Why should I worry about diabetes?
In the United States, type 2 diabetes (formerly called adult-onset diabetes) is reaching epidemic proportions. It has even reached an alarming number of teenagers and young adults, a group that seemed virtually immune to the disease just a few decades ago. There is no mystery behind this increase in incidence. Scientists do not need to explore various theories or conduct experiments to understand the problem. The reason for our national fight against diabetes is as obvious as our lifestyle. Overall, our diets, activity levels, and waistlines have taken an unhealthy turn, and type 2 diabetes is the price many of us end up paying.
The good news is that neither your lifestyle nor your risk of developing diabetes is set in stone. You can buck national trends by exercising regularly, eating a well-balanced diet, and managing your weight.
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In fact, people at risk for type 2 diabetes can more than halve their risk of developing the disease by exercising about half an hour a day and eating a nutritious diet, according to a study by the National Institutes of Health. Participants who walked about 30 minutes or other low-intensity exercise a day, along with a low-fat diet, lost an average of 5 to 7 percent of their body weight and reduced their chances of developing type 2 diabetes by 58 percent . Those treated with the diabetes drug metformin but didn’t make the lifestyle changes lowered their risk by just 31 percent.
Here’s a closer look at how healthy living can protect you from the disease that kills more Americans each year than prostate cancer and breast cancer combined.
- Exercise regularly. Physical activity acts against type 2 diabetes from its origin. The disease begins when muscle cells lose their sensitivity to insulin, the pancreatic hormone that controls blood sugar levels. For some reason, your muscle cells are much less likely to avoid insulin if you keep them fit through regular exercise. If you’re at high risk for diabetes, experts recommend increasing your level of exercise to at least 150 minutes of moderate activity (such as walking) per week. A study from the Cooper Institute for Aerobics Research in Dallas shows that staying fit may be the single most crucial step in avoiding type 2 diabetes. Researchers put 8,633 men (average age 43) through a treadmill test and they were then screened for diabetes six years later. Men who scored poorly on the physical fitness test were nearly four times more likely to show signs of the disease than those who did well. In fact, fitness scores turned out to be the best predictor of diabetes, more telling than age, obesity, high blood pressure, or even a family history of the disease. If you’re sedentary now, look for ways to fit more physical activity into your daily life. Start off easy, but work up to getting at least 30 minutes a day of moderate exercise.
- Eat a healthy and balanced diet. The typical American diet seems tailor-made to promote type 2 diabetes. According to two Harvard School of Public Health studies, men and women who eat high amounts of simple sugars but little fiber are more than twice as likely to develop develop the disease than people who follow high-fiber, low-sugar diets. And several studies have found that people with glucose (sugar) intolerance, an early warning sign of diabetes, are much more likely to become diabetic if they eat large amounts of saturated fat. You can stay on the right side of these findings by following a diet rich in healthy fats, such as avocado, and rich in fruits, vegetables, and whole grains.
- Avoid excess weight. It stands to reason that obese people are particularly prone to type 2 diabetes. After all, extra pounds are often a sign that a person isn’t getting enough exercise or making healthy food choices. However, this point goes beyond the obvious: recent studies have found that obesity plays an active role in the onset of diabetes. Extra body fat, especially around the midsection, can fuel the disease by making cells less responsive to insulin and slowing down production of the hormone. If you can stay slim through diet and exercise, you’ll be fighting diabetes on three fronts. Physicians are now being recruited to counsel patients who are obese. According to a survey in the Annals of Internal Medicine, only 42 percent of overweight adults have been told by their doctors or health care workers to lose weight. That’s why government health officials from the US Preventive Services Task Force recommend that doctors screen patients for their BMI. If they are obese, they should include weight loss advice in their talks. If you’re at high risk for diabetes, experts recommend that you lose at least 7 percent of your body weight.
- Check with your doctor. If you have special reasons to be concerned about diabetes, be sure to discuss it with your doctor. In particular, if you’ve been exercising regularly and eating well for months, but are still significantly overweight, it’s a good idea to get a physical. Ask your doctor if you might be insulin resistant or have another diabetes-related condition. Now, a simple blood test can detect diabetes (or a tendency toward it), and often the test can be done in a doctor’s office. Early detection of such a condition gives you a great opportunity to resolve it and keep diabetes at bay.
Standards of Medical Care in Diabetes — 2012.
Centers for Disease Control and Prevention, Diabetes: Get Active, May 2021
Kriska AM et al. Physical activity, obesity, and incidence of type 2 diabetes in a high-risk population. American Journal of Epidemiology. 2003 Oct, 158: 669-675.
Diabetes Care, Exercise and Type 2 Diabetes, 2010
US Preventive Services Task Force, Adult Obesity Screening: Recommendations and Rationale, Annals of Internal Medicine, Dec 2, 2003, Vol. 139 Number 11. p. 930-932.
United States Food and Drug Administration. The FDA approves the first inhaled insulin combination product for the treatment of diabetes. January 2006.