PROGRESSING FROM PRE-DIABETES TO DIABETES IS COMMON, but such a change is not inevitable. Today we explore seven ways you can drop your diabetes risk.
Type 2 diabetes is remarkably common in the United States and elsewhere. Did you know that approximately one in 10 Americans have diabetes, with about 95 percent of these cases of type 2 diabetes? That number translates into one in 10 (37 million) folks in the United States having diabetes.
The prevalence is no better for our friends across the pond in Great Britain. The numbers are similar to the United States: One in ten people over 40 in the UK are living with a diagnosis of type 2 diabetes. Ninety percent of the nearly one million people with diabetes have the type 2 form.
Recognizing those with type 2 diabetes but no formal diagnosis brings the affected number up to 4.7 million. The estimates are that this number will rise to 5.5 million by 2030.
This chronic condition is on the rise worldwide: The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014, according to the World Health Organization (WHO). The prevalence of type 2 diabetes has increased more quickly in low- and middle-income countries compared with high-income ones.
Tragically, the diabetes rates rose three percent between 2000 and 2019. In 2019, kidney disease and diabetes appeared to be associated with an estimated two million deaths.
The global diabetes prevalence in 2019 is estimated to have been over nine percent (463 million people), rising to over 10 percent (578 million) by 2030 and 11 percent (700 million) by 2045.
The alarming increase in prevalence is likely secondary to trends in obesity and a sedentary lifestyle.
Fortunately, type 2 diabetes (and its consequences, including blindness, heart disease, kidney problems, and more) may be prevented, managed, or delayed with lifestyle modifications, medicines, and regular screening and treatment for diabetes-related complications.
Over 84 million adults in the United States have pre-diabetes. That’s approximately one out of every three adults. In this context, I offer my top 7 ways to reduce your risk of developing type 2 diabetes.
1. Move
I hesitate to use the word exercise, as any physical activity may significantly reduce your risk of type 2 diabetes by simply avoiding being sedentary.
If you have pre-diabetes, you have a good chance of lower insulin sensitivity. In this condition, your pancreas creates more insulin to pull sugar into your cells. Insulin resistance is a type 2 diabetes characteristic but can also exist in Type 1 diabetes.
Now the good news: Physical activity improves your cells’ insulin sensitivity; you need less insulin to control your blood sugar levels.
Insulin resistance is a part of a cluster of cardiovascular and metabolic abnormalities known as metabolic syndrome, which may contribute to the development of type 2 diabetes.
Several types of movement reduce insulin resistance and blood sugar levels in adults with pre-diabetes or type 2 diabetes:
It doesn’t take much physical activity to improve glucose uptake. A single moderate-intensity exercise session improves sugar uptake by at least 40 percent.
If you are a beginner, you might want to begin with 10 minutes of brisk walking. Aim to work up to 150 minutes weekly (in minimum 10-minute intervals).
SUMMARY
Regular physical activity may increase your insulin sensitivity, lowering your risk of type 2 diabetes. In summary, regular physical activity may increase your insulin sensitivity, lowering your risk of type 2 diabetes.
2. Drink water
Drinking copious amounts of water is a go-to strategy for me. Having switched from sugary drinks, I never miss my former favorite, Sprite.
If you make water your primary beverage, rather than sugary drinks such as soda, you will decrease your chances of type 2 diabetes. You will also drop your risk of latent autoimmune diabetes in adults (LADA).
The Mayo Clinic (USA) explains that latent autoimmune diabetes in adults (LADA) is a slow-progressing form of autoimmune diabetes. Like autoimmune type 1 diabetes, LADA occurs because your pancreas stops making enough insulin, probably because of some insult that slowly damages the pancreas’ insulin-producing cells.
Unlike type 1 diabetes, those with LADA usually don’t need insulin for several months up to years after diagnosis.
An observational study from Scandanavia of 2800 individuals reports that those consuming over two daily servings of sugary beverages had double the risk of LADA and 1.2-times the risk of type 2 diabetes (compared with non-consumers).
Those drinking more than five daily servings had a 10-fold increase in type 2 diabetes risk. There appeared to be a linear dose: risk relationship; for every daily serving increment, type 2 diabetes risk increased by 1.2-times.
A separate study from the United Kingdom adds an interesting twist. Substituting water for specific beverages (such as sugary drinks) did not appear to be associated with lower odds of having a marker of poor glucose control (hemoglobin A1c over 5.5 percent). It seems that the addition of water appeared more relevant.
SUMMARY
Increasing your water intake (and perhaps cutting back the sugary beverages, too) may help you to manage your blood sugar and insulin levels, reducing your diabetes risk.
3. Watch your weight
Being overweight or obese increases your risk of type 2 diabetes. On the other hand, the Diabetes Prevention Program (DPP) reported a more than halving (58 percent reduction) in the incidence of diabetes over three years for those managed with intensive lifestyle intervention.
The intervention involved changes in physical activity and diet, but the researchers did not randomly assign each intervention component. They noted variation in diet, weight loss, and physical activity among the intensive lifestyle intervention group and thus analyzed the relative contributions of each component.
The authors concluded that increasing physical activity helps sustain weight loss and independently drops diabetes risk among those who do not lose weight.
SUMMARY
Weight loss reduced diabetes incidence similarly across all race/ethnicity groups, for both sexes, for all ages, and several levels of physical activity, regardless of initial obesity level.
4. Get your fiber
Getting lots of fiber can improve your gut health and aid weight management. Moreover, you may also prevent diabetes.
How does fiber work its magic? Soluble fiber and water combine to create a gel in your gut, slowing food absorption and helping keep blood sugar and insulin levels down.
Even modest increases in soluble fiber intake help to lower blood sugar levels. Soluble fiber may improve blood glucose levels in two ways. First, soluble fiber can slow the passage of food through the gut, giving digestive hormones more time to act. Second, by forming the gel with water, soluble fiber prevents carbohydrates from being rapidly absorbed by the small intestine.
Insoluble fiber (which does not absorb water) is also associated with drops in blood sugar levels. Insoluble fiber supports insulin sensitivity and can help keep your bowels in good shape. You can get this fiber type by consuming bran, seeds, nuts, wheat flour, and the skins of many fruits and vegetables.
One research investigation found an inverse relation between insoluble fiber intake and change in blood sugar levels measured two hours after eating.
Here’s some proof bout how fiber can reduce blood glucose levels. A 2000 study published in the prestigious New England Journal of Medicine compared a moderate fiber diet (including 24 grams of total fiber, with eight grams of soluble fiber) with a high fiber diet (50 grams, including 25 grams of soluble fiber) over six weeks.
Those on the high fiber diet had a drop in pre-meal blood glucose levels compared with the moderate fiber diet. In addition, those on the higher fiber diet had lower triglyceride and post-meal glucose levels.
Here are the Dietary Guidelines for Americans, 2020–2025. Adults should eat 22 to 34 grams of fiber each day. The specific amount will depend on your age and sex.
What are 30 grams of fiber? Thirty grams is about six apples daily. I don’t know about you, but that will not happen with me. The United States Centers for Disease Control (CDC) offers an alternative approach, spreading fiber intake among different foods throughout the day:
- Get some fiber into your breakfast. Consider a bowl of oatmeal with nuts and berries. Alternatively, try avocado toast topped with chickpeas.
- Choose whole grains. Have you looked at your bread ingredient list? Hopefully, it has whole-grain flour as the first ingredient. Change the white rice to brown rice or quinoa. I now consume whole wheat rather than regular pasta.
- Incorporate non-starchy vegetables. I start my dinners with a salad. Or at least I usually do. Alternatively, think about adding some broccoli, spinach, or a bag of frozen mixed veggies to your meals.
- Add beans (or other legumes). Lentils, peas, or beans added to soups, salads, casseroles, or other foods can boost your fiber. Some enjoy pureeing legumes to create dips and spreads.
- Snack on fruit, vegetables, and seeds. Choose fruits and vegetables as snacks. Apples, bananas, baby carrots, and pears are all rich in fiber. I keep almonds, pistachios, and sunflower seeds for a quick snack rich in fiber.
The CDC reminds us to take the fiber increase slowly, increasing it by a bit every few days. And remember that a quick increase in fiber can cause uncomfortable digestive problems, including bloating, gas, cramps, diarrhea, or other problems.
SUMMARY
Getting fiber at each meal may help prevent blood sugar and insulin spikes, which improve your risk of diabetes.
5. Eat fewer heavily processed foods
Consuming fewer heavily processed foods can improve numerous aspects of your health. While some processed foods, such as frozen yogurt and frozen vegetables, are not necessarily unhealthy (watch the added sugar with the former), other highly processed foods are problematic.
Highly processed foods often have unhealthy fats, chemical preservatives, and added sugar. Examples include chips, sodas, candy bars, hot dogs, and frozen desserts.
While observational studies do not represent high-level evidence, one study showed diets high in ultra-processed foods have a higher risk of type 2 diabetes.
You may also want to increase your consumption of fruits, vegetables, and nuts.
SUMMARY
Minimizing your highly processed foods and focusing on whole foods may decrease your diabetes.
6. Watch your portion sizes
Do you eat too much food at any given time? If you answered yes, you might be spiking your sugar and insulin levels.
Smaller portions may help you to consume fewer calories, facilitate weight loss, and lower your diabetes risk. Unfortunately, few studies look at portion control’s benefits for those with pre-diabetes.
However, we have some research examining how portion size can help those with type 2 diabetes. One study examined overweight and obese adults, including some with type 2 diabetes. Here are the findings:
Adults who followed a meal plan — with portion-controlled meal replacements and appropriate portions of other healthy foods — had weight and body fat loss.
Here are some tips: Don’t eat those chips or pretzels out of a bag. If you are going to eat these snacks, place your desired amount on a separate plate. In restaurants, I sometimes choose an appetizer as my main course or ask if a half-portion of the main dish is available.
SUMMARY
Avoiding large portions may help reduce insulin and blood sugar levels, facilitate weight loss, and reduce diabetes risk.
7. Don’t smoke
Smoking can raise your risk of diabetes. A study of 53,000 Japanese reports that this risk decreases after smoking cessation. By ten years, the diabetes risk is similar to that of non-smokers.
My take — Lifestyle and type 2 diabetes risk
I began by stating the enormous scope of the diabetes problem and how it continues to rise worldwide. Fortunately, there are several steps available to reduce type 2 diabetes risk.
A high risk for diabetes or a pre-diabetes diagnosis does not inevitably lead to diabetes but can motivate an individual to make changes to reduce risk.
I hope I have helped you understand that getting physical activity, eating well, and doing other healthy lifestyle behaviors can lower your chances of diabetes.
Thank you for joining me in this look at seven ways to use lifestyle to lower your diabetes risk.
Thank you.
The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you seek medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.
