4 Steps to Prevent Type 2 Diabetes

You don't have to strive for chiseled abs to drastically lower your risk of type 2 diabetes. Just a few minutes a day and making better choices can get you well on your way.

By Michael Smith
WebMD Feature

Reviewed By Brunilda Nazario

You can hardly turn on the TV or listen to the radio without hearing a new report on the epidemic of type 2 diabetes. But what can you do to not become part of this statistic?

Type 2 diabetes -- the most common type -- occurs when the body uses insulin inefficiently and can longer keep blood sugar levels in check. Over the years, damage to nerves and blood vessels can lead to complications such as heart disease, stroke, blindness, kidney disease, and leg amputation.

But type 2 diabetes is preventable in many people. And the results of a large study show you how to do just that.

We're Not Talking Six-Pack Abs

In the study, some 3,000 people at high risk for diabetes -- due to being overweight and having higher than normal blood sugar levels (a condition called prediabetes) -- followed a moderate diet and exercise program. Dropping their weight by just 5% to 7% delayed and possibly prevented type 2 diabetes. Average weight loss in the first year of the study was 15 pounds.

This doesn't mean devoting your life to six-pack abs. Just 30 minutes of exercise a day five days a week (usually by walking) and lowering their intake of fat and calories did the trick. They lowered their daily calorie total by an average of about 450 calories. People that followed this program reduced their risk of type 2 diabetes by 58%. The program was even more effective in those 60 and older -- reducing their risk of type 2 diabetes by 71%.

Do You Need to Lower Your Risk of Type 2 Diabetes?

There are several factors that increase the risk of type 2 diabetes -- some that you can control and some that you can't.

Factors you can't control:

• Age 45 years or older
• Having a parent, brother, or sister with diabetes
• Being of African-American, American Indian, Asian-American, Pacific Islander, or Hispanic-American/Latino descent
• Having had diabetes that developed during pregnancy (called gestational diabetes) or giving birth to at least one baby weighing more than nine pounds
• Having polycystic ovary syndrome -- a condition in women where the ovaries produce excess male hormones

Factors you can control:

• Being overweight
• Having blood pressure of 140/90 or higher
• Having abnormal cholesterol levels -- either HDL "good" cholesterol of 35 or lower or triglyceride levels of 250 or higher
• Exercising fewer than three times a week

Let's Get Started

You can do a lot to lower your chances of getting diabetes. Exercising regularly, reducing fat and calorie intake, and losing weight can all help you reduce your risk of developing type 2 diabetes.

Lowering blood pressure and cholesterol levels also help you stay healthy.

Making big changes in your life is hard, especially if you are faced with more than one change. You can make it easier by taking these steps:

• Make a plan to change behavior.
• Decide exactly what you will do and when you will do it.
• Plan what you need to get ready.
• Think about what might prevent you from reaching your goals.
• Find family and friends who will support and encourage you.
• Decide how you will reward yourself when you do what you have planned.

4 Steps to Living Better and Longer

Reach and Maintain a Reasonable Body Weight -- Being overweight can keep your body from using insulin properly. Insulin is the hormone that allows your body to use sugar for energy. Being overweight can also cause high blood pressure. Even losing a few pounds can help reduce your risk of developing type 2 diabetes because it helps your body use insulin more effectively. For example, if you weigh 200 pounds, losing only 10 pounds could make a difference.

If you are overweight or obese, choose sensible ways to get in shape:

• Avoid crash diets. Instead, eat less of the foods you usually have. Limit the amount of fat you eat.
• Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week. This will help your body use insulin more effectively, helping you lower high blood sugars and improving your cardiovascular health.
• Set a reasonable weight-loss goal, such as losing one pound a week. Aim for a long-term goal of losing 5% to 7% of your total body weight.

Make Wise Food Choices Most of the Time -- What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.

• Take a hard look at the serving sizes of the foods you eat. Reduce serving sizes of main courses (such as meat), desserts, and foods high in fat. Increase the amount of fruits and vegetables.
• Limit your fat intake to about 25% of your total calories. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. Your doctor or a dietitian can help you figure out how much fat to have. You can check food labels for saturated fat content, too, which increases LDL "bad" cholesterol.
• You may also wish to reduce the number of calories you have each day. Your doctor or dietitian can help you with a meal plan that emphasizes weight loss.
• Keep a food and exercise log. Write down what you eat, how much you exercise -- anything that helps keep you on track.
• When you meet your goal, reward yourself with a nonfood item or activity, such as watching a movie.

Be Physically Active Every Day --- Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin. Even brisk walking works.

If you are not very active, you should start slowly, talking with your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active for at least 30 minutes a day most days of the week.

Choose activities you enjoy. Here are some ways to work extra activity into your daily routine:

• Take the stairs rather than an elevator or escalator.
• Park at the far end of the parking lot and walk.
• Get off the bus a few stops early and walk the rest of the way.
• Walk or bicycle instead of drive whenever you can.

Take Your Prescribed Medications -- Some people need medication to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor whether there are any medicines you can take to prevent type 2 diabetes.

Should I be tested for diabetes?

Anyone 45 years old or older should get tested for diabetes. If you are younger than 45, overweight, and have one or more of the above, you should consider testing. Your doctor will tell you if you have normal blood sugar, prediabetes (a fasting blood sugar of at least 100), or diabetes (fasting blood sugar of 126 or greater).

What does it mean to have prediabetes?

It means you are at risk for getting type 2 diabetes and heart disease. The good news is if you have prediabetes you can reduce the risk of getting diabetes and even return to normal blood sugar levels. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. If your blood sugar is higher than normal but lower than the diabetes range (what we now call prediabetes), have your blood sugar checked in one to two years.

Originally published Nov. 4, 2003.

Medically updated July 28, 2004.

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SOURCE: National Institutes of Health.

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Last Editorial Review: 1/31/2005 7:03:42 AM