The two most common forms of diabetes are type 1 and type 2. Currently, there is no way to delay or prevent type 1 diabetes. However, research has shown that type 2 diabetes can be prevented or delayed in people at risk for the disease. Preventing type 2 diabetes can mean a healthier and longer life without serious complications from the disease such as heart disease, stroke, blindness, kidney failure, and amputations.
Preventing Type 2 Diabetes
Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not yet high enough for a diagnosis of diabetes. The good news is that if you have prediabetes, there are ways to reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes
Benefits of Weight Loss and Exercise
The Diabetes Prevention Program (DPP) is a landmark study by the National Institute of Diabetes and Digestive and Kidney Diseases. DPP researchers found that adults at high risk for type 2 diabetes were able to cut their risk in half by losing a modest amount of weight and being active almost every day. This means losing 5 to 7 percent of body weight (that's 10 pounds if you weigh 200 pounds) and getting 150 minutes of physical activity a week. The drug metformin reduced the risk of type 2 diabetes by 34 percent but was more effective in younger and heavier adults.
The benefits of weight loss and regular exercise have long-lasting value. In a DPP follow-up trial known as the Diabetes Prevention Program Outcome Study (DPPOS), people at risk of type 2 diabetes who kept off the weight they had lost and who continued to exercise regularly delayed the onset of type 2 diabetes by about 4 years.
The DPP study also showed that modest weight loss (achieved by following a low calorie, low-fat diet) and moderate physical activity were especially effective in preventing or delaying the development of diabetes in older people. In fact, people over the age of 60 were able to reduce their risk for developing type 2 diabetes by 71 percent.
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How to Lower Your Risk
Making modest lifestyle changes can help prevent or delay type 2 diabetes in people who are at risk. Here are some tips.
Reach and Maintain a Reasonable Body Weight
Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure.
The Body Mass Index chart (seen here) can be used to find out whether someone is normal weight, overweight, or obese. Body mass index is a measurement of body weight relative to height for adults age 20 or older. To use the chart
- find the person's height in the left-hand column
- move across the row to find the number closest to the person's weight
- find the number at the top of that column
- The number at the top of the column is the person’s BMI.
The words above the BMI number indicate whether the person is normal weight, overweight, or obese. People who are overweight or obese should consider talking with a health care provider about ways to lose weight and reduce the risk of diabetes.
The BMI has certain limitations. The BMI may overestimate body fat in athletes and others who have a muscular build and underestimate body fat in older adults and others who have lost muscle.
Waist Measurement. In addition to weight, the location of excess fat on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for type 2 diabetes. This is true even if a person’s body mass index (BMI) falls within the normal range.
To measure the waist, a person should
- place a tape measure around the bare abdomen just above the hip bone
- make sure the tape is snug but isn’t digging into the skin and is parallel to the floor
- relax, exhale, and measure.
Make Healthy Food Choices
What you eat has a big impact on your weight and overall health. By developing healthy eating habits, you can help manage your body weight, blood pressure, and cholesterol. Reducing portion size, increasing the amount of fiber you consume (by eating more fruits and vegetables) and limiting fatty and salty foods are key to a healthy diet.
Here are more tips for eating well with diabetes.
- Make a diabetes meal plan with help from your health care team.
- Choose foods that are lower in calories, saturated fat, trans fat, sugar, and salt.
- Eat foods with more fiber, such as whole grain cereals, breads, crackers, rice, or pasta.
- Choose foods such as fruits, vegetables, whole grains, bread and cereals, and low-fat or skim milk and cheese.
- Drink water instead of juice and regular soda.
- When eating a meal, fill half of your plate with fruits and vegetables, one quarter with a lean protein, such as beans, or chicken or turkey without the skin, and one quarter with a whole grain, such as brown rice or whole wheat pasta.
For more about healthy eating and older adults see "Eating Well as You Get Older."
Be Physically Active
Get at least 30 minutes of exercise at least five days a week. Regular exercise reduces diabetes risk in several ways. It
- helps you lose weight
- controls your cholesterol and blood pressure
- improves your body's use of insulin.
Many people make walking part of their daily routine because it’s easy, fun and convenient. But you can choose any activity that gets you moving. It’s fine to break up your 30 minutes of exercise into smaller increments, such as three 10-minute periods. Check with your doctor before beginning any exercise program.