Your body changes most of the food you eat into glucose (a form of sugar). Insulin is a hormone produced by the pancreas that allows glucose to enter all the cells of your body and be used as energy.

Diabetes is a disease that occurs when a person's body doesn't make enough insulin or can't use insulin properly. When you have diabetes, the sugar builds up in your blood instead of moving into the cells. Too much sugar in the blood can lead to serious health problems, including heart disease and damage to the nerves and kidneys.

There are 2 types of diabetes. Type 1 diabetes occurs when the body doesn't produce any insulin. In type 2 diabetes, the body either doesn't produce enough insulin or the cells ignore the insulin. Between 90-95% of people who are diagnosed with diabetes have type 2 diabetes.

What you eat is closely connected to the amount of sugar in your blood. The right food choices will help you control your blood sugar level.

There isn't one specific "diabetes diet." Your doctor will probably suggest that you work with a registered dietitian to design a meal plan. A meal plan is a guide that tells you what kinds of food to eat at meals and for snacks. The plan also tells you how much food to have. For most people who have diabetes (and those without, too), a healthy diet consists of 40% to 60% of calories from carbohydrates, 20% from protein and 30% or less from fat. It should be low in cholesterol, low in salt and low in added sugar.

Yes. In recent years, doctors have learned that eating some sugar doesn't usually cause problems for most people who have diabetes--as long as it is part of a balanced diet. Just be careful about how much sugar you eat and try not to add sugar to foods.

In general, at each meal you may have 2 to 5 choices (or up to 60 grams) of carbohydrates, 1 choice of protein and a certain amount of fat. Talk to your doctor or dietitian for specific advice.

Carbohydrates. Carbohydrates are found in fruits, vegetables, beans, dairy foods and starchy foods such as breads. Try to have fresh fruits rather than canned fruits (unless they are packed in water or their own juice), fruit juices or dried fruit. You may eat fresh vegetables and frozen or canned vegetables. Condiments such as nonfat mayonnaise, ketchup and mustard are also carbohydrates.

Protein. Protein is found in meat, poultry, fish, dairy products, beans and some vegetables. Try to eat poultry and fish more often than red meat. Don't eat poultry skin, and trim extra fat from all meat. Choose nonfat or reduced-fat options when you eat dairy, such as cheeses and yogurts.

Fat. Butter, margarine, lard and oils add fat to food. Fat is also in many dairy and meat products. Try to avoid fried foods, mayonnaise-based dishes (unless they are made with fat-free mayo), egg yolks, bacon and high-fat dairy products. Your doctor or dietitian will tell you how many grams of fat you may eat each day. When eating fat-free versions of foods (such as mayonnaise and butter), check the label to see how many grams of carbohydrates they contain. Keep in mind that these products often have added sugar.

The exchange list (see the sample below) is a tool to help you plan healthy meals and snacks. To add variety to your diet, you can substitute certain foods for other foods in the same group. Some examples are listed at the right.

People who have diabetes may have times when their blood sugar level is too low. Low blood sugar is called hypoglycemia. Signs of hypoglycemia include the following:

• Feeling very tired
• Frequent yawning
• Being unable to speak or think clearly
• Loss of muscle coordination
• Sweating
• Twitching
• Seizures
• Suddenly feeling like you're going to pass out
• Becoming very pale
• Loss of consciousness

People who have diabetes should carry at least 15 grams of a fast-acting carbohydrate with them at all times in case of hypoglycemia. The following are examples of quick sources of energy that can relieve the symptoms:

• Nondiet soda- ½ to ¾ cup
• Fruit juice- ½ cup
• Fruit- 2 tablespoons of raisins
• Milk- 1 cup
• Candy- 5 Lifesavers
• Glucose tablets- 3 tablets (5 grams each)

If you don't feel better 15 minutes after having a fast-acting carbohydrate, or if monitoring shows that your blood sugar level is still too low, have another 15 grams of a fast-acting carbohydrate.

High blood sugar (also called hyperglycemia) can occur even if you are eating properly and taking your insulin correctly. Eating too much food at a meal, illness, hormonal changes and stress can affect your blood sugar.

Symptoms of hyperglycemia include:

• Frequent urination
• Extreme thirst
• Blurry vision
• Feeling very tired

If your blood sugar level goes higher than it should, you may need to take an extra dose of rapid-acting insulin to return your blood sugar to the normal range. Your doctor can tell you how much insulin you need to take to lower your blood sugar level.

1. This handout was developed by the American Academy of Family Physicians in cooperation with the American Diabetes Association.