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The best way to prevent type 2 diabetes is to avoid gaining weight. Overweight people are four times more likely to develop type 2 diabetes than those who maintain normal body weight. Overweight diabetic patients can often reduce their need for drugs and control their blood sugar by weight loss.

The glucose tolerance factor (GTF) is a naturally occuring compound that helps regulate blood sugar. It is found in rich amounts in brewer's yeast. Chromium is an essential component of GTF, and diets deficient in chromium produce glucose intolerance (see Fig. 5.11 ).1-3 Diabetics who excrete glucose in their urine have increased urinary loss of minerals (such as magnesium, zinc, and chro mium). Deficiencies of these important minerals further impair the ability to control blood glucose. Therefore, diabetic diets should emphasize foods rich in these minerals.

The best diet for most diabetics is one low in refined sugars and high in complex carbohydrates and fiber (which slow absorption of dietary sugars, reducing peaks in blood glucose).4 Foods such as vegetables, fruits, legumes, and whole grains should be emphasized, and adopting a mainly vegetarian diet can be beneficial. To reduce elevated blood lipids and lower risk of cardiovascular disease, saturated fat intake should be minimized and replaced by high-quality plant oils that supply essential PUFAs.

Low plasma carotene and vitamin C

Low carotene, normal vitamin C

Normal carotene, low vitamin C

Normal plasma carotene and vitamin C

RR of stroke mortality

Fig. 5.11: Chromium supplements in diabetes. 180 subjects with type 2 diabetes were given either 1 mg chromium, 200 |ig chromium, or placebo daily for 4 months. In the group receiving chromium there were significant decreases in HgbAIC, serum cholesterol, and fasting glucose and insulin values, compared with placebo. (Adapted from Anderson RA, et al. Diabetes. 1997; 46:1786)

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