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What is Diabetes?

According to the American Diabetes Association, diabetes mellitus is defined as a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is required to convert sugar, starches and other food into the energy that is needed on a daily basis. The cause of diabetes is unknown, although genetics and environmental factors such as obesity and lack of exercise appear to play important roles.  There are two major types of diabetes:

Type 1 Diabetes

Type 1 diabetes results from the body's failure to produce insulin, which is the hormone that "unlocks" the cells of the body and allows glucose to enter and fuel them. An estimated 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Type 2 Diabetes

Type 2 diabetes is a result of insulin resistance, combined with relative insulin deficiency.  Insulin resistance is a condition in which the body fails to properly use insulin.  Type 2 is the most common type of diabetes.

Diabetes conditions can also occur in about 4% of all pregnant women as gestational diabetes, which translates into 135,000 cases in the United States per year.   Pre-diabetes is a condition that occurs when a person’s blood glucose levels are higher than normal, but not high enough for a diagnosis of Type 2 diabetes.

Healthy Eating with Diabetes

A lot of people hold the misconception that eating healthy with diabetes consists of special diabetic foods. Simply eating healthy reduces the risk for diabetes-related health complications, such as heart disease and stroke. Healthy eating involves eating a wide variety of foods including vegetables, whole grains, fruits, non-fat dairy products, beans, lean meats, poultry and fish. A good diet is made up of a variety of foods and appropriate portion sizes.  Choices are made from each food group and should include unprocessed food with the highest quality nutrients that are available, which means foods that are rich in vitamins, minerals and fiber instead of processed food.

The regulation of blood glucose in a person without diabetes is automatic, adjusting to whatever foods are eaten. However, someone with diabetes needs to take extra caution by balancing food intake with exercise, insulin injections and any other glucose altering activity. A good balance helps a patient with diabetes maintain a desirable weight and control the glucose level in their blood. It also helps to prevent a diabetes patient from heart and blood vessel related diseases.

Specific recommendations for healthy eating with diabetes differ from person to person.  A suitable diet is based on specific nutritional needs, lifestyle, as well as the action and timing of medications. For example, a diet for a person with Type 1 diabetes focuses primarily on matching food intake to the amount of insulin injected.  This means that one needs to know when the insulin peaks and how fast the body will metabolize certain types of foods. For someone with Type 2 diabetes, the recommended course of action is usually one more oriented towards weight loss in order to improve the body's ability to utilize the insulin that it does produce. In either case, understanding the basics of food nutrition is essential to healthy eating.

Blood Glucose Goals

Whether it is Type 1, Type 2 diabetes or even gestational diabetes, the goals of controlling blood glucose levels are very similar:  Keep blood glucose as near as possible to that of a person without diabetes. The following table issues the desired blood glucose level as recommended by the American Diabetes Association:

Blood Glucose Goals - Desirable Blood Glucose Levels

Time of Test Person without diabetes Person with diabetes
Before meals Less than 115 mg/dl 80 to 120 mg/dl
Before bedtime Less than 120 mg/dl 100 to 140 mg/dl

The American Diabetes Association also makes the following dietary recommendations:

  • Apportion your daily food and calorie count as follows:
    •  Carbohydrates-50% to 60%
    •  Protein-12% to 20%
    •  Fat-not more than 30%
  • Space meals throughout the day in order to avoid extremely high or low blood glucose levels.
  • Undertake a healthy diet with the supervision of your doctor.
  • Choose foods that help lower blood cholesterol.
  • Use food exchange lists in planning a well-balanced diet.

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Personal Health Check-up
  By Nicole Johnson, MA, MPH