Diabetes Prevention (cont.)
Is there anything that can help to prevent the onset of type 2 diabetes?
One of the most important factors in the development of
diabetes is genetics (which we have no control over). However, there are things in our environment we
can control to lower our personal risk of developing diabetes. And, frankly,
none of it is magic.
Exercise
Yes folks - it is true. Exercise is good for you. When adjusted for family
history, the benefits of exercise can be broken down based on previous studies;
for every 500 kcal burned weekly through exercise, there is a 6% decrease in
relative risk for the development of diabetes. This data is from a study done in
men who were followed over a period of 10 years. The study also notes a greater
benefit in men who were heavier at baseline. There have been similar reports on
the effects of exercise in women.
Exercise is thought to be a major determinant of insulin sensitivity in
muscle tissue. By increasing exercise, the body uses insulin more efficiently -
for up to 70 hours after the exercise period has occurred. Thus exercising 3-4
times per week would be beneficial in most people.
The same benefits are seen when looking specifically at
patients with impaired glucose tolerance/impaired fasting glucose. When
diet and
exercise are used as tools in this population over a six year study and compared
to a control group, glucose tolerance improves by about 76% compared to deterioration in 67%
of the control group. The exercise group also had a lesser rate of progression
to type 2 diabetes.
It should be noted that a lot of the benefit of exercise occurs independent
of weight loss. However, when combined with weight loss, the benefits increase
substantially.
Weight Loss
In patients at risk for diabetes,
weight loss can improve insulin
sensitivity, delay, and even prevent progression to type 2 diabetes. In patients
with overt diabetes, weight loss can play a tremendous role in improving blood
sugar control.
Two large studies - one in Finland and the other one U.S. (the Diabetes
Prevention Program- DPP) have shown the benefit of weight loss in diabetes
prevention. In the Finnish study, more than 500 men and women with impaired
glucose tolerance were assigned to a control group or an exercise/weight loss
group. By the end of the study, the weight loss group had lost about 8 pounds,
and the control group about 2 pounds. The weight loss group had significantly
less participants develop diabetes than the control group.
The DPP study showed a similar result. In this study, there was also a group taking
metformin (Glucophage) as a preventative measure. At the end of the study, the
lifestyle group actually did better at prevention of diabetes than those taking
metformin. In fact, the study was stopped early, because the benefit of weight
loss (the weight loss group lost about 15 pounds on average and kept it off) was
so dramatic. That just about says it all!
Smoking
Smoking more than 20 cigarettes a day can increase your risk of developing
diabetes to more than three times that of nonsmokers. The exact reason for this
isn't well understood. It may be that smoking directly decreases the body's
ability to utilize insulin. Moreover, it has been observed that after smoking,
blood sugar levels increase. Finally, there is also an association between
smoking and body fat distribution - smoking tends to encourage the "apple" shape
- which is a risk factor for diabetes.
So.....that's one more reason to quit, right?
Nuts
In as study of over 83,000 women, nuts (and peanut butter) consumption seemed
to show some protective effect against the development of diabetes. Women who
have more than five one-ounce servings of nuts a week lowered their risk of
developing diabetes compared to women who consumed no nuts at all.
Next: Are there medications that can help to prevent type 2
diabetes? »
- metformin, Glucophage - Drug information about metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet), a drug used for treating type II diabetes in adults and children.
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