How to Prevent Diabetes When You're at High Risk

If you're at high risk for type 2 diabetes, taking action now can prevent or delay the onset of the disease in the long run.

Diabetes is the fifth leading cause of death in the U.S., and there is no cure. Having diabetes raises your chances of other health problems too, like heart disease, blindness and kidney failure.

Being overweight, having high blood pressure, high cholesterol, a family history of diabetes or other factors ups your risk for diabetes. If you're at high risk, studies show that diabetes can often be prevented with some lifestyle changes and possibly medication prescribed by your doctor.

The Diabetes Prevention Program study
The Diabetes Prevention Program (DPP) is a large study of thousands of people who are at high risk for type 2 diabetes. Researchers are trying to learn how diabetes can be prevented by looking at these people's behaviors and health over the course of years.

Each person in this study falls into one of three groups:

  • Lifestyle group. This group gets nutrition and exercise counseling to learn how to lose weight. (For overweight persons, losing weight is the key to preventing type 2 diabetes.)
  • Medication group. The people in this group take an anti-diabetes drug called metformin each day to reduce their risk of diabetes.
  • Control group. These people do not take any action (no lifestyle changes or medicine) to try to prevent diabetes.

Every few years, scientists look at how many people in each group get diabetes. Using the control group for comparison, researchers found that:

  • After 3 years, people in the Lifestyle group cut their risk of diabetes by over half. Those in the Medication group reduced their risk by almost one third.
  • After 10 years, people in the Lifestyle group reduced their risk by about one third. Those in the Medication group lowered their risk by almost one fifth.

The take-home message
The DPP study is ongoing. But the message is clear: if you're at risk for type 2 diabetes, taking action now can often help prevent or delay the onset of the disease in the long run.

Lifestyle changes or medication?
In the DPP study, the lifestyle group was almost two times more successful in preventing diabetes than the medication group.

But what's the best therapy for you? Only your doctor can answer that question. Your doctor may prescribe medicine only if lifestyle tweaks don't help. Or he may suggest drugs plus behavior changes.

How to keep diabetes at bay
The key to preventing type 2 diabetes is reaching and keeping a healthy weight. People in both the lifestyle and medication groups in the DPP study lost weight.

Note that the weight loss does not have to be drastic to cut diabetes risk. In fact, lowering your body weight by 5 to 10 percent (just 10 to 20 pounds if you weigh 200 pounds) can cut your diabetes risk. Losing weight can also help delay the onset of diabetes.

The best approach to a healthy weight is to combine healthy eating with regular physical activity:

  • Eat right. You don't have to follow a rigid diet to lose weight. Start with eating smaller portions of the foods you normally eat. Try to limit foods high in saturated and trans fats, sodium and added sugars. Build your diet around fruits, vegetables, whole grains, lean sources of protein, low-fat and nonfat dairy products.
  • Exercise. First ask your doctor if it's OK for you to be active. Then start slowly and work up to 30 minutes of exercise, five days each week. If you don't have a 30-minute block of time, try spreading activity throughout the day into three 10-minute sessions or two 15-minute workouts. If you need to lose weight, your doctor may suggest 60 to 90 minutes of physical activity a day.

Even if you're not at a high risk for diabetes, know that having good habits and maintaining a healthy weight can help prevent a slew of other health conditions. So get started today!