Hesperian Health Guides

Staying Healthy with Diabetes

In this chapter:

Prevent and manage diabetes by eating healthy foods, being active and moving your body, and reducing stress. These things can help you and your family stay healthy even if you do not have diabetes.


What to do when you are thirsty: NO! YES!
 a bottle of Coca Cola with the word "NO!".
 a water jug with the word "YES!"

A sugary drink is like poison for your body — it can cause diabetes. Water keeps your body well.


Eat healthy foods

The foods our ancestors ate did not cause diabetes. If possible, eat more food you or others grow, gather, raise, or hunt. Avoid packaged and processed foods and other junk foods and drinks. They are harmful and a waste of money. See more on how to eat well with little money. Make a list of everything the family eats in a week. Go over the list with a health worker to talk about what foods help most or which ones cause most problems, and then talk with your family about how to make changes.

a man thinking of healthy food and talking.
I used to mostly eat fried food and fill up on rice. Now I eat many more vegetables.

Replace starchy foods with vegetables

Starchy foods such as rice, maize, wheat, yam, potatoes, plantain, and cassava are often the main foods people eat. But starchy foods turn into sugar in our bodies. A person with diabetes might be able to handle small amounts of starchy foods, but not larger amounts. Replacing some starchy foods with vegetables and leafy greens adds vitamins and nutrients.

The harder your body works, the more starchy foods you can eat without them causing harm to your body. A person who works in the fields all day can eat more than one who sits or stands still most of the day.

a woman sitting at a sewing machine.
a woman walking uphill carrying a hoe.
This person has a factory job and must sit all day. She should eat only a small amount of starchy foods, for example: 2 tortillas OR 1 cup of beans OR 2 small pieces of fruit OR 1 cup of rice. She can eat more fresh vegetables or protein foods instead. This person works outside all day and walks a lot, and starchy food in her meals, along with vegetables and protein foods, helps her have enough energy.

Whole grains are better

Grains are starchy foods that we need for energy. Whole grains with the germ and bran layers still attached, such as brown rice and whole wheat, are healthier. Choose flours made from whole grains.

White rice and flours are processed in factories to remove the nutritious germ and bran so they will last longer on store shelves without spoiling. Without the healthy bran and germ, the processed grains turn into sugar in the body too quickly and can make blood sugar rise to dangerous levels. Try not to eat processed grains.

Eat foods with fiber

Fiber is the tough parts of plants, such as leaves, stems, roots, and sprouts. Fiber helps slow down how fast sugar gets absorbed into the blood. This helps to manage blood sugar, protect the body, and improve digestion. Foods with fiber include vegetables, beans and other legumes, whole grains, fruits, nuts, and seeds.

To get more fiber:

  • After pounding and boiling, it is safe to eat the leaves of cassava (yuca) plants. Although people are used to mainly eating the roots of cassava and taro, the leaves of these plants have a lot of fiber.
  • Make flour from beans like soy and fava.
  • Eat green vegetables as often as you can.
  • Eat brown, red, or black rice or whole grains.

Eat protein foods

Combined with a good mixture of other healthy foods, protein foods such as fish, eggs, meat, nuts, seeds, tofu, and tempeh do not raise blood sugar and are good for diabetes.

Eat less packaged food and limit sweet drinks and alcohol

Foods in packages or cans can be tempting. They are easy to store and prepare, and can taste good. But packaged foods usually have too much sugar, salt, and unhealthy ingredients. If you are tired, hungry, or highly stressed, packaged food can be hard to resist. Like drugs or cigarettes, these foods make you feel good for a little while. Then the effect of the sugar passes and you feel worse than before. Everyone in the family will benefit from not eating these foods or at least eating less of them. Many processed foods use palm oil because it is a cheap ingredient but it is less healthy than other vegetable oils.

a woman turning away from food at the store.
Food companies know how to sell you their products and will even lie and say food is good for you when it isn’t. Their goal is to make money, not to keep you healthy.

Sweetened soft drinks are especially bad for you. They contain a large amount of sugar and raise your blood sugar levels very fast. Even fruit juices contain too much sugar. Drink water or tea without sugar instead. You can add mint leaves or lemon to your water or tea for more flavor. You can get used to less sugar in your tea or coffee by using a little less each week. Although all fruits have sugar, eating whole fruit instead of fruit juice is better for your diabetes because the fiber in fruit is good for you. Drinks with alcohol also turn into sugar in the body, so avoiding or limiting alcohol is best.

a woman talking.
Changing many habits at once is difficult. As a health worker, I help people pick one thing to work on at a time, like less sugary drinks or stopping smoking. Even one thing can make a big difference.

How often to eat

Skipping a meal can lead to low blood sugar or make you eat too much at the next meal. Having a very large meal can raise your blood sugar. Eating the same amount of food 3 times a day or having smaller meals 4 times a day can help you keep your blood sugar more steady.

Get more physical activity

NWTND Diab Page 16-2.png

Physical activity is an excellent way to keep blood sugar levels down. Doing at least some movement every day, and not just once in a while, is important. To treat and prevent diabetes, try fast walking, dancing, sports, or any exercise that makes your heart beat faster for 30 minutes or more. The more activity, the better.

In places where daily work is physically hard, you probably get enough physical activity. But if you are sitting or standing in one place all day, you may need to think of ways to move more.

Many people find it easier to be active with others instead of alone. Being active is also easier when it is fun, like walking with friends, playing sports, or dancing.

NWTND Diab Page 16-3.png

If you take a medicine such as a sulfonylurea or insulin for your diabetes, exercising may make your blood sugar levels drop too low. To prevent this, eat food with protein and healthy fats (like an egg or fish) at the meal before you exercise. If you know your blood sugar is dropping during or after exercising, you can drink fruit juice or eat a piece of candy to reverse this. That is why carrying these snacks with you is a good idea.

For signs of blood sugar levels dropping too low, see Diabetic Emergencies.

Reduce stress

a group of people talking.

Stress is the feeling of having more problems than you can solve. These problems can be about money, family, housing, safety, racism, or other dangers. Constantly feeling stress causes several physical problems, including raising blood sugar levels.

Talking about what is worrying you with a trusted friend, family member, or support group can help reduce stress, especially when people find ways to help each other. Do not be afraid to ask for help.

a man and a woman exercising.
Meditation, prayer, or exercise such as tai chi and yoga are also good ways to reduce stress.

Building self-confidence also reduces stress. We often live in fear because others are more powerful than we are. We may feel weak because our health is bad or we do not have enough money. But we can learn to build upon our own strengths. Some problems may be much bigger than something we can fix by ourselves, and for them we need to work with others. But there is still much we can do by ourselves. Make plans to try something new to improve your health, like walking more or trying a new food. When you succeed, you will build confidence in your ability to do more.


This page was updated:05 Jan 2024