Smoothies for Diabetes


Should you drink smoothies if you have diabetes? The answer depends on what kind of smoothie, and whether they help you get needed nutrients. Some smoothies are so high in sugar and calories that you would literally be better off eating an entire pint of ice cream. Others pack nutrients without a load of calories. 

If you need to control your blood sugar and love smoothies or want to sneak more superfoods into your diet, we have some guidelines for ordering and making smart smoothies. Here they are!

 

The Ideal: Whole Foods


Whole foods are foods in their “whole,” or less-processed, forms. Examples include whole or cut fresh fruit rather than canned or dried, whole grains rather than refined, fresh chicken or turkey instead of processed meat, and peanuts rather than peanut butter with sugar and hydrogenated oils. 

You may have heard that whole foods are healthiest. That is usually true, but not always. There are times when blending whole foods into a smoothie makes health sense.

 

Smoothies for Weight Loss in Diabetes


Smoothies can be a great choice if they help you lose weight because any extra pounds that you are carrying around may be raising your blood sugar levels. Still, it can be harder to lose weight drinking smoothies than eating whole foods. Smoothies can quickly become high-calorie, and they are faster to drink than, say, munching your way through a green salad, some chicken, and an apple.

Keep the following tips in mind if you plan to use smoothies for weight loss.

  • The smoothie should be the meal or snack, not a “beverage” that accompanies your meal or snack.

  • The calorie count should be about 300 to 500 for a meal or 100 to 200 calories for a snack.

  • Include protein and fiber to make your smoothie more filling and longer-lasting.

 

Smoothies for Nutrition in Diabetes


Another reason to choose smoothies is when they deliver blood sugar-lowering foods and nutrients that you otherwise would not get. Leafy greens, such as spinach and kale, are prime examples because of their fiber, antioxidants, and magnesium. If you are not a fan of eating them in salads, you can get the goods without the taste by blending them into smoothies.

These are some other superfoods and blood sugar-lowering nutrients that you can get from smoothies if you choose.

  • Blueberries and strawberries.

  • Beta-carotene from carrots, sweet potatoes, and pumpkin.

  • Omega-3 and omega-9 fats from flax, avocado, and peanut and nut butters.

  • Calcium from almond milk, soy milk, yogurt, or tofu.

  • Antioxidants and fiber from almost any healthy plant food: vegetables, fruit, nuts, and whole grains such as oats.

 

Whole Foods vs. Smoothies


When should you make a smoothie, and when should you stick with whole foods? It is up to you, but maybe this table can help you decide.

Whole foods are good when you: Smoothies are good when you:
Have time to sit down for a meal.
Need an on-the-go meal or snack.
Want the satisfaction of chewing and swallowing.
Want the simplicity of a meal-in-one.
Feel like tasting different flavors and feeling different textures in your meal.
Want an instant boost of nutrition and superfoods.
Enjoy eating big portions, such as large salads and plates of vegetables.
Know you need to eat more vegetables, but don’t like eating them.
 

 Skip the Smoothie Shop


You are looking for trouble when you step into a smoothie shop or order a smoothie at a restaurant. A basic smoothie with no additions can easily have 200 to 400 or more calories in a small order. That is a reasonable amount for a large snack or a meal, but keep your guard up. A larger sized smoothie can have over 1,000 calories.

The sugar content is scarier than the calorie content. Each smoothie tends to have at least 30 to 50 grams of sugar, with larger smoothies having 100 or even 200 grams. Not all that sugar is necessarily added sugar. It may be natural, such as from fruit and yogurt. Still, it contributes to higher blood sugar levels, and that is not what you want on your diabetes diet!

Smooth Rules for Smoothies

  • Make the smoothie your meal or snack, not an addition to your regular meal or snack.
  • Drink it slowly to allow your brain enough time to register that you are full.
  • Have no more than 1 or 2 small servings of high-calorie ingredients such as peanut butter, nuts, avocado, and flaxseeds.
  • Order the smallest size or, better yet, make your own healthy smoothies.
  • Keep it low-glycemic to prevent blood sugar spikes. Limit sugary ingredients, and include a source of protein and high-fiber foods such as vegetables and fruit.
 

Make Your Own: The Basic Formula


When you make your own smoothies, you can control what goes into them and how big they are. Here is how to build a healthy smoothie for diabetes. You can vary the suggested quantities as long as you keep the sugar and calories low.

 
 

Are you ready to try your hand at making healthy smoothies for diabetes? Follow the guidelines above, or get started with one of the recipes below.

 

Recipe: Zesty Ginger Carrot Smoothie


This smoothie has a delicious blend of spices and the apple adds a bit of sweetness. The lime juice and avocado lower the glycemic index to keep blood sugar in check.

Ingredients:

  • 1 tbs ginger

  • 1 medium carrot, cut into pieces

  • ½ zucchini, in pieces

  • 1 medium apple, cored and skin intact

  • ½ cup soft tofu (or plain yogurt)

  • ¼ avocado

  • 1tbs lemon juice

  • ½ tsp cinnamon

  • ¼ tsp allspice

  • ¼ tsp nutmeg

  • 1 tbs water 

Blend all ingredients and enjoy!

 

Recipe: Pear Beet Power Smoothie


This smoothie is high in protein and fiber to keep you going for hours, and the cinnamon helps stabilize blood sugar.

Ingredients

  • 1 small pear, skin intact, stem removed

  • 1 small beet, peeled and cubed

  • 1 cup spinach leaves

  • 1 cup 12 whole unsalted almonds

  • 1 tbs chia seeds

  • ½ teaspoon cinnamon

  • ½ cup of unsweetened coconut milk

Blend all ingredients and enjoy!

 

Recipe: Chocolate Peanut Butter Strawberry Smoothie


The name says it all! You can substitute any berries or apple for the strawberries. Boost the nutrition by tossing in whatever greens you like.

Ingredients

  • 1 cup strawberries

  • ½ cup nonfat cottage cheese

  • 1 tablespoon peanut butter

  • ½ cup jicama, peeled, in cubes

  • 2 tablespoons cocoa powder (baking cocoa)

  • ½ cup of unsweetened almond milk

  • ½ cup ice

  • Optional: a few mint leaves and/or orange zest.

Blend all ingredients and enjoy!

 

Medication for Prediabetes

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Prediabetes is a condition with higher-than-normal blood sugar levels.
You may not feel sick or have any symptoms, but having prediabetes puts you at higher risk for developing type 2 diabetes within a few years. About 5 to 10% of people with prediabetes develop diabetes each year, and 90% of people with prediabetes will develop diabetes within the next 20 years.

Prediabetes treatments can lower your risk for diabetes and complications of diabetes. Lifestyle modifications, such as losing extra weight and increasing physical activity, are the most effective approaches for most people. 

Certain medications can also help delay the onset of type 2 diabetes or prevent it altogether. Metformin is the most common blood sugar-lowering medication for prediabetes, but there are others. These prescription medications are only for some patients with prediabetes, and they work best when you also adapt a healthy lifestyle.

 

Prediabetes Treatment Approaches: Lifestyle and Medication


Prediabetes treatment has three main components.

  1. Lifestyle modification to make healthy behavior choices in daily life.

  2. Prediabetes medication(s) to control blood sugar and/or increase insulin sensitivity.

  3. Screening and any necessary treatment for high blood pressure and high cholesterol.

Lifestyle Modification: The American Diabetes Association (ADA) recommends that people with prediabetes take part in a lifestyle intervention program. This can be a Centers for Disease Control and Prevention (CDC)-Recognized Diabetes Prevention Program (DPP) with a focus on weight loss and physical activity. Eating well and getting enough sleep are examples of other healthy choices that can lower blood sugar.

Prediabetes Medication: Medications can help lower blood sugar and reduce type 2 diabetes risk. Metformin is most common, but there are other types of prediabetes medications that are sometimes prescribed. You are more likely to have prediabetes medications if you are at higher risk for diabetes or if you have not been able to control your prediabetes with lifestyle modifications.

Blood Pressure and Cholesterol Screening: Prediabetes and diabetes are risk factors for high blood pressure and high cholesterol. In turn, those can lead to stroke, kidney disease, and heart disease. Your prediabetes treatment plan may include regular blood pressure measurements and blood tests for cholesterol levels. Prescription medications may be necessary to control your numbers.

 

Most Common Medications for Prediabetes


Classes of medications for patients with prediabetes include biguanides, thiazolidinediones, and α-Glucosidase Inhibitors.[2]  The best-known biguanide may be metformin, with Glucophage being the most common brand name. Metformin lowers glucose levels in a few ways.[3]

  • It increases insulin sensitivity in your liver to decrease your body’s glucose production.

  • It increases insulin sensitivity in skeletal muscle, which allows your muscle cells to remove glucose from the bloodstream to lower blood sugar levels.

  • It increases anaerobic respiration, which uses glucose, in your gastrointestinal cells.

  • It increases glucagon-like peptide-1 (GLP-1) and beta cell GLP-1 receptors, which lowers blood glucose.

Metformin also improves cholesterol levels and may help you control your weight. It only appears to aid in a few pounds of weight loss and benefits may only last for a few months to a year, but that is better than most other diabetes medications, which can lead to weight gain.

There are other possible medications for prediabetes. Thiazolidinediones increase insulin sensitivity. They also lower blood glucose by increasing glucose metabolism, but they do this by reducing fat metabolism, and weight gain can occur. Thiazolidinediones raise “good” HDL cholesterol, but there are concerns with heart health because they also raise “bad” LDL cholesterol. Rosiglitazone and pioglitazone are examples of thazolidinediones.

The α-Glucosidase inhibitors are medications that interfere with the digestive process. They inhibit the action of α-Glucosidase, which is an enzyme that breaks down carbohydrates, such as table sugar and starches in foods, into glucose. The result is that less glucose gets into your bloodstream after you eat. Side effects of these medications can include flatulence and diarrhea.

 

Weight Loss in Prediabetes


For most people who have prediabetes and are overweight or obese, weight loss can greatly reduce your risk of type 2 diabetes. Weight loss can be daunting if you take an all-or-nothing approach, but it’s not necessary to lose 100 lb. to benefit. Every pound you lose helps prevent or delay type 2 diabetes.

  • Losing 2.2 lb. (1 kg) lowers your risk of developing type 2 diabetes by 16%.

  • Losing 5 to 7 percent of body weight lowers your risk by over 50%. That is 8 to 11 lb. if you start at 160 lb., or 10 to 14 lb. if you currently weigh 200 lb.

  • Hitting a “healthy/normal” weight if you are currently overweight or obese further reduces your risk.

Weight loss only lowers diabetes risk for as long as you keep off the weight. That means that your prediabetes weight loss plan should consider your ability to stick to your plan for the long-term. Here are a few do’s and don’ts of a prediabetes weight loss plan.

 

DO

  • Increase consumption of vegetables and lean proteins to stay full on fewer calories.
  • Fewer staff needed per patient, so lower costs.
  • Choose water and low-calorie beverages instead of sugar-sweetened ones.
  • Make small changes, such as removing fat from meat, taking skin off chicken, and choosing whole instead of refined grains.
  • Limiting sugary foods and desserts.
  • Allow for special occasions, restaurant meals, and occasional treats.
  • Take smaller portions of restaurant meals and high-calorie or high-sugar foods.
  • Track your food intake.
  • Plan ahead so you always have a healthy option available.
  • Be active most days.

DON’T

  • Depend on bars, shakes, cookies, and other processed meal replacement diet products.
  • Expect to lose a lot of weight quickly. Lose it slowly to increase your chances of keeping it off.
  • Start a diet without asking your doctor.
  • Skip meals, especially breakfast.
  • Depend on fast food or processed ready-to-eat meals and snacks.
  • Try to over-exercise to compensate for any over-eating.
 

Metformin is one of the few diabetes medications that helps with weight loss; the other ones can lead to weight gain. Metformin’s weight loss effect is small – about 2 percent of body weight, or about 3 lb. if you weigh 150 lb. – but every little bit helps. Metformin can promote weight loss by reducing your appetite so you eat less. It can also increase your calorie burn during exercise[4]. It is important to understand that metformin only helps you lose weight if you follow a diet and exercise program for weight loss.

 

Exercise for Prediabetes


Exercise burns calories and helps with weight loss, but it does far more for prediabetes beyond its weight loss effects. Exercise increases insulin sensitivity in your muscles so they take up more glucose from the blood and lower blood sugar. The effects last for 24 hours, and that is great incentive to get active every day.

How much do you need, and what counts? Any increase you make in your daily activity levels can help. The general goal is 150 minutes per week of moderate to vigorous-intensity aerobic physical activity, plus 2 to 3 sessions per week of strength training, such as with weights, body weight, resistance bands, or medicine balls.

It is not hard to get started. Almost anything counts, whether you walk, jog, swim, cycle, garden, or dance. As little as 5 minutes at a time helps, too. Just be sure to ask your doctor before you get started, and choose exercises that are safe and comfortable for you.

 

Medication versus Weight Loss and Exercise for Prediabetes


What is better: a pill or a lifestyle change? Can either of them really work, or are you going to get diabetes regardless of what you do? Researchers asked those very questions and set out to answer them in a clinical trial that compared metformin to lifestyle changes to a control group among participants with prediabetes. They made some important discoveries.[5]

  • You can prevent diabetes! Most cases of diabetes are largely preventable if you treat your prediabetes properly.

  • Metformin lowered risk of diabetes by 31% compared to the control group.

  • Lifestyle changes lowered risk of diabetes by 58% compared to the control group.

This study and similar ones have consistently shown that lifestyle changes, such as losing weight and getting active, are the most effective strategies for lowering blood sugar and preventing diabetes for most people. Most people who are diagnosed with prediabetes are likely to receive a recommendation to make healthier choices before their doctors decide to prescribe medications.

You are more likely to be prescribed metformin for prediabetes if your body mass index (BMI) is over 35, if you had gestational diabetes (diabetes that came during pregnancy and then left), or you are younger than 60 years old. Your doctor may also ask you to consider metformin if lifestyle changes have not worked to bring down your blood sugar levels.

 
Medications Weight Loss and Exercise
Recommended for
High-risk patients
Nearly all patients
Effect on Diabetes Risk
31% lower type 2 diabetes risk over 2.8 years
58% lower type 2 diabetes risk over 2.8 years (Diabetes Prevention Program)
Effect on Blood Sugar
Lowers it
Lowers it
Side Effects
Gastrointestinal discomfort, hypoglycemia, possible weight gain
Negative effects are unlikely. Positive side effects can include better energy, mood, sleep, and focus.
Safety
Possible complications such as liver disease and heart disease
Safe if done cautiously
Other Health Effects
Risk of vitamin B12 deficiency
Lowered risk for heart disease, certain cancers, Alzheimer’s disease, stroke, depression, and more
 

Healthy Lifestyle Changes: Diabetes Prevention Program


The lifestyle intervention in that landmark clinical trial was a Diabetes Prevention Program (DPP). The DPP focuses on hitting weight loss of 5 to 7% of starting weight and achieving 150 minutes per week of physical activity. It is a year-long program that includes 16 lessons in the first 6 months and another 6 lessons in the final 6 months.

There are many DPP providers nation-wide, and many healthcare providers offer them as a benefit. Lark DPP is recognized by the Centers for Disease Control and Prevention (CDC) as a fully online program. You can access it at your convenience with no need to travel to in-person meetings on a specific schedule. Lark’s program is personalized and designed to help you not only with weight loss and physical activity, but also with healthy eating, stress management, better sleep, and motivation.

 

Healthy Eating and Other Natural Remedies for Prediabetes


Losing weight and getting active are the two most effective strategies for lower blood sugar and diabetes risk, but there are other natural prediabetes remedies. Healthy eating, aside from whether you lose weight, can lower blood sugar. So can managing stress, getting adequate sleep, and certain dietary supplements.

Healthy eating for prediabetes means eating more of the foods that lower blood sugar and insulin resistance, and less of the ones that increase those measures. In general, look for fresh foods, fiber, healthy fats, and lean proteins. When you can, limit sugary foods, refined starches, fast foods, fried foods, and highly processed foods.

 

Choose

  • Vegetables
  • Beans, lentils, and other legumes
  • Whole grains
  • Fish, eggs, chicken, and other proteins
  • Low-fat yogurt and cheese
  • Fresh fruit
  • Nuts
  • Avocados

Limit

  • Candy, desserts, jelly
  • Sugar-sweetened beverages
  • White bread and other refined grain products, such as white rice and pasta
  • French fries, fried chicken, doughnuts, chips, and other fried foods
  • Red meat, bacon, and processed meat

Dietary and nutritional supplements could help lower blood sugar or raise insulin sensitivity, but research is ongoing. Ask your doctor before taking any supplements, since they can have side effects or may not be effective. Cinnamon, chromium, Gymnema sylvestre, and bitter melon are a few of the more common nutritional supplements for blood sugar.

If you have prediabetes, it is worth taking steps to treat it because you can greatly lower your risk for type 2 diabetes. Medications for prediabetes are a strategy that can help, but they are more effective with lifestyle treatments, and may not even be necessary. Talk to your doctor about your options, and see if a DPP such as Lark can help you turn healthy choices into habits that can change your life.

 


 Reference

  1. 5. Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes—2018. American Diabetes Association. Diabetes Care 2018 Jan; 41(Supplement 1): S51-S54. http://care.diabetesjournals.org/content/41/Supplement_1/S51

  2.  Bansal N. Prediabetes diagnosis and treatment: A review. World J Diabetes. 2015;6(2):296-303. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360422/

  3.  Hostalek U, Gwilt M, Hildemann S. Therapeutic Use of Metformin in Prediabetes and Diabetes Prevention. Drugs. 2015;75(10):1071-94. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498279/

  4.  Diabetes Prevention Program Research Group. Long-term safety, tolerability, and weight loss associated with metformin in the Diabetes Prevention Program Outcomes Study. Diabetes Care. 2012;35(4):731-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3308305/

  5.  Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. N Engl J Med 2002; 346:393-403. DOI: 10.1056/NEJMoa012512. https://www.nejm.org/doi/full/10.1056/NEJMoa012512