Change the way you eat. Give up your favorite foods. Reduce your portion sizes. That's the typical advice the newly diagnosed diabetic hears right from the start. Yet even though people with diabetes understand that the best way to prevent complications and to avoid going on insulin is to eat healthy, putting the plan into action can be daunting.

One reason so many diabetics don't follow the meal plan outlined by their health care provider is simply because food has such a strong psychological and cultural component, says Kellie Rodriguez, director of patient education for the Diabetes Research Institute at the University of Miami.

"We constantly reward ourselves with food or celebrate with food," she says. "Many people aren't even aware that they are doing this. They're unaware of the food options that they choose."

For a fairly long period of time after getting a diagnosis, people with diabetes typically don't have the kind of painful or debilitating symptoms that would likely motivate them to change their diet, says Dr. Rose Gubitosi-Klug, pediatric endocrinologist at University Hospitals in Cleveland, Ohio. That's why it's called the silent killer, she explains. "But 10 years after diagnosis, if they are in poor control, that's when people develop health problems," she says. "There can be changes in their kidney function, pains in their legs from nerve damage, problems with vision."

By the time a diabetic has a scary episode of bleeding in the eye, which impairs vision, or needs to start renal dialysis for kidney problems, it's a bit late to start thinking about eating healthy, Gubitosi-Klug says. Usually, she says, eye problems present as the first complication while cardiovascular complications, such as a heart attack, occur later in life, she explains.  

Adults who may have had diabetes for five or six years before it was even diagnosed could already have health problems like hypertension and high blood glucose. "Their bodies could already be in the early damage stages since the diabetes wasn't diagnosed promptly," says Dr. Gubitosi-Klug. "These people may not follow up with their physician routinely, and so they may not be learning about how they should eat."  

Fit a Healthy Diet into Your Life

Cook meals at home, says Rodriguez. When you eat out, portions are supersized and you eat more. "There is less time for home cooked meals today because it's hard to get out of work in time to get home and make a healthy dinner," she explains.  Planning ahead, both in terms of shopping for and cooking the food, ensure that you and the family will eat healthier.   

Be supportive of the family member with diabetes, says Dr. Gubitosi-Klug. If you let the siblings have regular soda and the newly diabetic child can't have these, that can be a problem," Dr. Gubitosi-Klug says. "It's better when the whole family adopts the program of eating."

Read the labels on food products, says Dr. Gubitosi-Klug, and you may be surprised at what you learn. For instance, the front of a bottle of oil may say "light" but in fact this refers to the color of the oil, not the calorie content.

Don't forget the other half of the equation, which is exercise. Resolve to adopt an active lifestyle, says Dr. Gubitosi-Klug. Find some form of activity you enjoy so the half hour a day you spend on it is one you look forward to. When you like exercise, you're less likely to be a quitter.

Limit TV watching and video game time, sedentary activities that are about as far from cardiovascular activities that you can get. And don't rely on school gym classes to be your child's workout: these periods tend to be shorter and shorter these days, warns Dr. Gubitosi-Klug.