Borderline Diabetes: Signs, Symptoms, and More

Borderline diabetes, generally known as prediabetes, is usually a condition that frequently develops before someone gets diabetes. It’s also called impaired fasting glucose or glucose intolerance. It basically means your blood glucose levels are elevated, but they’re less than high enough to be considered diabetes.

During the prediabetes phase, your pancreas usually still produces enough insulin in reaction to ingested carbohydrate. The insulin is less capable at detaching the sugar in the bloodstream, though, which means that your blood sugar remains high. This condition is termed insulin resistance.

To determine your blood sugar levels, your personal doctor will perform fasting blood glucose levels test. This is often a relatively simple test. After an overnight fast or even a fast of 8 hours, your physician will draw your blood. Using this blood sample, your sugar levels will probably be tested. The amount of sugar as part of your blood will determine for those who have borderline diabetes or diabetes.

Alternatively, your personal doctor may instead execute a hemoglobin A1c (HbA1c) test or perhaps oral glucose tolerance test (OGTT). HbA1c is surely an indicator of your glucose levels patterns over the past two to three months, therefore it is often a better overall picture over a single fasting blood glucose check. An HbA1c level between 5.7 and 6.4 indicates prediabetes.

Condition                                                 Blood Sugar Levels
Normal Fasting Blood Glucose                         Below 100 mg/dL
Borderline Diabetes Fasting Blood Glucose Between 100 mg/dL and 126 mg/dL
Diabetes Fasting Blood Glucose                 Above 126 mg/dL

If you might have prediabetes, you should consider you’re one of many. In 2012, it had been estimated that 86 million people age 20 and older had the trouble. That’s one inch three Americans.

Having prediabetes doesn’t mean you’ll definitely develop diabetes. It is really a warning products could lie ahead, however. People with prediabetes employ a five to 15-fold greater risk for diabetes than someone with normal sugar levels. Those chances increase should you don’t make any healthy changes for a diet or activity habits.

Early Warning Signs
“Prediabetes isn't pre-problem,” says Jill Weisenberger, M.S., R.D., C.D.E., and author of “Diabetes Weight Loss Week by Week.”

Someone with insulin resistance continuing can develop diabetes type 2 symptoms if it continues of sufficient length. Only ten % of people with prediabetes have any idea they have it because individuals often don't display any symptoms. If you can find symptoms, they are able to easily be mistaken for the next cause.

If you might have prediabetes, possibly you have one or more of such symptoms:

increased thirst
tiredness
blurry vision
cuts that won’t heal
gum inflammation
You may exhibit no symptoms, however.

“Often, people think about these symptoms section of their normal day, so they’re ignored,” says Toby Smithson, R.D.N., C.D.E., a spokesperson to the Academy of Nutrition and Dietetics and co-author of “Diabetes Meal Planning and Nutrition for Dummies.”

Borderline Diabetes Risk Factors
Any of those risk factors can enhance your chances of developing prediabetes:

being overweight or obese
being inactive
high blood pressure
high cholesterol
having an end family member with type two diabetes
giving birth into a baby weighing over 9 pounds
Take Control
Prediabetes is usually a silent condition, so acquiring a regular wellness checkup is vital for early detection. If you think it's likely you have borderline diabetes, discuss your concerns with a medical expert.

If there’s concern, your physician will order among three tests:

a fasting blood glucose levels test
an oral glucose tolerance test
a hemoglobin A1C test
A fasting test will measure your blood sugar before you eat. The oral test measures your glucose levels before you eat, and after that it measures it again as soon as you drink a sugary beverage. The A1C is really a simple nonfasting blood test. All are built to see if the insulin within your body is performing what it should.

That’s important because when you might have prediabetes your system produces extra insulin to push blood glucose levels numbers down, says Weisenberger.

High blood sugar levels, particularly when they’re unattended, can impact other systems as part of your body. This can add vulnerable to your variety of health hazards and chronic health issues. For example, uncontrolled diabetes can bring about vision loss, periodontal disease, kidney damage, or perhaps cardiovascular disease. The high insulin levels that are included with insulin resistance might cause additional problems.

If you have prediabetes, a medical expert may even dictate a medication, for example metformin (Glumetza, Glucophage, Fortamet, Riomet). This can also aid in increasing insulin sensitivity and keep blood sugar in check.

The Power of Lifestyle Change
A large, multicenter research study referred to as Diabetes Prevention Program considered how change in lifestyle could help prevent diabetes. What they found should supply you with a lot of hope. With modest weight-loss and exercise, study participants reduced their chance developing diabetes by 58 percent over 36 months.

The power of healthy food and use habits are not overstated. Take charge within your health by emphasizing simple dietary and changes in lifestyle.

Eat Healthier
Focus on sector and complex carbohydrates including beans, grains, and starchy vegetables. Pass on the straightforward sugars, like those invoved with processed baked goods. Those can raise blood glucose without providing wholesome nutrition.

For assistance in planning meals to counteract diabetes, schedule an appointment with a dietitian. The American Diabetes Association also provides great tips on diabetes-friendly cooking.

Move More
Aim for 150 minutes of exercise every week. Any activity is superior to nothing. Even walking counts.

Lose Weight
If you happen to be overweight, shedding weight can help decrease your risk. A healthier diet and boosting your activity level should assist you achieve this goal. Even losing 5-10 percent of your respective body weight will help decrease your risk for diabetes.

Buy A Glucose Monitor
Some people discover it useful to check their blood sugar at home. It can assist show how foods affect blood sugar levels more than others. It’s obviously any good motivating factor for a lot of. If you’ve been identified as having prediabetes, your insurance plan could even cover it.

Start Today
Start any diet and change in lifestyle today. It’ll provde the best probability of preventing diabetes to begin with while also avoiding any potential complications from uncontrolled diabetes.

While figuring out this early diagnosis might be upsetting, it doesn't have to mean you may develop diabetes, says Dr. Kristine Arthur, an internist at Orange Coast Memorial Medical Center in Fountain Valley, California.

“It is usually reversed and you will stop the progression to diabetes,” she says.

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Cinnamon and Diabetes: An Update

Cinnamon and Diabetes: An Update. About nine years back (sources that are in 2006), I wrote about cinnamon and diabetes. To this date, people still find out and post comments with this topic. Since then, more principals are available that (hopefully) sheds more light on whether cinnamon lowers blood sugars and HbA1c (a step of glucose levels control over the last 2–a few months) — or you cannot. Let’s check out where things stand it 2015.

Back thenA study that I cited in 2006 was one published inside journal Diabetes Care back 2003 by Khan et al. The researchers gave different doses (1, 3, or 6 grams) of cassia cinnamon to subjects with Type 2 diabetes for 40 days. All three sets of subjects had a noticeable difference in their fasting glucose levels levels, in addition to their lipid (blood fat) levels. As a result of these studies, a lot of people have jumped for the cinnamon bandwagon, as they say, taking cinnamon supplements, adding cinnamon sticks to tea, and sprinkling cinnamon on his or her foods. In addition, much debate has occurred in connection with type of cinnamon that’s advisable to use for diabetes: cassia or ceylon.

Where we're nowKhan’s study certainly launched a firestorm and possesses led to more research within the use of cinnamon for diabetes management. The tricky issues around studying cinnamon are that:

• There are a variety of cinnamon, primarily cassia and ceylon.

• It’s hard to assess the potency of the particular “batch” of cinnamon, no matter what type.

• The ingredient or ingredients in cinnamon which may have a glucose-lowering effect have yet for being identified.

Without definitive techniques to these issues, it’s tough to be certain in the role of cinnamon on glucose control. Much on the “evidence” is anecdotal: Someone reports that taking cinnamon helped to decrease his blood glucose, therefore cinnamon definitively lowers blood sugar levels. Unfortunately, from the world of research, anecdotal reports don’t work.

But what has newer research revealed considering that the 2003 study?

On the “nay” sideVanschoonbeek et al, 2006: Cinnamon supplementation of just one.5 grams daily for 6 weeks didn't affect glucose levels or lipid levels in postmenopausal women with Type 2 diabetes.

Baker et al, 2008: A meta-analysis (analysis of knowledge from several many studies — in this instance, an assessment of five prospective randomized trials) determined that cinnamon didn't improve blood sugar levels, HbA1c, or lipid levels in people who have either Type 1 or Type 2 diabetes.

Leach et al, 2012: Another meta-analysis reviewed 10 different many studies involving an overall of 577 subjects with Type 1 or Type 2 diabetes, taking a typical dose of 2 grams of cinnamon daily for 4–16 weeks, figured that there is “insufficient evidence to guide the using cinnamon for Type 1 or Type 2 diabetes mellitus.” Of note, however, the authors stated that a great many of these studies just weren't well conducted and lacked in quality.

On the “yay” sideLu et al, 2012: This was a Chinese study of 66 subjects with Type 2 diabetes who have been given a placebo (inactive treatment), or 120 milligrams or 360 milligrams of cinnamon extract, plus a sulfonylurea (oral diabetes medicine), for a couple of months. Both HbA1c and fasting blood glucose levels were significantly reduced from the treatment groups however, not the placebo group. Lipid levels remained unchanged. The authors figured cinnamon is most effective at improving glucose control in Chinese patients with Type 2 diabetes.

Akilen et al, 2012: A review of six numerous studies with 435 subjects who have been given doses of cinnamon from 1–6 grams every day, and followed for between 40 days and 4 months, showed a “significant decrease” in average HbA1c degrees of 0.09%.

Allen et al, 2013: A review article of many studies looking at the effect of cinnamon on blood glucose levels and lipid control determined that cinnamon is owned by a “statistically significant” loss of fasting glucose levels, total cholesterol, LDL (“bad” cholesterol), and triglyceride levels (a style of blood fat), yet not HbA1c. However, the most preferred dose and length of therapy remains to be unclear.

I’ll indicate that the studies stated earlier are not a comprehensive listing; other research has been published, too. My time highlighting these types of studies is usually to emphasize that, based around the available research thus far, the situation of the usage of cinnamon in diabetes management continues to be somewhat controversial. What’s also murky is always that, if cinnamon can be so effective:

• What’s the right kind of cinnamon make use of?• What’s the most effective formulation to administer cinnamon — capsule, extract, tea?• What’s the best dose to adopt?• For how long should one take cinnamon?• Does cinnamon work differently in numerous populations?

Cinnamon may indeed perform the job, a minimum of for a number of people, in lowering glucose levels levels. Yet many diabetes medicines perform better job. Understandably, however, a number of people are leery of taking medication due to potential uncomfortable side effects; pricing is another factor, too.

The good newsCinnamon can be a relatively safe supplement when consumed with a dose of a few grams each day (1 teaspoon of powdered cinnamon is concerning 4 grams). No significant adverse events have already been reported. However, it’s good to become reminded that “natural” substances aren’t necessarily any safer than medication. As many readers have described, cassia cinnamon boasts a compound called coumarin, that is toxic for the liver which enable it to cause potentially irreversible damage. Definitely, individuals who have liver disease or liver problems should avoid taking this style of cinnamon.

My conclusionI suspect many readers take cinnamon in varying forms. Certainly, adding cinnamon on your food or drinking a cupful of cinnamon tea really should be fine. But make an effort to this:

• Always check with the health-care provider before investing in this or any style of supplement.

• Check your blood sugars regularly to find out what the effect is alone blood sugars. (And don’t necessarily pass by what your neighbor or perhaps a fellow reader informs you — everyone handles hyperhidrosis differently! What works persons may not do the job.)

• Don’t stop taking your diabetes medication without checking along with your doctor.

• Give yourself a period frame in order to see results. If you’re not seeing any improvements as part of your blood sugars and/or HbA1c, stop taking it.

Let’s hope, in the years ahead, more research is going to be done with cinnamon and now we will continue to acquire more information.


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Cinnamon And Diabetes – Clearing The Confusion.

Cinnamon And Diabetes – Clearing The Confusion. The using cinnamon for glucose levels control is definitely not without controversy and confusion. The debate started way back in 2003 every time a group of researchers reported that among 60 patients studied and for only 40 days that three amounts of cinnamon used reduced fasting serum glucose 18–29%, triglycerides 23–30%, LDL cholesterol 7–27%, and total cholesterol 12–26%.[1] Those impressive results caused much stir one of many Diabetes association groups who feared that diabetics would begin to use cinnamon alternatively for the meds their doctors had prescribed to control blood glucose levels. Then a meta-analysis published in 2007 reviewed five studies and concluded Cinnamon Has No Benefit for People With Diabetes.[2] And finally recently, another meta-analysis published in 2012 included 6 studies and concluded just the opposite on the 2007 study. They reported positive conclusions on the glucose levels lowering effect of cinnamon.[3]

US Department of Agriculture identifies the compound that produces cinnamon work
So who's to be believed and how come there such discrepancies? The US Department of Agriculture could possibly have found the response. Through their research, they determined the bioactive compounds in cinnamon – what makes them work – are water-soluble compounds called Type-A polymers.[4] These compounds were isolated from cinnamon and were found to raise in vitro insulin activity with a factor of 20. They work by increasing the effect of insulin on blood glucose levels. This discovery clears up some in the confusing mixed upshot of clinical studies. The type cinnamon used along with the amount of this active compound present will be the determining consider the effectiveness of cinnamon for blood glucose levels control.Cinnamon and Diabetes – Clearing the Confusion

For consumers aiming to take advantage of this research, consideration needs to be given to with all the patented cinnamon supplement Cinnulin PF that is a standardized extract containing high and measureable amounts of Type A polymers. This type of cinnamon is widely and inexpensively offered by online and retail supplement providers and may even make the difference between cinnamon in your favor or not. Use the dosage recommended because of the manufacturer.

The best way of controlling blood glucose of all…
One message is obvious from all the controversy. That message is the fact that in spite of cinnamon’s beneficial effect on glucose levels, it really should be only a section of an overall program to control glucose levels. Lifestyle changes are definitely the number one best approach to reduce and blood glucose levels. In fact, as reported inside New England Journal of Medicine in 2002, the national, multi-year Diabetes Prevention Program found out that lifestyle changes were two times as effective because the diabetes drug metformin. So there isn't a substitute for slimming down, getting some moderate exercise 4-5 times each week, stop smoking cigarettes and start eating a delicious Mediterranean diet. And let cinnamon turn into a regular section of that overall plan. Go here to know how cactus can assist fight diabetes too.

What can be your experience? Has cinnamon lowered glucose levels for you?
Share your experience in order that other readers may gain advantage from your own results. If you are a pre-diabetic, what has helped you continue from slipping into full diabetes? Have you tried the Cinnulin PF extract, and if so, what were the outcome?

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Cinnamon And Diabetes Treatment Link

Cinnamon and Diabetes Treatment Link. Recent samples of cinnamon used to effectively lower sugar levels are being reported from America. Although taking cinnamon every day does not affect every patient with raised glucose levels, for a lot of others it's extremely useful.
Apparently, an evergrowing group of physicians are prescribing cinnamon thus to their type 2 diabetes patients, as well as their patients struggling with pre-diabetes. Richard Anderson, a pro at the Human Nutrition Research Centre, originally found out that cinnamon helped the efficiency of insulin, with insulin improving the body to metabolise sugar. The component in cinnamon is apparently methylhydroxy chalcone polymer, that helps to convert glucose into energy. Further studies in Pakistan, published on the time in Diabetes Care, learned that cinnamon was instrumental in lowering blood glucose levels.

However, other research has found cinnamon to get ineffective. One expert endocrinologist reportedly stated: Why hunt for such an agent if we have a great number of effective ways to control sugar in [diabetes]?"

Other experts in the heart of the debate necessary further research before any conclusions may be drawn. All patients should talk to their physician and GP before self-administering cinnamon.


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Diabetes: How To Control It By Proper Diet

Diabetes: How To Control & Prevent It By Proper Diet

Planning ahead of time at what time you travel reduces trim.  This is specially, focal to get a diabetic.  These 5 diabetes travel tips are simple to apply andessentialto your diabetic control.  They are specifically, valuable should you be traveling abroad.

1)  Take part in a very pre-travel check-up.  Promote to definite your A1C sugar levels; your high blood pressure and your cholesterol layer are OK.  Get the right shots in support of several people you proposal to travel to.

2)  Wear a diabetes health ID.  Ideally it should take place in the word what spoken near your vicinity you’re visiting.  Not each individual speaks foreign languages and you don’t need medical problems through confusion.

3)  Keep your medication and glucose refreshments within your hand-baggage.  Check-in baggage does, unfortunately, go astray. Don’t chance your diabetes medication by packing it within your main luggage.

4)  Keep your medication to use unusual box, detailed with pharmacy labels.  It will avoid confusion in this subject why you are carrying drugs and, in case you are on insulin, syringes.

5)  Be alert to stage zone changes, especially as is going to be watch.  Remember since you travel east your time and energy becomes shorter; when you travel west your time and effort becomes longer.  You could possibly need to affect the timings within your medication.

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Warning! American Diabetes Association Diet Programs Threaten The Health of Diabetics

Yess! Its BIG Warning You must care about! American Diabetes Association Diet Programs Threaten The health of Diabetics.

ADA(NaturalHealth365) As of 2014, 29.2million people (9.3% with the population) have diabetes inside the United States while 86 million people (27.5% in the population) have prediabetes. Of those that have prediabetes, 15 to 30 % will develop type-2 diabetes within 5yrs.

This particular disease cost the united states approximately $245 billion in a mere medical costs and lost work or wages in 2014. And, in addition to all this, the United States Centers for Disease Control and Prevention predicts that certain in three individuals will be told they have diabetes by 2050.

The American Diabetes Association (ADA) can be a trade association perfectly found on the United States. For 75 years, they've already claimed to enjoy the fight against the deadly consequences of diabetes, and also fight for the people affected by the ailment. They do this through funding research in order to avoid, cure, and manage the condition. They also deliver services to numerous communities together with online.

Because the danger of death for diabetics is half higher than adults without diabetes, prevention from the disease is essential. The American Diabetes Association provides diet programs, recipes, along with food information for diabetics. After all, diabetes is really a disease the place that the body cannot metabolize blood glucose levels properly which results in an excess sugar buildup within the bloodstream that accelerates the the signs of cardiovascular disease and damages other bodily systems.

Therefore, learning how to eat correctly is critical for diabetics.

So, here’s the ’$64,000 question’: Do the eating plans of the ADA really help for treating symptoms? According to several studies, the solution is no. In fact, research indicates that their recommendations actually increase blood sugar levels levels – levels so dangerous that they’ve been accused of killing diabetics!

The ADA recommends diabetics eat meals consisting of approximately fifteen to twenty percent protein, 55 percent carbohydrates, and 25 to 30 % fat. The carbohydrate portions must be 45 to 60 grams per meal. While this macronutrient split could possibly be appropriate for certain healthy individuals, scientific research prove this guideline is misleading which enable it to actually be detrimental to blood glucose levels for diabetics.

Even a survey published in one with the association’s professional publications is the opposite of their own recommendations. In Diabetes, the recommended eating plan of moderately high carbohydrates was tested against a lesser carbohydrate diet. The mean result with the 24-hour serum blood glucose levels at the end to the higher carb eating habits was 198 mg/dl, even though the mean result was 126 mg/dl using the lower carb eating plan.

According to Diabetes Action (an exploration and education foundation for diabetics), normal or good blood glucose levels levels taken whenever you want of day with or without fasting must be less than 140 mg/dl to the diabetic. Therefore, this proves the association’s advice is unhealthy.

Another large study published in Nutrition & Metabolism found similar results with low carb diet programs. They tested three kinds of isocaloric weight loss eating plans for sixty days: very low carbohydrate, high unsaturated fat, and suprisingly low fat.

While the very reduced carb and high unsaturated fat fat loss programs resulted in similar weight loss, the very low carbohydrate diet had good results in several other locations that are good to diabetics – improved triacylglycerols, HDL-C, together with fasting and post prandial glucose and insulin concentrations.

In fact, insulin levels dropped 33 percent on the suprisingly low carb diet program. The study concluded how the very low carbohydrate diet “could be useful within the short-term therapy for subjects with insulin resistance and hypertriacylglycerolemia.” However, long-term studies still ought to be completed.

Several other studies mimic exactly the same results because these two studies which prove that this American Diabetic Association’s recommendations may be detrimental to the healthiness of diabetics.

It is extremely unfortunate how the primary source for consumer info on treating diabetes is resulting from the American Diabetic Association. Their recommended and misguided eating plans are too an excellent source of carbohydrates to truly control blood sugar levels and insulin levels to adequately control the complications of diabetes – especially type-2 diabetes.

The Revue Mêdicale Suisse journal reports that type-2 diabetes is “a potentially reversible disease.” Along the identical lines, an exceptionally recent study published in October 2015 by Newcastle University inside United Kingdom revealed an experimental treatment to reverse type-2 diabetes.

By placing diabetics using a low calorie diet for two months, these people were able to determine that insulin production on the pancreas regained normalcy. Blood sugar have also been improving after every meal. Fat content in the the pancreas and liver also returned to normalcy.

According to Professor Roy Taylor who led case study:

“We believe this implies that Type 2 diabetes is centered on energy balance within the body… for anyone who is eating more than you burn, then your excess is stored within the liver and pancreas as fat encourage Type 2 diabetes in most people.”

This research was revealed with the American Diabetes Association conference in 2015. Therefore, you might find revisions on their current guidelines quickly.

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Paleo Diet A Lot Better Than American Diabetes Association Diet For Diabetes Type 2

A just published study comparing The American Diabetes Association Diet using a hunter gatherer (paleolithic or paleo) diet, shows superior blood glucose control and improved insulin sensitivity around the paleo diet.

Metabolic and physiologic effects from consuming a hunter-gatherer (Paleolithic)-type diet in diabetes type 2 symptoms

Twenty-five patients with diabetes type 2 symptoms (50-69 years) were randomly used on the paleo (n=14) or ADA diet (n=10). They ate a ramp-up diet for seven days then the test diet for 2 weeks.

The Paleo diet contains meat, fish, poultry, eggs, fruit, vegetables, tree nuts, canola oil, mayonnaise and honey. Foods excluded were milk products, legumes, cereals, grains, potatoes and products containing potassium chloride. Some foods are not typically hunter- gatherer food: mayonnaise, carrot juice and domestic meat, but contained the nutritional characteristics of pre-agricultural foods. The diets were split into three meals and three snacks, all served by the research centre kitchen staff.

The diets contained enough calories so patients lost a maximum of 3 lbs, whenever they did calories were increased.

The primary outcomes due to this study were difference in insulin sensitivity and improvements in lipid profiles (total cholesterol, triglycerides and high-density lipoprotein (HDL) cholesterol). Blood pressure have also been measured.

Here may be the actual breakdown of diet eaten with the 14 day test period. What is interesting may be the the diets were matched for calories and macro-nutrients. Notable will be the carbohydrate content for both diets. Not at all low – carbs remain 400 grams on a daily basis. Previous studies of paleo diets when compared with standard diets were naturally short of carbohydrates, which means this study adjusted for that.


Results: Table from paper


Lipids (cholesterol)

There were statistically significant reductions overall cholesterol, HDL cholesterol and low-density lipoprotein (LDL) cholesterol within the Paleo diet . The total cholesterol, HDL cholesterol and LDL cholesterol trended downward for the ADA diet, but only the decline in HDL cholesterol reached statistical significance. The triglycerides trended downward into a greater degree around the Paleo diet than about the ADA diet.

Changes in Insulin resistance

Fructosamine, a marker of blood sugar levels control reduced by 34umol/l inside the paleo group and simply 3umol/l inside the ADA group. Insulin resistance (IR) improved more inside paleo group, and people with the worse IR from the beginning improved probably the most.



The diets were similar except the cause of carbohydrates inside the paleo diet was different —from fruits, vegetables and honey. The ADA group  ate rice, bread and pasta as recommended. There was a tremendous difference in fibre content in the diets —about 35 g/2500 kcal inside the paleo diet vs 12 g/2500 kcal within the ADA diet. It is possible the fibre slowed the post-prandial glucose rise and this this was the key driver improving overall glucose control.

There continues to be criticism how the ADA diet must have been full of whole grain carbohydrates with additional fibre. However people following ADA diet recommendations would typically choose similar grains to prospects provided on this study. The paleo meals are naturally an excellent source of fibre when selecting the recommended vegetables and fruit.

Another reason the paleo diet could be more successful compared to ADA diet would be the type of carbohydrate; vegetables and fruit have starch found in cells, instead of granular starch. This has a brilliant effect on gut bacteria, and recent reports show gut bacteria type is linked to diabetes type 2.

Microbiota associated with diabetes type 2 and its related complications

Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and could possibly be the primary dietary reason for leptin resistance and obesity

If you have diabetes type 2 symptoms, simply switching to some paleo diet of meat, fish, poultry, eggs, fruit, vegetables, tree nuts, organic olive oil, avocado, or a bit of honey,  and eating as much vegetables that you can manage can be your best bet to deal with it.

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