Type 2 diabetes is a growing epidemic in the United States and around the world. One-third of U.S. adults are projected to have diabetes by 2050. Its numbers are exploding in middle- and low-income countries as the nutrient-poor Western diet spreads. It’s also alarming that children and young people are increasingly being diagnosed with type 2 diabetes.

   Type 2 diabetes is a chronic disease that affects the way the body metabolizes sugar. It is characterized by a progressive loss of sensitivity to insulin, the pancreatic hormone that regulates blood sugar levels. First the body will try to produce more insulin but in the long run will not be able to produce enough to maintain blood sugar levels, resulting in high blood sugar or hyperglycemia.

   It has been debated and explored for decades to try and find out why a person develops type 2 diabetes. Dietary fats have been blamed as has obesity. It is now clear that type 2 diabetes can occur in the absence of obesity. There is not any single factor to blame. The disease is a process driven by a complex network of diet and lifestyle factors, oxidative stress and genetics.

   The Western diet, full of refined carbohydrates, fructose and industrial seed oils, is an established risk factor for type 2 diabetes. Wherever the Western diet goes, type 2 diabetes follows.

   The conventional medicine approach to type 2 diabetes is fraught with problems. Practitioners wait until people have full-blown type 2 diabetes before initiating treatment. Little is done to alter the course of the disease in the prediabetic stage when the body is more responsive to diet and lifestyle changes. The drugs used to treat type 2 diabetes have serious side effects, and the conventional diet guidelines for diabetics are outdated. Dietary approaches may actually make the condition worse.

   The functional medicine approach emphasizes prevention and treatment through diet and lifestyle changes. It is well established that a high-starch, low-fiber diet increases the risk of type 2 diabetes. A growing body of scientific research indicates that low-carbohydrate diets are superior to high-carbohydrate diets for the treatment of type 2 diabetes.

   In addition to adjusting carb quantity, you also need to change the quality of the carbs you consume. Instead of refined carbohydrates like pasta and bread, eat moderate amounts of starchy tubers (sweet potatoes, cassava, beets and rutabaga), plantains, whole fruit and moderate amounts of full-fat dairy, if tolerated.

   To better understand which carbohydrate-containing foods your body tolerates best and which ones cause unhealthy blood sugar swings, you’ll need to test your blood sugar at home. You will need to buy a glucometer such as the ReliOn Prime. You will also need to purchase glucose test strips. Then follow these seven steps.

   First, test your blood sugar first thing in the morning after fasting for at least 12 hours. The measurement you obtain is your fasting blood sugar level. Second, test your blood sugar again just before lunch. Third, eat your typical lunch and test your blood sugar one hour, two hours and three hours after. Do not eat anything in between. Fourth, record your blood sugar results, along with what you ate. Fifth, repeat this practice the following day. The blood sugar measurements you gather will tell you how the foods you usually eat influence your blood sugar levels. Sixth, on day three follow steps one and two but on step three, instead of your typical lunch, consume 60 to 70 grams of fast-acting carbohydrates (boiled potato or cooked white rice) and avoid any fat or protein during this test. Seventh, after your carbohydrate-rich meal on day three, record your blood sugar results.

   The goal is to make sure your blood glucose doesn’t consistently rise higher than 140 ng/ml an hour after a meal but does steadily drop to 120 ng/ml two hours after eating and returns to baseline after three hours.

   Many are experimenting with the ketogenic diet for the treatment of type 2 diabetes. This is a very low carb, moderate protein, high fat diet that causes the body to rely on fatty acids and ketones for fuel, rather than glucose. Studies are showing this can be helpful.

   Getting rid of gluten is also something to think about. Studies have shown that gluten may contribute to the development and progression of diabetes. Gluten can lead to a leaky gut.

   Protein is a powerful tool for managing type 2 diabetes. Increasing protein intake improves blood sugar control and satiety (the feeling of fullness) and preserves lean body mass in diabetics.

   There are nine functional foods that can help diabetes. They are: Blueberries, cacao (dark chocolate), coffee and green tea, fermented foods (yogurt, kefir and kimchi), nuts and seeds (almonds, walnuts and chia seeds), olive oil, resistant starch, seafood (fish and shellfish) and spices (cinnamon, garlic and curcumin).

   There are also five nutrients and nutraceuticals that are good for type 2 diabetes if you get enough of them. They are: Vitamin D, magnesium, B12 and folate, berberine and alpha-lipoic acid.

   Some other ways to help prevent type 2 diabetes are the following.

   Improve Your Gut Health: Recent studies have identified a previously unrecognized effect of metformin on the gut microbiota. This indicates the gut microbiota does play a pivotal role in type 2 diabetes.

   Exercise: A sedentary lifestyle is a significant risk factor for type 2 diabetes, so exercise should be a central part of any treatment plan. Walking just 30 minutes a day can reduce the risk of type 2 diabetes by 50 percent.

   Sleep: Research indicates the lack of sleep is related to diabetes. You should aim for seven to eight hours of sleep every night.

   Normalize Your Circadian Rhythm: Your circadian rhythm is a set of biochemical processes that occur in your body on an approximately 24-hour schedule and regulate many aspects of your behavior and physiology. Jet lag, an erratic eating schedule and blue light exposure at night can all throw this off.

   Reduce Your Stress Levels: Chronic stress is a significant risk factor for type 2 diabetes. Meditation, yoga and breathing exercises have all been found to help.

   Avoid Environmental Toxins: These have been proven to contribute to diabetes, so it makes sense to reduce your exposure.