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Diseases & Conditions
The rate of type 2 diabetes is increasing around the world. Type 2 diabetes is a major cause of vision loss and blindness, kidney failure requiring dialysis, heart attacks, strokes, amputations, infections, and even early death. Over 80% of people with prediabetes (that is, high blood sugar with the high risk for developing full-blown diabetes) don’t know it. And one in four people who have full-blown diabetes don’t know they have it. Research suggests that a healthy lifestyle can prevent diabetes from occurring in the first place — and even reverse its progress.
The Diabetes Prevention Program (DPP), a large, long-term study, asked the question: we know an unhealthy diet and lifestyle can cause type 2 diabetes, but can adopting a healthy diet and lifestyle prevent it? This answer is yes: the vast majority of prediabetes and type 2 diabetes can be prevented through diet and lifestyle changes, and this has been proven by 20 years of medical research.
Researchers from the DPP took people at risk for type 2 diabetes and gave them a 24-week diet and lifestyle intervention, a medication (metformin), or a placebo (a fake pill), to see if anything could lower their risk for developing diabetes. The very comprehensive diet and lifestyle intervention had the goal of changing participants’ daily habits, and included: 16 classes teaching basic nutrition and behavioral strategies for weight loss and physical activity; lifestyle coaches with frequent contact with participants; supervised physical activity sessions; and good clinical support for reinforcing an individualized plan.
Perhaps not surprisingly, the diet and lifestyle intervention was incredibly effective. After three years, the diet and lifestyle group had a 58% lower risk of developing diabetes than the placebo group. Participants ages 60 and older had an even better response, with a whopping 71% lower risk of developing diabetes. The diet and lifestyle effect lasted: even after 10 years, those folks had a 34% lower risk of developing diabetes compared to placebo.
Men, women, and all racial and ethnic groups had similar results (and almost half of participants represented racial and ethnic minorities). These results are not surprising to me or to other doctors, because we have all seen patients with prediabetes or diabetes get their sugars down with diet, exercise, and weight loss alone.
Meanwhile, the medication group had a 31% lower risk of diabetes after three years, and an 18% lower risk after 10 years, which is also significant. It’s perfectly all right to use medications along with diet and lifestyle changes, because each boosts the effect of the other. Studies looking at the combination of medication (metformin) with diet and lifestyle changes have shown an even stronger result.
The CDC’s Diabetes Prevention Program, used in many clinics, is a free tool to help you learn and stick with the healthy diet, physical activity, and stress management techniques that reduce your risk of diabetes.
Another helpful tool is the Harvard T.H. Chan School of Public Health Nutrition Source Healthy Eating Plate, which shows you what your daily food intake should look like: half fruits and vegetables, about a quarter whole grains, and a quarter healthy proteins (plant protein is ideal here), with some healthy fats and no-sugar-added beverages.
Adapted from a Harvard Health Blog post by Monique Tello, MD, MPH
Harvard Health Publishing Staff
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing
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Respiratory health harms often follow flooding: Taking these steps can help
Want to cool down? 14 ideas to try
A fresh look at risks for developing young-onset dementia
Are you getting health care you don’t need?
Weighing in on weight gain from antidepressants
Dengue fever: What to know and do
How do trees and green spaces enhance our health?
Testosterone-blocking drugs boost heart disease risk when given in combination
Parenting isn’t easy: Two important skills can help
Does sleeping with an eye mask improve learning and alertness?
Staying Healthy
Staying Healthy
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