Reducing Your Risk of Developing Type 2 Diabetes

If you have been diagnosed with prediabetes, or insulin resistance, or you have risk factors for type 2 diabetes, there are steps you can take to lower your risk of developing the condition. These include:

Regular Exercise and Weight Loss

According to the Joslin Diabetes Center, recent research suggests that you can lower your risk of type 2 diabetes by as much as 58% through a program of moderate, sustained weight loss and daily exercise. Excess body weight makes your tissues less responsive to insulin, leading to high blood sugar. By losing weight, your body tissues will be better able to use insulin.

In a recent randomized trial of 523 patients ages 40-65 who were overweight (body mass index > 25) and had impaired glucose tolerance (prediabetes), lifestyle changes (with considerable support) reduced the incidence of diabetes for up to seven years. In this study, lifestyle changes included weight loss, reduced intake of total and saturated fat, increased intake of dietary fiber, and increased physical activity. *

Regular exercise can help reduce your risk of type 2 diabetes in two ways. First, exercise alone lowers blood sugar levels. And second, regular exercise will help you lose weight. In combination with regular exercise, eating a healthful, reduced calorie diet is an essential part of losing weight and maintaining your weight within a healthful range. In addition, regular exercise can help lower the levels of fat and cholesterol in your blood and lower your blood pressure, which will decrease your risk for heart disease (a common complication of diabetes).

Choose exercises that you enjoy and can make a regular part of your day. Strive to maintain an exercise program that keeps you fit and at a healthful weight. For most people, this could include walking briskly or participating in another aerobic activity for at least 30 minutes per day.

Before you start any exercise program, remember to ask your doctor to screen you for any diabetic complications which might be worsened by exercise. Also, it is important that you wear a diabetes identification bracelet when you exercise.

Medications

Metformin

Metformin (Glucophage) has been shown, in recent research, to lower the risk of type 2 diabetes by 31%. This medication is used to treat type 2 diabetes, but may be a good option if you have risk factors that you cannot change through lifestyle modifications. Such risk factor include family members with type 2 diabetes, a history of gestational diabetes, or if you are a member of an ethnic group that is at higher risk.

Ethnic groups at higher risk of type 2 diabetes include:

  • African American
  • Hispanic American
  • Pima Indians
  • Native American
  • Asian American
  • Pacific Islander

Rosiglitazone

Rosiglitazone (Avandia) has also been shown to reduce the incidence of type 2 diabetes in patients over the age of 30 with insulin resistance, though it may slightly increase the risk of heart of failure. *

It should be noted that although these medications may delay the onset of diabetes in prediabetic patients, there is no evidence that starting them early, rather than waiting until diabetes sets in, actually reduces the risk of diabetes complications down the road (eg, heart, eye, or kidney disease).

Talk to your doctor about your risk factors for type 2 diabetes to determine if any of these preventive methods are right for you.

References:

American Diabetes Association website. Available at: http://www.diabetes.org . Accessed February 8, 2006.

Gillies CL, Abrams KR, Lambert PC, et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Brit Med J. 2007;334:299-302.

Joslin Diabetes Center website. Available at: http://www.joslin.org/ . Accessed February 8, 2006.

Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med . 2002;346(6):393-403.

*Updated section on Regular Exercise and Weight Loss on 11/29/06 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet . 2006 Nov 11;368(9548):1673-9.

*Updated section on Medications on 11/29/06 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : DREAM (Diabetes REduction Assessment with ramipril and rosiglitazone Medication) Trial Investigators; Gerstein HC, Yusuf S, Bosch J, Pogue J, Sheridan P, Dinccag N, et al. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet . 2006 Sep 23;368(9541):1096-105.



Last reviewed April 2007 by David Juan, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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