When bariatric surgery isn’t an option, experts say, there are more moderate dietary techniques that can help put diabetics on track for their ideal diet.
Some involve meal planning. Ghada Haddad, head of endocrinology at Cooper University Hospital, suggests the "Idaho plate" method: Fill half a plate with nonstarchy vegetables, a quarter with a starch, and the remainder with a piece of chicken or fish.
"People have the misconception that they have to eat a very low-carb diet," Haddad said. "Diabetics should be able to eat carbs, but in moderation."
To combat morning blood-sugar spikes - a result of the liver's overnight sugar production - dietitian Cheryl Marco, director of education at the Jefferson Weight Management Program, suggests a breakfast that combines a carbohydrate, such as toast, with a protein.
And instead of assuming that blood sugar will spike at the first sign of sweets, diabetics should determine their tolerance to different foods by testing their blood-sugar after eating, she said.
"Most people are going to find that their blood sugar does not go nearly as high with a dessert as it would, say, with a soft pretzel," she said.
Anthony Fabricatore, assistant professor of psychology at the University of Pennsylvania's School of Medicine, said studies show that a low-glycemic-load diet, which favors nonstarchy vegetables, whole grains, healthy fats and lean proteins over starches and sugars, can help control blood sugar.
Whatever the method, Fabricatore said, diabetics should follow a low-calorie diet and keep a food record. "The trick is finding something that you can tolerate and focusing on the calorie intake," he said. "The best diet to follow is the one that you can follow the best."