Living well with diabetes means putting in the hard work of making lifestyle changes, including choosing and sticking with the best food for managing the condition. Getting there can be a major accomplishment, but another obstacle, however well-intentioned, could come along: the food pusher.

Food pushers probably have the best of intentions, even as they're offering you another serving of food or a selection of sweets. But there's good reason to resist foods that aren't part of your healthy diet.

In a meta-analysis of 16 studies published in the journal Metabolism, making lifestyle changes that included eating healthy and exercising helped people with type 2 diabetes lose weight and improve blood sugar, cholesterol and blood pressure levels. As a result, they significantly lowered their risk of cardiovascular disease, a complication of diabetes.

What to Say When Faced with A Food Pusher

"No, thank you" can be difficult to say to family, friends, and co-workers. But that doesn't mean you have to give in to their demands.

Remember, your health depends on you asserting yourself! The next time food pushers are nearby, breathe easy knowing you have these tips in your back pocket.

• Say no, but give a compliment. Tell your friend her quiche looks delicious, but you aren't hungry.
• Explain that you're working on healthy eating. If someone is giving you a hard time about your food choices, say, "I'm following my dietitian's advice."
• Steer clear of work treats in the break room. If tempting, unhealthy food is in the break room and eating would impact your blood sugar levels, take a walk to another part of the office to fill your water cup and have a healthy snack at your desk.
• Bring your own healthy dish. A family gathering will be less stressful if you know there's good, diet-friendly food to indulge in. When someone suggests a dish that isn't good for you, you'll have something else to point to. Also, don't arrive to a celebration starving — have a healthy snack or Glucerna bar to tide you over.

• Suggest a walk instead of dessert. Your friend may suggest food only as an excuse to spend time with you. Ask to go for a walk instead.

• Control your portions. Compromise by taking a small slice of lasagna or another family favorite, and then fill the rest of your plate with vegetables.
• Fill your glass with club soda and lime. You still can join friends for a drink, just don't overdo it. Switching to club soda and lime passes the sight-test as a beverage without disrupting your blood sugar level or the good time you're having.
• When the time is right, offer brief reasoning. Take a moment to explain why passing on your aunt's famous chocolate cake helps keep your blood sugar in your targeted range, and that means you'll live a longer, healthier life with diabetes.