 2)

Early detection and treatment of diabetes can decrease the risk of developing the condition.
There are several ways to diagnose diabetes. Each way usually needs to be repeated on a second day to diagnose diabetes.

Testing should be carried out in a health care setting (such as your doctor’s office or a lab). If your doctor determines that your blood glucose level is very high, or if you have classic symptoms of high blood glucose in addition to one positive test, your doctor may not require a second test to diagnose diabetes.

The A1C test measures your average blood glucose for the past 2 to 3 months. The advantages of being diagnosed this way are that you don’t have to fast or drink anything. Diabetes is diagnosed at an A1C of greater than or equal to 6.5%.

Fasting Plasma Glucose (FPG)
– This test checks your fasting blood glucose levels. Fasting means after not having anything to eat or drink (except water) for at least 8 hours before the test. This test is usually done first thing in the morning, before breakfast. Diabetes is diagnosed at fasting blood glucose of greater than or equal to 126 mg/dl.

Oral Glucose Tolerance Test (also called the OGTT) – The OGTT is a two-hour test that checks your blood glucose levels before and 2 hours after you drink a special sweet drink. It tells the doctor how your body processes glucose. Diabetes is diagnosed at 2 hour blood glucose of greater than or equal to 200 mg/dl.

Random (also called Casual) Plasma Glucose Test – This test is a blood check at any time of the day when you have severe diabetes symptoms. Diabetes is diagnosed at blood glucose of greater than or equal to 200 mg/d.

Overall Numbers, Diabetes and Prediabetes


Prevalence: In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes.
Approximately 1.25 million American children and adults have type 1 diabetes.
Undiagnosed: Of the 29.1 million, 21.0 million were diagnosed, and 8.1 million were undiagnosed.

Prevalence in seniors: The percentage of Americans age 65 and older remains high, at 25.9%, or 11.8 million seniors (diagnosed and undiagnosed).

New Cases: 1.4 million Americans are diagnosed with diabetes every year.
Prediabetes: In 2012, 86 million Americans age 20 and older had prediabetes; this is up from 79 million in 2010.

Deaths: Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death.

Eating and Diabetes
You can take good care of yourself and your diabetes by learning what to eat, how much to eat and when to eat. Making wise food choices can help you feel good every day. Lose weight if you need to. Lower your risk for heart disease, stroke, and other problems caused by diabetes

Healthful eating helps keep your blood glucose, also called blood sugar, in your target range. Physical activity and, if needed, diabetes medicines also help. The diabetes target range is the blood glucose level suggested by diabetes experts for good health. You can help prevent health problems by keeping your blood glucose levels on target.

Blood Glucose Levels

What should my blood glucose levels be?


How can I keep my blood glucose levels on target? You can keep your blood glucose levels on target by making wise food choices, being physically active and taking medicines if needed.
For people taking certain diabetes medicines, following a schedule for meals, snacks, and physical activity is best. However, some diabetes medicines allow for more flexibility. You’ll work with your health care team to create a diabetes plan that’s best for you.


Talk with your doctor or diabetes teacher about how many meals and snacks to eat each day.

Your Physical Activity Plan

What you eat and when also depend on how much you exercise. Physical activity is an important part of staying healthy and controlling your blood glucose. Keep these points in mind.

Talk with your doctor about what types of exercise are safe for you. Make sure your shoes fit well and your socks stay clean and dry. Check your feet for redness or sores after exercising. Call your doctor if you have sores that do not heal.

Warm up and stretch for 5 to 10 minutes before you exercise. Then cool down for several minutes after you exercise.

For example, walk slowly at first, stretch, and then walk faster. Finish up by walking slowly again. Ask your doctor whether you should exercise if your blood glucose level is high.
Ask your doctor whether you should have a snack before you exercise. Know the signs of low blood glucose, also called hypoglycemia. Always carry food or glucose tablets to treat low blood glucose.

Always wear your medical identification or other ID. Find an exercise buddy. Many people find they are more likely to do something active if a friend joins them.

Low Blood Glucose (Hypoglycemia)

Low blood glucose can make you feel shaky, weak, confused, irritable, hungry, or tired. You may sweat a lot or get a headache. If you have these symptoms, check your blood glucose. If it is below 70, have one of the following right away:

    • 3 or 4 glucose tablets
    • 1 serving of glucose gel-the amount equal to 15 grams of carbohydrate
    • 1/2 cup (4 ounces) of any fruit juice
    • 1/2 cup (4 ounces) of a regular (not diet) soft drink
    • 1 cup (8 ounces) of milk
    • 5 or 6 pieces of hard candy

  • 1 tablespoon of sugar or honey

After 15 minutes, check your blood glucose again. If it’s still too low, have another serving. Repeat these steps until your blood glucose level is 70 or higher. If it will be an hour or more before your next meal, have a snack as well.

The Diabetes Food Pyramid


The diabetes food pyramid can help you make wise food choices. It divides foods into groups, based on what they contain. Eat more from the groups at the bottom of the pyramid, and less from the groups at the top. Foods from the starches, fruits, vegetables, and milk groups are highest in carbohydrate. They affect your blood glucose levels the most. See “How much should I eat each day” to find out how much to eat from each food group.

How much should I eat each day?

Have about 1,200 to 1,600 calories a day if you are a small woman who exercises, small or medium-sized woman who wants to lose weight, or medium-sized woman who does not exercise much.


Talk with your diabetes teacher about how to make a meal plan that fits the way you usually eat, your daily routine, and your diabetes medicines. Then make your own plan.

Have about 1,600 to 2,000 calories a day if you are a large woman who wants to lose weight, small man at a healthy weight, medium-sized man who does not exercise much or medium-sized or large man who wants to lose weight.


Talk with your diabetes teacher about how to make a meal plan that fits the way you usually eat, your daily routine, and your diabetes medicines. Then make your own plan.

Have about 2,000 to 2,400 calories a day if you are a medium-sized or large man who exercises a lot or has a physically active job, large man at a healthy weight or medium-sized or large woman who exercises a lot or has a physically active job.


Talk with your diabetes teacher about how to make a meal plan that fits the way you usually eat, your daily routine, and your diabetes medicines. Then make your own plan.

Make Your Own Diabetes Food Pyramid Each day!


Use “Your Meal Plan” to make your own meal plan. Write down how many servings to have at your meals and snacks.


Starches are bread, grains, cereal, pasta, and starchy vegetables like corn and potatoes. They provide carbohydrate, vitamins, minerals, and fiber. Whole grain starches are healthier because they have more vitamins, minerals, and fiber.

Eat some starches at each meal. Eating starches is healthy for everyone, including people with diabetes.


Examples of starches are:

  • Bread
  • pasta
  • corn
  • pretzels
  • potatoes
  • rice
  • crackers
  • cereal
  • tortillas
  • beans
  • yams
  • lentils

How much is a serving of starch?

Examples of 1 serving:


Examples of 2 servings:


Examples of 3 servings:


What are healthy ways to eat starches?

Buy whole grain breads and cereals. Eat fewer fried and high-fat starches such as regular tortilla chips, potato chips, french fries, pastries, or biscuits. Try pretzels, fat-free popcorn, baked tortilla chips or potato chips, baked potatoes, or low-fat muffins.

Use low-fat or fat-free plain yogurt or fat-free sour cream instead of regular sour cream on a baked potato. Use mustard instead of mayonnaise on a sandwich. Use low-fat or fat-free substitutes such as low-fat mayonnaise or light margarine on bread, rolls, or toast.

Eat cereal with fat-free (skim) or low-fat (1%) milk.



Vegetables provide vitamins, minerals, and fiber. They are low in carbohydrate.


Examples of vegetables are

  • lettuce
  • broccoli
  • vegetable
  • juice
  • spinach
  • peppers
  • carrots
  • green beans
  • tomatoes
  • celery
  • chilies
  • greens
  • cabbage

How much is a serving of vegetables?

Examples of 1 serving


Examples of 2 servings


Examples of 3 servings


If your plan includes more than one serving at a meal, you can choose several types of vegetables or have two or three servings of one vegetable. A diabetes teacher can help you with your meal plan.

What are healthy ways to eat vegetables?

  • Eat raw and cooked vegetables with little or no fat, sauces, or dressings.
  • Try low-fat or fat-free salad dressing on raw vegetables or salads.
  • Steam vegetables using water or low-fat broth.
  • Mix in some chopped onion or garlic.
  • Use a little vinegar or some lemon or lime juice.
  • Add a small piece of lean ham or smoked turkey instead of fat to vegetables when cooking.
  • Sprinkle with herbs and spices.
  • If you do use a small amount of fat, use canola oil, olive oil, or soft margarines (liquid or tub types) instead of fat from meat, butter, or shortening.


Fruits provide carbohydrate, vitamins, minerals, and fiber.


Examples of fruits include:

  • apples
  • fruit juice
  • strawberries
  • dried fruit
  • grapefruit
  • bananas
  • raisins
  • oranges
  • watermelon
  • peaches
  • mango
  • guava
  • papaya
  • berries
  • canned fruit

How much is a serving of fruit?

Examples of 1 serving


Examples of 2 servings


If your plan includes more than one serving at a meal, you can choose different types of fruit or have several servings of one fruit. A diabetes teacher can help you with your meal plan.

What are healthy ways to eat fruits?

  • Eat fruits raw or cooked, as juice with no sugar added, canned in their own juice, or dried.
  • Buy smaller pieces of fruit.
  • Choose pieces of fruit more often than fruit juice. Whole fruit is more filling and has more fiber.
  • Save high-sugar and high-fat fruit desserts such as peach cobbler or cherry pie for special occasions.



Milk provides carbohydrate, protein, calcium, vitamins, and minerals.


How much is a serving of milk?

Examples of 1 serving


A diabetes teacher can help you with your meal plan.

What are healthy ways to have milk?

  • Drink fat-free (skim) or low-fat (1%) milk.
  • Eat low-fat or fat-free fruit yogurt sweetened with a low-calorie sweetener.
  • Use low-fat plain yogurt as a substitute for sour cream.

Meat and Meat Substitutes

The meat and meat substitutes group includes meat, poultry, eggs, cheese, fish, and tofu. Eat small amounts of some of these foods each day. Meat and meat substitutes provide protein, vitamins, and minerals.


Examples of meat and meat substitutes include:

  • chicken
  • beef
  • fish
  • canned tuna or other fish
  • eggs
  • peanut butter
  • tofu
  • cottage cheese
  • cheese
  • pork
  • lamb
  • turkey

How much is a serving of meat and meat substitutes?

Meat and meat substitutes are measured in ounces. Here are examples.

Examples of 1-ounce serving:


Examples of 2-ounce serving:


Examples of 3-ounce serving:


Three ounces of meat (after cooking) is about the size of a deck of cards. A diabetes teacher can help you with your meal plan.

What are healthy ways to eat meat and meat substitutes?

  • Buy cuts of beef, pork, ham, and lamb that have only a little fat on them. Trim off the extra fat.
  • Eat chicken or turkey without the skin.

Cook meat and meat substitutes in low-fat ways:

Broil, grill, stir-fry, roast, steam and microwave. To add more flavor, use vinegars, lemon juice, soy sauce, salsa, ketchup, barbecue sauce, herbs, and spices. Cook eggs using cooking spray or a non-stick pan. Limit the amount of nuts, peanut butter, and fried foods you eat. They are high in fat. Check food labels. Choose low-fat or fat-free cheese.

Fats and Sweets

Limit the amount of fats and sweets you eat. Fats and sweets are not as nutritious as other foods. Fats have a lot of calories. Sweets can be high in carbohydrate and fat. Some contain saturated fats, trans fats, and cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and keep your blood glucose and blood fats under control.


Examples of fats include:

  • salad dressing
  • oil
  • cream cheese
  • butter
  • margarine
  • mayonnaise
  • avocado
  • olives
  • bacon

Examples of sweets include:

  • cake
  • ice cream
  • pie
  • syrup
  • cookies
  • doughnuts

How much is a serving of sweets?

Examples of 1 serving


How much is a serving of fat?

Examples of 1 serving


Examples of 2 servings


How can I satisfy my sweet tooth?

Try having sugar-free popsicles, diet soda, fat-free ice cream or frozen yogurt, or sugar-free hot cocoa mix. Other tips: Share desserts in restaurants. Order small or child-size servings of ice cream or frozen yogurt. Divide homemade desserts into small servings and wrap each individually. Freeze extra servings. Remember, fat-free and low-sugar foods still have calories. Talk with your diabetes teacher about how to fit sweets into your meal plan.


Alcoholic Drinks

Alcoholic drinks have calories but no nutrients. If you have alcoholic drinks on an empty stomach, they can make your blood glucose level go too low. Alcoholic drinks also can raise your blood fats. If you want to have alcoholic drinks, talk with your doctor or diabetes teacher about how much to have.


When You’re Sick

Take care of yourself when you’re sick. Being sick can make your blood glucose go too high.

Tips on what to do include the following:
Check your blood glucose level every 4 hours. Write down the results. Keep taking your diabetes medicines. You need them even if you can’t keep food down. Drink at least one cup (8 ounces) of water or other calorie-free, caffeine-free liquid every hour while you’re awake. If you can’t eat your usual food, try drinking juice or eating crackers, popsicles, or soup.

If you can’t eat at all, drink clear liquids such as ginger ale. Eat or drink something with sugar in it if you have trouble keeping food down, because you still need calories. If you can’t eat enough, you increase your risk of low blood glucose, also called hypoglycemia. In people with type 1 diabetes, when blood glucose is high, the body produces ketones. Ketones can make you sick. Test your urine or blood for ketones if your blood glucose is above 240 you can’t keep food or liquids down Call your health care provider right away if your blood glucose has been above 240 for longer than a day, you have ketones, you feel sleepier than usual, you have trouble breathing,
you can’t think clearly, you throw up more than once or you’ve had diarrhea for more than 6 hours.

For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit

American Diabetes Association

For more information please call the American Diabetes Association at 1-800-DIABETES (800-342-2383) or visit Information from both these sources is available in English and Spanish.

The source of all information contained here online and in CCD FOUNDATION’S booklet “What Is Diabetes” is quoted from the American Diabetes Association and the U.S. Food and Drug Administration on January 13, 2016 by CW Smith, President CCD Foundation.

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