Diabetes: Preventing Type 2 Diabetes

Last Editorial Review: 5/24/2005
The Cleveland Clinic

There is nothing you can do to prevent type 1 diabetes. Doctors have identified a few risk factors for the disease, but currently, screening the general public to identify people at risk for type 1 diabetes is not recommended.

However, there are steps you can take to ward off type 2 diabetes, such as adopting a healthy lifestyle and taking medication. Many doctors recommend that screening for diabetes begin at age 30 among people at risk, such as those with a family history of the disease or who are overweight.

Lifestyle

Certain risk factors like age, family history, and ethnicity cannot be altered, but a change in lifestyle that includes a healthier diet and increased physical activity with or without weight loss may help reduce your risk.

In addition, if you have high blood pressure, are overweight, smoke, or use alcohol or drugs, you can help lower your risk by modifying your lifestyle. Your doctor can make specific recommendations that are right for you including diet changes, exercise, and medications to help you quit smoking or lower your weight and blood pressure.

In fact, a study done by the Harvard School of Public Health and published in The New England Journal of Medicine found that being overweight and obese was the single most important factor that predicted who would develop type 2 diabetes. During a 16 year follow-up period the study concluded that regular exercise, at least 30 minutes a day and an improved diet that's low in fat and high in fiber significantly cut the risk of type 2 diabetes for participants of the study. The bottom line: Type 2 diabetes could be prevented by living a healthier lifestyle.

Another study to show the effects of weight loss, diet and exercise on decreasing the risks of developing type 2 diabetes showed that with changes geared at weight loss and improving physical activity levels, people at high risk of developing diabetes could reduce their risk by more than 50 %. The Finish Diabetes Prevention Study Group studied over 500 people who were not only overweight but had pre-diabetes or borderline diabetes -- with an impaired glucose tolerance test.

Can Medication Help?

New research shows that medications may aid in diabetes prevention and not just control of the disease once you have it. There are several different studies that show drugs along with a healthy lifestyle, can reduce the risk of developing diabetes in a high risk person.

A clinical trial conducted by the National Institutes of Health called the Diabetes Prevention Program (DPP) found that people who have a high risk for developing type 2 diabetes (borderline diabetes or pre-diabetes) could reduce that risk by 31% when using the prescribed medication Glucophage. While this is significant, the study also concluded that these individuals could have reduced this risk even further -- by 58% -- through healthy lifestyle changes alone. Participants in the study had blood glucose levels that were higher than normal, but not yet diabetic. This is a condition that often precedes diabetes, called impaired glucose tolerance (IGT).

Other studies have suggested that the weight loss drug Xenical and the diabetes drug Precose might delay the onset of type 2 diabetes. Further studies are needed to confirm these findings.

Reviewed by Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic.

Edited by Brunilda Nazario, MD, WebMD, MD, October 2004.

Portions of this page copyright © The Cleveland Clinic 2000-2005


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