For optimal control of glucose (blood sugar) and weight, patients should adhere to the meal plan established with their physician and registered dietitian. In addition, there are several guiding principles patients can follow in planning out their diet. General tips include:

• Eat breakfast daily.
  
  
• Do not go more than three or four hours without eating. Do not skip meals or snacks.
  
  
• Eat nutritious snacks and have them available throughout the day.
  
  
• Eat meals and snacks at roughly the same time each day.
  
  
• Increase intake of fiber, unless complications such as gastroparesis (form of autonomic neuropathy that hinders digestion) rule this out. Eat plenty of fruits and vegetables.
  
  
• Trim saturated fats and restrict or eliminate artery-clogging artificial trans fats from meal plans. Include adequate amounts of beneficial fats such as olive oil, seeds and nuts.
  
  
• Use foods, not pills, to get a full complement of vitamins and minerals.
  
  
• Drink enough water each day, such as eight glasses, to avoid dehydration, which is particularly dangerous in people with diabetes.
  
  
• Limit sugar, salt and caffeine. Drink alcohol only in moderation and only if approved by a physician.
  
  
• Avoid indulging in fad diets.
  
  
• Make changes gradually, and remember that health benefits such as weight loss will likely come slowly.
  
  
• Do not use diet pills unless diet and exercise alone are inadequate in shedding excess pounds and a physician recommends these drugs and will offer supervision.

A great deal of research is conducted on diet and diabetes. Some studies have shown possible benefits from certain foods, spices, vitamins and minerals in managing or helping to prevent diabetes, including omega-3 fats (from sources including walnuts, flaxseeds and fish), soy protein, black soya beans, whey protein, buckwheat, olive oil, vinegar, cherries, cocoa, cloves, cinnamon, ginger, tumeric, magnesium, zinc, calcium, vitamin B1, vitamin D and chromium. Patients are advised to consult their physician or registered dietitian before taking supplements or consuming large quantities of any food.

The many herbs and other supplements that are sometimes used by alternative practitioners include bitter melon, fenugreek, ginseng, gymnema and vanadium. However, scientific research and information about safe doses are often lacking, and the quality and strength of supplements can vary widely. It should be emphasized that “natural” does not always mean safe.

Patients are advised to consult their physician before trying complementary and alternative methods. Some supplements may interact with insulin, antidiabetic agents, antihypertensives or other medications and may require a physician to alter dosages.

Another controversy involving diet and diabetes is caffeine. Some research has shown that consuming caffeine may raise the risk of diabetes or impair glycemic control, but other studies have found opposite effects. Again, patients are advised to talk with their physician or dietitian.