Diabetes is a chronic disease that effects almost sixteen million Americans. This disease results in the body being unable to produce enough insulin or to be unable to use the insulin that is produced (Lorig, 1994). Diabetes is divided into tow main types, type 1 and type 2, with the exact cause for each being unknown. Type 1 diabetes, which usually begins in childhood, is thought to be an autoimmune disease that destroys the ability of the pancreas to produce insulin (Lorig, 1994). Type 2 diabetes is a complex disease characterized by elevated blood glucose levels (Kendall & Bergenstal, 2001). Type 2 accounts for approximately 90% of diabetes cases, and its symptoms include lowered insulin secretion and an increased resistance to the action of insulin, causing hyperglycemia and other metabolic disturbances (Umpierrez & Kitabchi, 2001). This type of diabetes is most prevalent among those who are overweight. It is believed that because of excess body fat, the body becomes resistant to the insulin produced and therefore is ineffective in moving glucose from the blood stream to the body's cells (Lorig, 1994). Type 2 diabetes often goes undiagnosed for several years because of its undetectable onset and slow progression (Kazi & Blonde, 2001).
The management of type 2 diabetes revolves around lowering blood glucose levels to prevent the progression of long term complications as well as to prevent the occurrence of cardiovascular disease (Van den Arend, Stolk, Krans, Grobbee, & Schrijvers, 2000). There are two main ways to lower blood glucose levels: diet therapy and medical treatments. It is also important to change unhealthy habits such as smoking. Diet therapy is used in order to help those with diabetes to use proper nutrition and exercise to improve metabolic control (Umpierrez & Kitabchi, 2001). The aim of dietary management is to eat foods high in fiber and low in fat, in the correct quantities and at the right time in order to maintain healthy blood glucose levels (Lorig, 1994).