By: Ryan Jeannotte, LWDI Intern
What is diabetes?
Diabetes is a disease that occurs when blood glucose is too high. In diabetes, insulin, a hormone that helps glucose enter your cells to give you energy, is either lacking or not functioning properly causing glucose to build up in your bloodstream. (8) Ninety to ninety-two percent of people with diabetes have type 2, which is largely preventable. This means that with early detection, nutritional interventions, and an increase in physical activity we can prevent the condition and symptoms associated with uncontrolled diabetes from occurring. Intervening when an individual has a pre-diabetes diagnosis can significantly reduce the risk of developing a variety of serious health conditions.
What are the risk factors for developing type 2 diabetes?
Determining if you are at risk for developing diabetes is important for effective prevention. Acknowledging risk factors for different health conditions can help individuals become more aware of their current lifestyle choices and health status. If preventative measures are taken early on, the chances of receiving a diagnosis are lowered.
Risk Factors (5)
- Pre-diabetes diagnosis
- Age of 45+
- Family history of type 2 diabetes
- Physical inactivity
- Tobacco use
- Previous occurrence of gestational diabetes
- You are African American, Hispanic/Latio American, Native American, or Native Alaskan
What are the signs of untreated Type 2 Diabetes?
If an individual has undiagnosed type 2 diabetes, there are serious symptoms to look out for:
- Feeling very thirsty
- Feeling very hungry
- Unintentional weight loss
- Urinating more often
- Blurred vision
- Tingling/numbness in the feet
- Darkened areas on the skin (armpits/neck)
What does it mean to have Pre-Diabetes?
Pre-diabetes is a health condition with blood glucose levels that are higher than normal but do not classify as a type 2 diabetes diagnosis. Detecting pre-diabetes through routine screening can have the biggest impact on preventing type 2 diabetes. If you are at risk for developing type 2 diabetes it is important to have your fasting blood glucose (sugar) levels, A1C%, and glucose tolerance testing routinely checked or monitored.(2) These are laboratory values that show your immediate blood sugar levels, your a average blood sugar level for the past 3 months, and your abilities to tolerate glucose after consumption. (10) Here are the criteria for diagnosing prediabetes and diabetes:
In pre-diabetes, there is still hope to prevent a type 2 diabetes diagnosis. The American Diabetes Association has a Diabetes Prevention Program (DPP) that was created to lower the increasing rates of prediabetes and type 2 diabetes in the United States. This is an intensive lifestyle behavioral lifestyle intervention program. This program can help reduce the risk of developing type 2 diabetes by 58% in 3 years. (11)
How can you prevent type 2 diabetes?
The Diabetes Prevention Program has two major goals in their intensive lifestyle change intervention. (11)
- Achieve and maintain a 5-7% weight loss
- Increase physical activity to 150 minutes per week
- Dietary Changes
To achieve weight loss, you will need to create a caloric deficit. A caloric deficit means that you are burning more calories than you are consuming. Calorie goals are calculated by determining an individual’s estimated calorie needs for their initial weight and subtracting 500-1000 calories per day. (11) Eating a well balanced diet is important in maintaining a healthy nutritional status. A variety of eating patterns can be appropriate for pre-diabetic patients. (11) Overall quality of food choices are also important. Dietary changes to incorporate are:
- Focusing on incorporating fruits, vegetables, whole grains, and lean proteins daily
- Eating a variety of foods
- Increasing fiber intake
- Reducing the amount of added or refined sugars
- Swapping out high calorie and high sugar drinks for water
- Consuming smaller, more frequent meals
The diabetes plate method can be a helpful tool in making well balanced meals:
- Physical Activity
Exercising regularly has a variety of health benefits. Exercise is important in the prevention of diabetes because a result of physical inactivity is the development of insulin resistance. Insulin resistance causes your body’s cells to not be able to absorb glucose into the cells. When this occurs, glucose stays in the bloodstream. Lack of physical activity also can lead to being overweight or obese, which increases the risk of developing type 2 diabetes as well.
For type 2 diabetes prevention, it is recommended to incorporate 150 minutes of moderate physical activity per week. (11) Exercise can be incorporated into daily activities through a variety of different outlets. Exercise can be completed at home, through leisure activities, through transportation, at a gym, or outdoors. Here are some forms of exercise that you can add into your weekly routine:
- Weight training
- Yard Work
- Stair climbing
- Active household chores
- Resistance training
- Maintain a Healthy Body Weight
If you are overweight or obese, 5-7% weight loss is recommended within the first 6 months of the intervention which can help to lower blood sugar levels and improve the function of insulin. (11,5) In long term prevention, a 7-10% weight loss is recommended for maximal prevention. (11)
- Set small weight loss goals of 1-2 lbs per week
- Increase lean muscle mass through weight bearing exercise
- Decrease body fat percentage through physical activity and healthy eating habits
- Create a Support Team
Surrounding yourself with supportive friends, family, or joining pre-diabetes support groups can help you be more successful in your health journey.
- Make healthy meals with your friends/family to encourage healthier eating for everyone
- Find a workout/walk/leisure activity buddy to help hold one another accountable
- Support groups can help educate, motivate, and share success and struggles with people who can related
- Pharmacologic Interventions
In some cases, pharmacology agents may be prescribed by your doctor as a preventative method of therapy. The medication prescribed for diabetes prevention is Metformin. Metformin works to reduce the amount of sugar your liver releases into the blood. It can also improve the body’s insulin response. Metformin therapy is more commonly prescribed for individuals with: (11)
- BMI of 35 or higher
- Women with previous diagnosis of gestational diabetes mellitus
- Men and women over the age of 60
Why is it important to prevent type 2 diabetes?
Type 2 diabetes is a very serious health condition that has consistently growing rates in the United States. If there is no lifestyle change with a pre-diabetes diagnosis, there will likely be a type 2 diabetes diagnosis within 10 years. (8) A study showed that in the span of 4 years, 37% of patients developed type 2 diabetes after they were diagnosed with pre-diabetes who did not have a nutritional or medical intervention. (6) The American Diabetes Association created the idea of a prediabetes diagnosis and its criteria in an attempt to catch signs of type 2 diabetes before it is an official diagnosis. Preventing a type 2 diabetes diagnosis will save lives, improve quality of life, and save money in medical bills and prescriptions.
There are also very serious health complications associated with untreated diabetes (7). Some of these complications can lead to coma or death. Early detection and prevention methods can help to delay or prevent the development of a variety of life threatening health complications. These include (7,4,3):
- Diabetic Neuropathy
- Diabetic Ketoacidosis
- Heart Disease
- Eye damage
- Sleep Apnea
- Increased risk of infection
- Slow healing wounds
- Diabetic ketoacidosis: MedlinePlus Medical Encyclopedia. MedlinePlus. https://medlineplus.gov/ency/article/000320.htm. Accessed October 5, 2020.
- Diabetes Tests. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/getting-tested.html. Published May 15, 2019. Accessed October 4, 2020.
- DKA (Ketoacidosis) & Ketones. DKA (Ketoacidosis) & Ketones | ADA. https://www.diabetes.org/diabetes/complications/dka-ketoacidosis-ketones. Accessed October 5, 2020. Kidney Disease (Nephropathy). Kidney Disease (Nephropathy) | ADA. https://www.diabetes.org/diabetes/complications/kidney-disease-nephropathy. Accessed October 5, 2020.
- Neuropathy. Neuropathy | ADA. https://www.diabetes.org/diabetes/complications/neuropathy. Accessed October 5, 2020.
- Prediabetes – Your Chance to Prevent Type 2 Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/prediabetes.html. Published June 11, 2020. Accessed October 4, 2020.
- Tuso P. Prediabetes and lifestyle modification: time to prevent a preventable disease. Perm J. 2014;18(3):88-93. doi:10.7812/TPP/14-002
- Type 2 diabetes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193. Published August 26, 2020. Accessed October 6, 2020.
- What is Diabetes? National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes. Published December 1, 2016. Accessed October 4, 2020.
- Nutrition Overview. https://www.diabetes.org/nutrition. Accessed October 14, 2020.
- CDC – About the Program – National Diabetes Prevention Program – Diabetes DDT. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/prevention/about.htm. Published November 15, 2018. Accessed October 15, 2020.
- 3. Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes—2020. (2019). Diabetes Care, 43(Supplement 1). doi:10.2337/dc20-s003