20.8 million people in the United States are living with diabetes, and almost 20% of these people don't even know they are suffering from blood sugar and insulin problems. According to the American Diabetes Association, approximately 4,110 people are diagnosed with diabetes each day. With the rise in obesity and poor diets across America, the risk of diabetes continues to run high, and can have a significant impact on both sufferers and family members.

Not only can diabetes make it difficult to manage meals and eating day-to-day, but it can also lead to chronic health conditions, various illnesses, and even death. Diabetes is the fifth-deadliest disease in the United States, and many sufferers experience a number of health conditions throughout their lifetime. Common problems associated with diabetes include blindness, nervous system damage, pregnancy complications, and heart disease.

Managing diabetes with a healthy diet, regular exercise, and a commitment to a healthy lifestyle are just a part of the process.

Diabetes is a condition where the body does not break down sugar from food during digestion. This process is essential for providing the body with energy; in a healthy person, food molecules are broken down into glucose which then circulates in the blood and fuels the cells. Insulin in the body moves the glucose into the cells, but insulin levels are either too low or non-existent in people with Type 1 diabetes. People with Type 2 diabetes can produce insulin but cells simply do not respond to it; the result is usually blood glucose levels that are too high.

Diabetes can be managed and controlled with a healthy lifestyle and well-balanced diet, and many diabetics follow a variation of the USDA Food Pyramid. The Diabetes Food Pyramid identified by the American Diabetes Association offers the following eating plan:

Grains and Starches: 6-11 servings per day

These include bread, cereal, pasta, and rice. Starchy vegetables such as potatoes and corn are included in the diabetic diet, and these provide a healthy source of carbogydrates. Carbohydrates are essential for energy and need to be the basis of the diabetic diet.

Vegetables: 3-5 servings per day

Green, leafy vegetables are most sufficient for diabetics and the best choices include spinach, chicory, Siwss chard, broccoli, cauliflower, carrots, and tomatoes. Vegetables can be eaten raw or cooked, and fresh is better than canned or processed varieties.

Fruit: 2-4 servings per day

Fruit can be high in sugar, so diabetics do need to be careful about the type and quantity of fruit consumed. Fruit contains minerals, vitamins, and plenty of natural fiber; these are all essential for a balanced diet and at least two different types of fruit per day can keep blood sugar levels in check. Blackberries, apricots, pears, peaches, and bananas are great choices for diabetics. Fresh is always better than canned fruit, and canned fruit options should not contain extra sugar. Some canned fruit brands now offer fruit sweetened with Splenda, a sugar substitute.

Milk: 2-3 servings per day

Milk and dairy products provide essential nutrient including calcium and protein. Protein is important for strength and can also help curb hunger. Low-fat dairy products such as yogurt, low-fat cheese, and skim milk are important for a balanced diet.

Meat: 4-6 oz. per day

Meat is another valuable source of protein, and can provide other vitamins and minerals that are essential for optimum health. Lean meats are better than fattier cuts of meat since they do not contain saturated fat. Diabetics who are vegetarian can substitute tofu, peanut butter, and cottage cheese for various meats so that they still get plenty of protein in their diet.

Fats, Desserts, and Alcohol: occasional

High fat foods aren't healthy for anyone, but diabetics in particular need to steer clear of high-fat and high-sugar foods. Since sugary foods and treats are limited, finding low-sugar and sugar-free treats offers more variety and flexibility in the diet.

The healthy eating plan for diabetics includes a variety of fresh fruits, vegetables, dairy products, and does allow for dessert. Dessert is often considered to be ‘off limits' for many people with diabetes, but there are ways to create tasty and satisfying treats that do not contain excess sugar.

Nutrasweet (aspartame) has long been used by diabetics as an altenrative to sugar, but research has revealed many harmful side effects of aspartame and deemed it unsafe for most people. Splenda has also come under scrutiny by many scientists, researchers, and health advocates, but no long-term studies are available to report on the side effects and potential dangers of the artificial sweetener.

Still, there are alternatives for lowering the sugar content of most foods. For cooking and baking, a few healthier sugar substitutes include:

• Organic applesauce

• Apple butter

• Plum butter

• Stevia powder

• Mashed bananas

• Xylitol, a sweetener that does not cause blood sugar imbalances

For day-to-day use, sugar substitutes include:

• Whey Low

• Splenda

• Single blossom honey

• Fructose, a natural source of low-glycemic sugar

• Sugar Twin Brown Sugar substitute

Many restaurants recognize the special menu requirements of diabetics, and offer a range of sugar-free or low-sugar options. Japanese and Asian food can easily be prepared with less salt and steamed vegetables, giving you a healthy choice for lunch and dinner-and one that doesn't contain extra sauces loaded with fats and sugars.

Don't forget that you can make special requests for your meal so that you have more control over the ingredients. Sauces and salad dressings ordered on the side make it easier to exercise some portion control, and you can order a lemon juice and oil, or vinaigrette substitute for most salads. Requesting that foods be grilled or prepared with olive or canola oil can also make your meal much more healthy!

A few more tips:

• Order larger portions to share, and cut back on extra calories with ease
• Call the restaurant ahead to make special requests, and find out if they have a low-carb, gluten-free, or sugar-free menu available.

• Choose steamed and lightly sauteed vegetable dishes as often as possible
• Request all sauces and condiments on the side
• Bring your own miniature bottle of low-sugar ketchup if necessary
• Eat high quality, lean protein to balance out a high-carb meal if you have limited choices. Protein slows down the release of sugar in the blood
• Don't be afraid to ask the server about low sugar or sugar-free options
• Choose thin-crust pizza to lower the carbohydrates in your dish
• Don't hesitate to bring along your own sweetener or fat-free spreads

• Subsittue fresh vegetables or fruit for other sides whenever possible

Restaurant Choices for Diabetics

From sugar-free salad dressings to low-sugar desserts, here are just a few popular chain restaurants that make it easy to relax and enjoy eating out again!

Perkin's Restaurant & Bakery: You can enjoy a muffin or two with the sugar-free and low-sugar Blueberry muffins in the pastry case! Perkin's also offers sugar-free syrups for pancakes.

IHOP: The International House of Pancakes serves Cary's sugar free syrup so you can still enjoy our favorite waffles and pancakes

Old Country Buffet: Choose from reduced sugar pudding, pies, and Range Cookies at the dessert station. Be warned that the nonfat frozen vanilla dessert is made with Nutrasweet Starbucks: Choose sugar-free syrups with your favorite drinks and enjoy a variety of flavors with that espresso or coffee!

Souplantation & Sweet Tomatoes: this healthy buffet features sugar-free desserts and jello. You also have plenty of great low-fat salads and soups to choose from, and eating your salad without dressing, or just a splash of lemon juice or balsamic vinegar is another option.

Carrabas Italian: this Italian chain restaurant features a gluten free menu that makes it easier to pick low-glycemic foods and entrees. Choose from pizzas, sandwiches, and a variety of tasty entrees