Type 2 Diabetes and Risk Reduction

Type 2 diabetes, formerly called adult-onset or non-insulin-dependent diabetes, is the most common form of diabetes. People can develop Type 2 diabetes at any age, even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Being overweight and inactive increases the chances of developing Type 2 diabetes. Treatment includes taking diabetes medicines, making wise food choices, exercising regularly, and controlling blood pressure and cholesterol.

What are the signs and symptoms of Type 2 diabetes?

Many people have no signs or symptoms. Symptoms can also be so mild that you might not even notice them. More than 5 million people in the United States have Type 2 diabetes and do not know it. Here is what to look for:

  • Increased thirst
  • Increased hunger
  • Fatigue
  • Increased urination, especially at night
  • Weight loss
  • Blurred vision
  • Sores that do not heal

Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as blurry vision or heart trouble. It is important to find out early if you have diabetes because treatment can prevent damage to the body from diabetes.

What does it mean to have pre-diabetes?

If you have been told that you have pre-diabetes, it means you are at risk for getting Type 2 diabetes and heart disease. The good news is if you have pre-diabetes you can reduce the risk of getting diabetes and even return to normal blood glucose levels. With modest weight loss and moderate physical activity, you can delay or prevent Type 2 diabetes. If your blood glucose is higher than normal but lower than the diabetes range (what is now called pre-diabetes), have your blood glucose checked in 1-2 years.

What can I do about my risk?

You can do a lot to lower your chances of getting diabetes. Exercising regularly, reducing fat and calorie intake, and losing weight can help you reduce your risk of developing Type 2 diabetes. Lowering blood pressure and cholesterol levels also helps you stay healthy.

Reach and maintain a reasonable body weight

Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. Losing even a few pounds can help reduce your risk of developing Type 2 diabetes because it helps your body use insulin more effectively. In the Diabetes Prevention Program (DPP), a study evaluating standard diabetes care, metformin, and lifestyle modification, people who lost 5-7% of their body weight significantly reduced their risk of Type 2 diabetes.

If you are overweight or obese, choose sensible ways to get in shape:

  • Avoid crash diets. Instead, eat less of the foods you usually have. Limit the amount of fat you eat.
  • Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week.
  • Set a reasonable weight-loss goal, such as losing 1 lb per week. Aim for a long-term goal of losing 5-7% of your total body weight.

Make wise food choices most of the time

What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.

  • Take a hard look at the serving sizes of the foods you eat. Reduce serving sizes of main courses (such as meat), desserts, and foods high in fat. Increase the amount of fruits and vegetables.
  • Limit your fat intake to about 25% of your total calories. For example, if your food choices add up to about 2,000 calories/d, try to eat no more than 56 g of fat. Your doctor or a dietitian can help you figure out how much fat to have. You can check food labels for fat content too.
  • You may also wish to reduce the number of calories you have each day. People in the DPP lifestyle modification group lowered their daily calorie total by an average of about 450 calories. Your doctor or dietitian can help you with a meal plan that emphasizes weight loss.

Be physically active every day

Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin. People in the DPP who were physically active for 30 minutes a day five days a week reduced their risk of Type 2 diabetes. Many chose brisk walking for exercise.

If you are not very active, you should start slowly (see list), talking with your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active for at least 30 minutes a day most days of the week. When preparing to exercise, if you haven’t eaten for more than an hour or if your blood glucose is less than 100-120, have a snack before you begin.

Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. For more information, please see: www.diabetes.niddk.nih.gov/dm/pubs/riskfortype2/index.htm.