Preventing Diabetes: Steps You Can Take

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Last week I reviewed the definition of prediabetes, as well as risk factors for developing Type 2 diabetes. I also listed the “diagnostic criteria,” as they’re called in the medical world, for both prediabetes and diabetes. We know that about 26 million people in the US have diabetes (90% to 95% have Type 2 diabetes), and a staggering 79 million people have prediabetes, which is about one-third of adult Americans and half of adults aged 65 years and older. People who have prediabetes are 5 to 15 times more likely to develop Type 2 diabetes than people who don’t.

We also know that once you get Type 2 diabetes (and Type 1, too, for that matter), it doesn’t go away. Hopefully a cure is around the corner, but for now, the goal for people with diabetes is to successfully manage it in order to avoid or delay complications and, as we say at Joslin Diabetes Center, live a long, healthy life. These things are certainly possible, as evidenced by our 50- and 75-year medalists — folks who have been living with diabetes for a long time.


So while researchers work on the cure, we need to focus on the 79 million people who have prediabetes. What can they do to prevent Type 2 diabetes from becoming inevitable? The good news? There’s quite a bit they can do. Here’s the rundown:

Lose weight. Now, before you become discouraged, bear in mind that a landmark clinical trial called the Diabetes Prevention Program (DPP for short) showed that Type 2 diabetes can be prevented or at least delayed in those at high risk. Losing 5% to 7% of body weight using lifestyle approaches (healthy eating, physical activity, behavior change) lowered their risk of diabetes by 58%. That’s major! What does 5% to 7% weight loss look like? Let’s say you weigh 160 pounds. Losing 5% of weight is 8 pounds, and losing 7% is 11 pounds. That’s not too bad.

And even more good news: Losing this weight provides long-term protection against diabetes (provided you keep it off) for at least 10 years. I realize losing any amount of weight can be challenging for some. And for others, the real challenge is keeping it off. There’s no one “right” approach to weight loss. There are many decent weight loss plans and programs out there. Of course, there are the more extreme plans, too, which will help you lose weight, but may not help you keep it off long-term.

As I always say to my patients, you need to find an approach that you can stay with. Quick fixes aren’t the answer. At the risk of sounding like a broken record, I encourage people to meet with a dietitian for advice and guidance for a safe, effective weight-loss approach. Or check out programs in your community, or consider a commercial program, such as Weight Watchers. You might also check out U.S. News and World Report’s ranking of diets called “Best Diabetes Diets.”

Move it, move it. The other important finding of the DPP was that folks who were able to stave off diabetes did physical activity for at least 150 minutes each week (or about 30 minutes each day). Physical activity helps your insulin work better (decreasing insulin resistance) and also helps to lower blood glucose. So get out and walk, take a dance class, use an exercise DVD, power walk around the mall. The fact is that you need to move.

Here’s something else: You can lower your risk of getting diabetes by doing weight, or strength, training. In a new study done by Harvard School of Public Health and the University of Southern Denmark, men who did weight training regularly lowered their diabetes risk by 34%. And the men who combined both aerobic exercise with weight training got the most benefit, slashing their risk by 59%. Strength training helps by forcing muscles to use glucose for energy. Also, strength training builds muscle and can change your ratio of lean to fat tissue; doing so makes cells more sensitive to insulin so that insulin works better. Using hand weights, machines at the gym, or resistance bands are ways to incorporate strength training into your activity program. Aim for doing this two to three times per week.

Sleep. But not too much. Thirty-five percent of Americans don’t get enough sleep. Not only does lack of sleep leave you feeling groggy and unproductive, it can boost your diabetes risk. Why? Glucose metabolism is adversely affected by not getting enough sleep. Studies of people who have sleep problems, like difficulty falling or staying asleep, or sleeping fewer than six hours a night, have shown that these people are more likely to develop Type 2 diabetes compared to those without sleeping problems. But too much sleep isn’t good either. Sleeping more than 8 hours a night also raises risk of diabetes. Aiming for 7 to 8 hours a night is the goal.

More on diabetes prevention next week!

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