How to Prevent Type 2 Diabetes

Type 2 diabetes is a metabolic disorder. The risk of developing it can be decreased by maintaining a healthy body weight, getting regular physical activity, eating a diet high in fiber, and more.

In this article, we’ll explore what type 2 diabetes is as well as how to know if you have prediabetes. We’ll cover 7 ways to decrease risk of developing type 2 diabetes, look at risk factors, and summarize the most important information you need to know about diabetes prevention.

What is Type 2 Diabetes?

Type 2 diabetes mellitus or T2D, is a metabolic disorder. It involves a few disruptions to the body’s normal metabolic processes:

• Insulin is a hormone made by islet beta cells in the pancreas. Insulin triggers the uptake of glucose (blood sugar) out of the blood and into cells, where it can be used for energy. When the body becomes resistant to insulin, glucose stays in the blood longer, leading to higher glucose levels.

• Elevated glucose, known as hyperglycemia, can harm blood vessels, negatively affect blood circulation, and impair the availability of energy and nutrients for cells throughout the body.

• Over time, high glucose levels can cause damage to tissues and organs and can lead to immune system problems and poor wound healing.

• Uncontrolled type 2 diabetes is a leading cause of kidney failure. It increases the risk of heart attack and stroke by 2-3 times. It is the 9th leading cause of death.

While type 2 diabetes can have serious health consequences if left untreated, it can be managed with diet, medication, and lifestyle.

Prediabetes

Type 2 diabetes is diagnosed when a person’s glucose levels rise above a certain threshold. When fasting plasma glucose is 126 mg/dLor higher, it can indicate diabetes. There is a middle area, known as prediabetes, where glucose levels are higher than normal, but not elevated enough to qualify as diabetes.  According to the American Diabetes Association diagnostic criteria, prediabetes can be diagnosed when fasting plasma glucose levels are between 100-125 mg/dL.

Prediabetes means:

• You have a higher risk of being diagnosed with type 2 diabetes
• Your risk for heart disease and stroke is higher
• You may be able  to prevent development of type 2 diabetes through lifestyle changes, like high fibre diet and exercise.

Tips to Prevent Type 2 Diabetes

Type 2 diabetes is a chronic condition that, for many people, responds well to targeted lifestyle changes. Your medical provider will help create a plan to manage your health if you are diagnosed with prediabetes or type 2 diabetes. This could include management by a primary care provider as well as working with a dietitian, endocrinologist, and other medical experts.

The following 7 ways are evidence-based ways to decrease the risk of developing type 2 diabetes. They are also part of a treatment plan to manage and reverse type 2 diabetes after it has been diagnosed.

Reduce total simple carbohydrates intake

Many diets are high in carbohydrates. While carbs are not all bad, high consumption of refined carbohydrates that do not contain fiber can contribute to several problems. These problems then worsen or impact diabetes risk and they include:

• Increased body weight, since excess carbohydrates are often stored in fat cells

• Increased blood sugar levels, when the body cannot keep up with using carbohydrates for energy or storing them as fat

• An increased output of insulin from the pancreas because blood sugar levels are higher. This can lead to an overall desensitization of the body cells to its effects (known as insulin resistance)

While you do not necessarily need to adopt a low-carbohydrate diet, choosing better quality complex carbohydrates like whole grains, vegetables, and fruits can improve how your body breaks down carbohydrates for energy.

You do not have to strictly avoid sugar either, but make sure that your carbohydrate intake is balanced. Reducing portion sizes can also help to decrease an excessive intake of carbohydrates.

Some simple ways to reduce carbohydrate intake include:

• Swap sodas and sugary drinks for water, sparkling water or herbal tea
• Choose whole grain bread instead of white bread
• Eat brown rice instead of white rice
• Choose other starchy vegetables, like sweet potatoes, in place of white potatoes
• Consider carb alternatives, like zucchini noodles, in place of pasta
• Eat whole grain oatmeal instead of sugary cereal

Exercise regularly

The Physical Activity Guidelines for Americans (written by the U.S. Department of Health and Human Services), state that healthy adults benefit from 150 minutes of moderate physical activity per week. That’s a little over 20 minutes per day or 30 minutes five days per week. This level of activity leads to a 33% lower risk of mortality from all causes. Exercise benefits prediabetes and type 2 diabetes in several direct ways:

• Exercise uses glucose and can lead to lowered blood sugar levels, especially following a meal.

• Physical activity helps improve insulin sensitivity.

• Regular exercise contributes to a healthy weight.

• Being physically active can also reduce stress levels, which are known to worsen poor blood glucose control.

• Physical activity also combats sedentary behavior, which on its own can double the risk of developing type 2 diabetes.

Increase water intake

Many people do not drink enough water. But increasing water intake and focusing on proper hydration has an added benefit if you replace sugary drinks with it. Sugar in soda or beverage form is strongly implicated in type 2 diabetes as well as in latent autoimmune diabetes of adults (LADA).

While the amount of water that adults need per day can vary based on body size and activity level, aiming for 6-8 glasses of water is a good starting place. Urine should be light yellow, indicating adequate hydration. If it is a dark amber color, it’s a sign that your body is not getting enough fluids.

Lose weight

Extra weight is a well-known risk factor for type 2 diabetes. Having excess weight or being obese can increase the likelihood of developing insulin resistance.

Body weight distribution plays a role too, as excessive abdominal fat can worsen the risk for insulin resistance. You do not have to lose a substantial amount of weight to reduce the risk of type 2 diabetes. Shedding off at least 5%-7% of your body weight can be effective for prevention of type 2 diabetes if indicated.  Some recommended diet and lifestyle modifications include:

• Eat more fiber
• Reduce portion sizes
• Limit foods with added sugar
• Get regular exercise
• Drink plenty of water
• Get good quality sleep
• Reduce saturated fats and red meat
• Eat poultry
• Consume omega-3s like salmon, walnuts, and chia seeds
• Increase consumption of vegetables and fruits
• Choose low-fat dairy products
• Eat whole grains instead of white grain products 

Quit smoking

Tobacco use can cause or contribute to many serious health risks including heart disease, chronic obstructive pulmonary disease (COPD), cancer, stroke, and more. Smoking can also contribute to cellular problems that may worsen insulin resistance in prediabetes and type 2 diabetes.

Some studies link quitting smoking with a reduced risk for diabetes. If you use tobacco or smoke, speak to a medical provider about smoking cessation programs or options.

Increase fiber intake

Fiber has important roles for health, ranging from normal digestive function to a healthy microbiome (gut), weight balance, and bowel function. Fiber also supports balanced glucose levels and can help reduce the risk of insulin resistance. The recommended daily intake of fiber for adults is:

• People born female: 25 grams per day up to age 50 and 21 grams per day for age 51+
• People born male: 38 grams per day up to age 50 and 30 grams per day for age 51+

Most people consume 15 grams of fiber per day or less, which does not meet necessary requirements. Foods high in fiber include:

• Fruits
• Vegetables
• Oats
• Barley
• Legumes
• Peas
• Beans
• Nuts and seeds

Vitamin D

Vitamin D is a nutrient that has hormone-like properties. It can be made in the body from direct UV exposure, but is also found in some foods and as a dietary supplement. Insufficient  vitamin D levels have been linked to insulin resistance and type 2 diabetes. Vitamin D also has a complex, somewhat indirect relationship with appetite and obesity. 

While researchers agree that vitamin D may be important for preventing type 2 diabetes, there are no current established universal guidelines on supplementation. A medical provider may recommend an appropriate supplemental intake of vitamin D, if needed, based on testing your blood levels and considering both sun exposure and potential dietary sources.

Who Is At Risk for Type 2 Diabetes?

There are many possible risk factors for type 2 diabetes.

• Prediabetes
• Age 45 or older
• Overweight or obesity
• Family history of type 2 diabetes
• High blood pressure
• Low HDL cholesterol
• Low physical activity or sedentary lifestyle
• Certain racial/ethnic backgrounds
• History of gestational diabetes
• Large for gestational age baby (over 9 pounds)
• Polycystic ovary syndrome (PCOS)

Takeaway

The risk of developing type 2 diabetes can be decreased with lifestyle, diet, and exercise. Even people with more risk factors can still play a major role in decreasing the risk factors by being physically active, eating a healthy diet, and managing their health.

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