Diabetes is a disease rising in prevalence. About 1 in 3 Americans are at risk for developing type 2 diabetes, and many don’t even know it.
The chances that you know somebody with diabetes is likely very high; it could even run in your family. For this reason, many people are concerned about the risk factors for developing diabetes and are interested in how to prevent diabetes from developing.
What is diabetes?
Diabetes is a disease affecting the pancreas and its ability to produce the hormone insulin. More specifically, the beta cells of the pancreas are responsible for producing insulin.
Diabetes mellitus occurs when the beta cells of the pancreas are destroyed when the beta cells don’t produce enough insulin to keep blood sugar levels regulated, or when the body doesn’t respond to insulin effectively.
Insulin helps blood glucose(blood sugar) enter our cells, where it’s used as fuel to support all of the body’s functions. Without enough insulin, sugar remains in the bloodstream and can become dangerously high.
Having high blood sugar over a prolonged period of time is detrimental to health. Our bodies make sugar, and we also obtain it from certain foods we eat, such as carbohydrates.
High blood sugar damages arteries and blood vessels, which supply blood to all of our organs and body systems. It also damages nerves and can result in loss of sensation in limbs, which can lead to serious wounds and amputations.
Type 1 vs. type 2
Type 1 diabetes is an autoimmune disease. The body mistakenly views the beta cells of the pancreas as invaders, and it works to destroy them. People with type 1 diabetes have little to no beta-cell function left and must inject insulin to live a healthy life.
Type 1 diabetes isn’t associated with lifestyle factors such as weight, ethnicity, physical activity level, etc. like type 2 diabetes. Many people with type 1 diabetes can appear thin and be at a normal weight or be underweight. This occurs due to the complete lack of insulin, which is needed to feed the body’s cells.
Type 2 diabetes is much different than type 1. It can occur in adolescence but is more common in older adults.
Unlike type 1 diabetes, it isn’t an autoimmune disease. Type 2 diabetes occurs when the pancreas stops producing enough insulin, or the body doesn’t respond to insulin the way it should. When the body doesn’t use insulin effectively, it’s called insulin resistance.
Unlike type 1, people with type 2 diabetes may not always need to inject insulin to manage it. Other diabetes medications, many in pill form, can be used to treat type 2 diabetes. Some people with type 2 diabetes are even able to manage and even reverse it through lifestyle alone, without medication.
Tips to prevent type 2 diabetes
While there is no clear-cut way to prevent type 2 diabetes absolutely, there are several things that can help reduce the risk.
1) Limit refined carbs. A healthy diet is essential for diabetes and Refined carbohydrates, such as white bread and enriched pasta, tend to raise blood glucose levels and have been associated with an increased risk of type 2 diabetes. Instead of choosing white flour/enriched grains, opt for whole grains/high-fiber foods to help promote more balanced blood sugars. Foods like whole-wheat bread, oatmeal, and brown rice raise blood sugar more slowly, which reduces the spike in blood sugar that can lead to blood sugar imbalances and insulin resistance.
2) Cut back on sugar. While eating sugar doesn’t cause diabetes, a higher intake of sugar has been associated with an increased risk of diabetes, along with many other factors. Added sugars tend to be especially detrimental to health since they don’t provide any nutritional value and cause large blood sugar fluctuations.
Added sugar is hidden in many common foods, which can make it hard to avoid for those who don’t know how to identify added sugar. Foods that are marketed as healthy can actually be very high in sugar, such as yogurts, cereal, and nutrition bars.
Added sugar is also hidden in less-obvious foods like pasta sauce, salad dressings, and condiments. The American Heart Association recommends that women consume no more than 6 teaspoons of added sugar per day (24 grams) and men consume no more than 9 teaspoons of added sugar per day (36 grams).
3) Eat a high-fiber diet. Plant-based foods rich in fiber tend to raise blood sugar levels more slowly than low-fiber plant-based foods. Fiber is in foods such as fruits and vegetables, grains, nuts, seeds, and legumes. A high-fiber diet has been associated with a decreased risk of type 2 diabetes. Fiber is also beneficial for promoting heart health and can help reduce the risk of cardiovascular disease. A good amount of fiber to aim for is around 30 grams per day.
4) Drink more water. Sugary beverages are one of the leading contributors of added sugar. Soda, sweetened teas, fruit drinks and sweetened coffee all pack a lot of added sugar and often contain more than a whole day’s worth of sugar in one serving. Opting for water instead will help reduce overall added sugar intake, and is very important for overall health in general.
5) Quit smoking. Smokers are 30-40% more likely to develop type 2 diabetes than non-smokers. Smoking also increases the risk of cardiovascular disease, which can lead to heart attack and stroke. Having type 2 diabetes increases the risk of heart disease, as well. For more information on smoking in regards to diabetes risk, as well as tips for quitting, check out our post here.
6) Weight loss. Being at a higher weight (“overweight” or “obese” according to body mass index [BMI]) is associated with an increased risk of type 2 diabetes. Studies have found that a 5% reduction in body weight in those considered overweight or obese significantly reduced their risk of developing type 2 diabetes. It’s important not to follow anything overly-restrictive, such as fad diets, as these usually don’t result in long-term weight loss. Focusing on small, realistic lifestyle changes is more beneficial, even if it means it takes longer to lose weight.
7) Watch portion sizes. Portion sizes have increased dramatically over the years, which may be one of the factors contributing to the worldwide rise in obesity rates. Foods with nutrition facts labels only list the amount of fat, sugar, etc. for one serving; many times, the typical amount consumed is more than a single serving, so those numbers need to be multiplied by how many servings were actually consumed.
8) Exercise. Being physically active is a very important way to reduce the risk of type 2 diabetes. 150 minutes per week of moderate physical activity, such as brisk walking, is associated with a reduction in diabetes risk. Promoting muscle mass through resistance training is also associated with improved blood sugar and reduced insulin resistance. Having an exercise routine with both cardiovascular and strength training exercises is ideal.
9) Get support. Making lifestyle changes isn’t always easy! Changing lifelong habits takes time, patience, and dedication. Every day isn’t going always to go the way you want it to, so it’s important to plan for the ups and downs that life will always bring!
Getting your support people on board with you can make all the difference in the world. Let your spouse, friends, coworkers, etc. know what your health goals are and how they can help support you. It might mean going for a walk with a coworker at lunch, or not having your spouse suggest eating out as often!
Another way to get support is by enrolling in a Diabetes Prevention Program. You can find a program in the United States near you here.
10) Set realistic goals. Reducing your diabetes risk is a lifelong journey, not a short-term thing. The key to promoting health and reducing disease risk is to choose sustainable, realistic goals. Think of your health journey as a marathon, not a sprint. If you set yourself up with restrictive, unattainable goals, you’re more likely to become frustrated and go back to old lifestyle habits.
For example, instead of choosing a goal to lose 50 pounds in one year, focus on a goal of five pounds in the next month or two. Instead of swearing off all carbs, make a goal to cut back on how much soda you drink. These small changes really add up!
To make sure your goals are realistic, consider using the acronym SMART – goals should be Specific, Measureable, Attainable, Relevant, and Time-Based.
11) Know your risk factors. Certain risk factors increase your risk of developing prediabetes and diabetes. Knowing your risk factors can help you be more aware of your lifestyle habits and can facilitate lifestyle changes to reduce the risk of developing diabetes. Some risk factors that increase your risk of type 2 diabetes include:
- Being age 45 or older
- Being Black, Hispanic/Latino, American Indian, Asian American, or Pacific Islander
- Have a parent, brother or sister with diabetes
- Being overweight
- Being physically inactive
- Having high blood pressure or take medicine for high blood pressure
- Having low HDL cholesterol and/or high triglycerides
- Having had diabetes during pregnancy (gestational diabetes)
- Having been diagnosed with Polycystic Ovary Syndrome
12) Get screened. Having borderline diabetes (prediabetes) is a risk factor for developing type 2 diabetes. It doesn’t mean you’re destined to get diabetes, though. Healthy lifestyle changes can reverse prediabetes and return blood sugar levels back to normal.
If you have a family history of blood sugar problems, or just want to know where your blood sugar levels are, ask your healthcare provider for a blood glucose screening. They’ll likely order a fasting blood glucose test and/or a hemoglobin A1c test.
A normal fasting blood sugar is below 100 mg/dL, and a normal hemoglobin A1c is below 5.7%. A fasting blood sugar indicative of prediabetes (impaired fasting glucose) is 100-125 mg/dL, and a hemoglobin A1c indicative of prediabetes is 5.7-6.4%.
The hemoglobin A1c test tends to be more reliable and helpful, since it measures the average blood sugar over the past 2-3 months, giving you a larger picture of blood sugar than just a fasting blood sugar.
13) Understand how medications affect your blood sugar. Certain medications raise blood sugar and can cause blood sugar problems if they’re taken for long periods of time. The most common class of medication known to cause increased blood sugar are steroids.
Steroids (corticosteroids) are a class of medications used to treat a variety of different health problems, including skin rashes, asthma, COPD (chronic obstructive pulmonary disease), arthritis, and other inflammatory conditions.
Steroids can be applied topically, such as hydrocortisone ointment for rashes; inhaled (or taken via nasal spray) for conditions such as asthma; taken orally in the form of pills; and administered via injection, such as injecting into an arthritic knee.
Steroids are often taken after transplant surgery, such as a kidney transplant for chronic kidney disease. However, some healthcare facilities are trying out steroid-free medication options for transplant patients due to the negative side effects steroids have.
Some examples of steroids include:
If your healthcare provider has prescribed steroids for a long period of time, have a discussion with them about your potential options, especially if you’re concerned about your blood sugar risk.
14) Practice good sleep hygiene. Poor sleeping habits and shift work have been associated with an increased risk of developing type 2 diabetes.
Lack of sleep or a disrupted circadian rhythm seems to interfere with the body’s insulin response, leading to insulin resistance. The National Sleep Foundation also recommends several things to improve sleep hygiene, such as:
- Limiting daytime naps
- Avoiding caffeine and other stimulants close to bedtime
- Exercising during the day
- Avoiding heavy, fatty or spicy foods close to bedtime
- Being exposed to natural light during the day
- Establishing a relaxing bedtime routine
- Keeping the sleeping environment comfortable, e.g., temperature between 60-67 degrees, using white noise machines, etc.
15) Manage your stress. Some studies have suggested a link between stress and the increased risk of developing type 2 diabetes. Stress stimulates our body’s fight or flight response, which can result in increased blood sugar levels and insulin resistance in people with diabetes.
Stress can also lead to poor eating habits, low-quality sleep, and other aspects of reduced self-care, which can also contribute to diabetes risk. Finding ways to manage stress can help improve both mental and physical health. Some popular methods to relieve stress include:
- Meditation, yoga, etc.
- Keeping a journal
- Participating in therapy
- Not relying on alcohol or other drugs to relieve stress
- Using mindfulness apps
- Making time for self-care
- Promoting regular, quality sleep
Type 2 diabetes has many known risk factors. Some of these factors can’t be controlled, such as genetics, age, ethnicity, etc. The good news is that many of the other risk factors can be controlled and modified in order to reduce diabetes risk.
Making sustainable, realistic goals towards improving your lifestyle habits is one of the greatest things you can do for your health. Instead of focusing on fad diets and other things that are difficult to continue long-term, focus on a few realistic goals at a time.
Simple things such as swapping out sugary drinks for water, getting more physical activity, managing stress, and getting more fiber and healthy fats in your diet are all helpful habits to not only reduce your diabetes risk but to promote your overall health and wellness.
If you’re concerned about your blood sugars, getting screened is another proactive thing you can do. Catching your blood sugars when they’re borderline high (prediabetes) is incredibly helpful in identifying potential lifestyle changes to make to reverse prediabetes. Once prediabetes turns to the development of diabetes, it can’t be reversed, so a large part of prevention is in your hands.