diabetes7 Ways to Reduce Your Risk

I’m betting you know someone who has type 2 diabetes. You may even have it yourself. What you may not know is that type 2 diabetes is the seventh leading cause of death in the United States and the top cause of kidney failure, limb amputation, and new-onset blindness in adults. Heart disease death rates are about two to four times higher in adults who have diabetes than in those who don’t, while the risk of stroke is two to four times higher among people with diabetes. And here’s a staggering prediction: One in three people born in the United States after the year 2000 is expected to develop type 2 diabetes.

There are two forms of diabetes. The more common, type 2, affects 90% to 95% of all people with diabetes.

How does it take a toll on the body?
When digested, foods that contain carbohydrate normally turn into glucose (or blood sugar), which is used by every cell in the body for energy. Insulin, a hormone produced by the pancreas, helps transport glucose from the bloodstream into each cell. In type 2 diabetes, there are two major systemic glitches. The first is insulin resistance, which is the failure of muscle, liver, and fat cells to effectively use insulin. The second is that the pancreas gradually produces less insulin. As a consequence of these two problems, blood sugar levels rise because glucose isn’t being used effectively.

The good news is that making changes to decrease your risk of developing type 2 diabetes will also help decrease your risk of heart disease. High levels of blood sugar create atherosclerosis, or hardening of the arteries—one of the first manifestations of heart disease. By changing your eating habits and increasing your activity level, you can decrease your risk of developing both type 2 diabetes and heart disease.

The Diabetes Prevention Program, a major multicenter research study, conclusively shows that lifestyle changes can reduce a person’s risk of developing type 2 diabetes by 58%. A follow-up study of participants after 10 years in the program shows that those who kept their weight at a healthy level and continued to exercise reduced their risk by 34%. On average, they delayed the onset of type 2 diabetes by about four years.


In a nod to David Letterman, we’ll start at the bottom of the list and work our way up to the No.1 lifestyle change you can make to decrease your risk of developing type 2 diabetes and improve your overall health:

7) Keep a journal. Writing down everything you eat and drink, plus the amount of exercise you get each day, helps you stay focused on your goals. In addition, it’s a fact that simply writing down your food choices throughout the day can lead to weight loss. The National Weight Control Registry, which tracks more than 5,000 people who’ve lost significant amounts of weight and kept it off, has found that keeping a journal is the most commonly used strategy among those who succeed.

6) Eat more vegetables, especially leafy greens. A study published in BMJ suggests that eating 1. extra servings of green leafy vegetables such as spinach, kale, and arugula might decrease the risk of type 2 diabetes by as much as 14%. (One serving is 1 cup raw or 1 cup cooked.) Green leafy vegetables are low in calories and good sources of fiber, magnesium, and antioxidants that promote overall good health.

5) Accumulate a minimum of 150 minutes of moderate-intensity exercise each week, the amount recommended in the Diabetes Prevention Program. Daily exercise such as a brisk walk, an exercise class, or riding a bike helps reduce insulin resistance and promotes weight loss. Remember that 150 minutes per week is the minimum; more exercise, up to 60 minutes per day, is even more beneficial.

4) Eat less fat. The Diabetes Prevention Program set goals for participants to get no more than 25% of their total calorie intake from fat. Because fat contains more calories than does carbohydrate or protein, eating less of it almost always results in weight loss. Use low-fat salad dressing instead of regular dressing, switch to fat-free milk instead of whole or 2% milk, or simply eat smaller portions of high-fat foods such as nuts.

3) Consume fewer calories. One simple method is to eat 500 to 1,000 fewer calories less than you normally do. You can cut those calories by consuming less fat and fewer sugary drinks such as soda or other sugar-sweetened beverages and high-calorie snacks or by eating smaller portions of foods. Use your food record to identify where you can cut calories from your usual food choices. For example, simply switching from a Starbucks Venti Cafe Mocha to a Tall Cafe Mocha will save 160 calories. If you make that swap twice each workday, you’ll save 1,600 calories in one week. Cut all your food portions by 25%, and you can enjoy your favorite foods while you consume fewer calories.

2) Lose at least 7% of your body weight. People in the Diabetes Prevention Program set the goal of losing 7% of their body weight through changes in eating habits and activity levels. Losing 7% (or 14 pounds for a person who weighed 200 pounds) may not sound like much, but it makes a big impact. Body weight is the risk factor most closely tied with developing type 2 diabetes, and the more weight you lose, the more you decrease your risk. Even small, gradual changes in body weight can produce big health benefits.

1) Combine all the lifestyle changes listed above, and you have the best chance of drastically reducing your risk of developing type 2 diabetes. Good eating habits, weight loss, and regular activity will set you on the path to good health.


Risk factors for prediabetes and diabetes—in addition to being overweight, obese, or age 45 or older—include the following:

• being physically inactive;
• having a parent or a sibling with diabetes;
• having a family background that is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander;
• giving birth to a baby weighing more than 9 pounds or being diagnosed with gestational diabetes (diabetes that occurs first during pregnancy);
• having high blood pressure (140/90 mm/Hg or higher) or being treated for high blood pressure;
• having an HDL (“good”) cholesterol level lower than 35 mg/dL or a triglyceride level higher than 250 mg/dL;
• having polycystic ovary syndrome;
• having impaired fasting glucose or impaired glucose tolerance on previous blood testing;
• having other conditions associated with insulin resistance, such as severe obesity or a condition called acanthosis nigricans, which is characterized by a dark, velvety rash around the neck or armpits; and
• having a history of cardiovascular disease.