Prevention of Diabetes
Prevention of Diabetes: A recently concluded federally funded study of 3,234 people at high risk for diabetes, the Diabetes Prevention Program, showed that diet and exercise can sharply lower your risk of getting type 2 diabetes.
The DPP was a major clinical trial that studied ways to prevent or delay diabetes in people at high risk for type 2 diabetes. Participants were overweight and had higher than normal levels of blood glucose, called impaired glucose tolerance. Both conditions are strong risk factors for type 2 diabetes. Because of the high risk among some minority groups, about half of the DPP participants were African American, American Indian, Asian American, Pacific Islander, or Hispanic.
The DPP compared two approaches to preventing diabetes: an intensive healthy eating and exercise program and the diabetes drug metformin. People who engaged in moderate physical activity for about 30 minutes a day, followed a low-fat, low-calorie diet, and lost 5 to 7 percent of their body weight reduced their risk of getting type 2 diabetes by 58 percent, according to preliminary analysis of the results. Those receiving metformin reduced their risk by 31 percent.1
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.1
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.
Your doctor, a dietitian, or a counselor can help you make a plan. Here are some of the areas you may wish to change to reduce your risk of diabetes.
Reach and maintain a reasonable body weight
Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. The DPP showed that losing even a few pounds can help reduce your risk of developing type 2 diabetes because it helps your body use insulin more effectively. In the DPP, people who lost between 5 and 7 percent of their body weight significantly reduced their risk of type 2 diabetes. For example, if you weigh 150 pounds, losing about 10 pounds would make a difference.
Body mass index (BMI) is a measure of body weight relative to height. You can use BMI to see whether you are underweight, normal weight, overweight, or obese. Use the body mass index table below to find your BMI.
- Find your height in the left-hand column.
- Move across in the same row to the number closest to your weight.
- The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese.
Body Mass Index Table
|Body Weight (pounds)|
|Body Weight (pounds)|
Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.
* pdf versions require the free Adobe® Acrobat Reader software for viewing.
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. (See below for easy suggestions.)
- Set a reasonable weight-loss goal, such as losing 1 pound a week. Aim for a long-term goal of losing at least 7 percent 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 percent 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 fat content too.
- 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, like 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 effectively. People in the DPP who were physically active for 30 minutes a day reduced their risk of type 2 diabetes. Many chose brisk walking for exercise.
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 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.1
If you have kidney damage, the liquid, called a contrast agent, used for special x-ray tests can make your kidney damage worse. Your doctor can give you extra water before and after the x-ray to protect your kidneys. Or your doctor may decide to order a test that does not use a contrast agent. 2
To help prevent type 2 diabetes, control your weight, exercise daily,
and eat a healthy diet. A healthy diet includes a balance of all the food
groups, with less fatty foods, foods lower in cholesterol, and more foods
rich in fiber. Too much fat or cholesterol and inactivity can make you
overweight and prevent your body from functioning effectively. Not being
able to regulate blood sugar correctly is one effect. Cut down on fat and
cholesterol by choosing low-fat dairy products, lean cuts of meat, more
fish and poultry without the skin, and margarine instead of butter. Also,
limit foods high in salt and sugar. 3
1. excerpt from Am I at Risk for Type 2 Diabetes: NIDDK
2. excerpt from Keep your kidneys healthy: NIDDK
3. excerpt from Diabetes: NWHIC
Last revision: April 10, 2003
Medical Tools & Articles:
- Risk Factor Center
- Medical Statistics Center
- Medical Treatment Center
- Prevention Center
- Medical Tests Center