Fair Trade-Off: Manage Your Choices for Diabetes Control

86491950How often are you out with friends who order and eat whatever they like? Appetizers, a few slices of bread, a glass of wine and dessert – so tasty, and all gone. Meanwhile, you’re being good and watching every bite but thinking to yourself, “It’s not fair. Why can everyone else eat whatever they want but I can’t?”

Unfortunately, having diabetes is not easy, nor is it fair. It requires daily management of your lifestyle — especially if you want your blood glucose levels to stay under control. You may miss out on some treats right now, but learning about your diagnosis and your food options will help you to make choices that can satisfy your health and your appetite and cravings over the long-term.


Before we get to those healthy choices, it’s important to understand what led to your diabetes diagnosis in the first place. It has to do with how your body processes insulin.

Insulin is the hormone that helps food enter your body’s cells.  It’s the key that unlocks the cells so your body can receive nourishment. Insulin can either be sensitive or resistant.

People with insulin sensitivity can eat or drink whatever they want without any obvious side effects on their health or weight.

But if you have diabetes, your insulin is resistant, which means you don’t tolerate carbohydrates well, especially processed and starchy ones like bread or pasta.


So how did this start and why did it happen to you? Believe it or not, it could have started before you were born when your mother’s pancreas had what we call a beta-cell dysfunction.  Beta cells produce insulin and are needed to digest and process carbohydrates.

If your mother’s beta cells were not working well, either due to her genetics or hormones produced during the pregnancy, it may have affected your pancreas. The result is insulin resistance, which you may have had as a baby, but only become a reality in childhood or adulthood.

Diabetes also develops from unhealthy eating habits and lack of activity or exercise, but more often than not, chances are it started with your genes and became a reality based on your lifestyle.


Clearly, there is nothing fair with how diabetes develops, but since you can’t change your genes, focusing on how to manage your diabetes is the most important thing you can do. Your actions determine whether your diabetes is under control or gets worse. Here are some steps you can take to stay as healthy as you can:

  1. Have empathy for your genes:  don’t be hard on yourself about your condition, it can be managed.  Controlling what you eat and being active are important for both your diabetes and your overall health.
  2. Balance your meals and snacks to combine protein with healthy sources of fat and avoid modified forms of carbohydrate (especially processed, starchy carbohydrates like chips, cookies, etc.)Example:  eating eggs with fruit for breakfast instead of cereal goes a long way to help balance your blood glucose values. This can mean the difference between feeling full instead of hungry within a few hours. It also helps your metabolism stay strong.  At lunch, eat a salad with vegetables, chicken or fish and some sliced avocado instead of a slice of pizza or a burger and fries.
  3. Make exercise like brushing your teeth:  a daily, non-negotiable activity.  Although we know exercise is important and keeps your heart healthy, there are even more reasons to exercise when you have diabetes. Exercise makes your insulin almost 50% more sensitive, which allows the food you eat to get into your cells without prompting the pancreas to work harder. This benefit is essential to keep and “rest” the beta-cells in the pancreas so your diabetes stays in control.

When it comes to your long-term health, research shows that a 30-minute walk every day can lower your risk of diabetes by 58%.  And the prevention or delay of diabetes that comes with this type of lifestyle exercise can be effective for up to 10 years or even more.

So, the next time you are eating out with friends, choose restaurants that offer a wide variety of healthy options to help you keep your glucose levels within your goal range. Consider walking to dinner or even parking the car some distance away. With healthy food choice and exercise, your blood glucose and metabolism will thank you, and the long-term health rewards will be sweeter than any single night of eating out. A fair trade-off, don’t you think?


Knowles, WC., et. al. (2002) “Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin”; New England Journal of Medicine. 346(6):393-403.

Knowles, WC., (2009) “10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study”; Lancet. 374(9707): 2054.


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Susan B. Dopart, M.S., R.D., C.D.E., is a nutrition and fitness expert in private practice in Los Angeles, CA. Susan views her clients and their physicians as her partners in wellness. Her expertise is in treating the nutritional aspects of diabetes, heart disease, weight management, cancer, pregnancy, infertility, PCOS and exercise nutrition. Susan received her B.S. in Nutrition and Clinical Dietetics from UC Berkeley and her M.S. in Exercise Physiology and Sports Medicine from California State University, Hayward. She is certified as an Exercise Test Technologist from the American College of Sports Medicine.

Susan is passionate about looking for lifestyle solutions that anyone can use to improve their health and happiness. She is the author of, A Recipe for Life by the Doctor’s Dietitian – a nutrition guidebook, resource, and teaching tool with cutting-edge nutrition information; Healthy You, Healthy Baby: A Mother’s Guide to Gestational Diabetes; and A Healthy Baker’s Dozen: Gluten-free low sugar cookies with real ingredients – treats designed for those with diabetes. You can find her books by visiting her website,

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