Is Diabetes a Dangerous Disease in 2021 ?

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Is Diabetes a Dangerous Disease in 2021 ?

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 Is Diabetes a Dangerous Disease in 2021 ?

Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces.

Insulin is a hormone made by the pancreas, that acts like a key to let glucose from the food we eat pass from the blood stream into the cells in the body to produce energy. All carbohydrate foods are broken down into glucose in the blood. Insulin helps glucose get into the cells. 

Not being able to produce insulin or use it effectively leads to raised glucose levels in the blood (known as hyperglycemia). Over the long-term high glucose levels are associated with damage to the body and failure of various organs and tissues.

Types of diabetes

There are three main types of diabetes – type 1, type 2 and gestational.

  • Type 1 diabetes can develop at any age, but occurs most frequently in children and adolescents. When you have type 1 diabetes, your body produces very little or no insulin, which means that you need daily insulin injections to maintain blood glucose levels under control.
  • Type 2 diabetes is more common in adults and accounts for around 90% of all diabetes cases. When you have type 2 diabetes, your body does not make good use of the insulin that it produces. The cornerstone of type 2 diabetes treatment is healthy lifestyle, including increased physical activity and healthy diet. However, over time most people with type 2 diabetes will require oral drugs and/or insulin to keep their blood glucose levels under control. 
  • Gestational diabetes (GDM) is a type of diabetes that consists of high blood glucose during pregnancy and is associated with complications to both mother and child. GDM usually disappears after pregnancy but women affected and their children are at increased risk of developing type 2 diabetes later in life. 

Type 1 diabetes is caused by an autoimmune reaction where the body’s defense system attacks the cells that produce insulin. As a result, the body produces very little or no insulin. The exact causes of this are not yet known, but are linked to a combination of genetic and environmental conditions.

Type 1 diabetes can affect people at any age, but usually develops in children or young adults. People with type 1 diabetes need daily injections of insulin to control their blood glucose levels. If people with type 1 diabetes do not have access to insulin, they will die.

The risk factors for type 1 diabetes are still being researched. However, having a family member with type 1 diabetes slightly increases the risk of developing the disease. Environmental factors and exposure to some viral infections have also been linked to the risk of developing type 1 diabetes.

Symptoms of type 1 diabetes

The most common symptoms of type 1 diabetes include:

  • Abnormal thirst and dry mouth
  • Sudden weight loss
  • Frequent urination
  • Lack of energy, tiredness
  • Constant hunger
  • Blurred vision
  • Bedwetting

Diagnosing type 1 diabetes can be difficult so additional tests may be required to confirm a diagnosis.

Management of type 1 diabetes

People with type 1 diabetes require daily insulin treatment, regular blood glucose monitoring and a healthy lifestyle to manage their condition effectively.

Insulin

All people with type 1 diabetes need to take insulin to control their blood glucose levels. There are different types of insulin depending on how quickly they work, when they peak, and how long they last. Insulin is commonly delivered with a syringe, insulin pen or insulin pump.

Types of insulin include:

  • Rapid-acting: usually taken just before or with a meal. These insulins act very quickly to limit the rise in blood sugar, which follows eating. It is essential to avoid overdosage to minimize the risk of low blood sugar (hypoglycemia). Rapid-acting insulins include Asparat, Glulisine, Lispro.
  • Short-acting: usually taken before meals. These insulins are also called regular or neutral insulins. They do not act as quickly as rapid-acting insulins and therefore may be more appropriate in certain people. Short-acting insulins include Actrapid, Humulin R, Insuman Rapid.
  • Intermediate-acting: often taken together with a short-acting insulin. Intermediate-acting insulins start to act within the first hour of injecting, followed by a period of peak activity lasting up to 7 hours. Intermediate acting insulins include Humulin NPH, Protaphane, Insulatard.
  • Long-acting: insulins that are steadily released and can last in the body for up to 24 hours. They are commonly taken in the morning or in the evening, before going to bed. Long-acting insulins include Detemir, Glargine.

Two common insulin treatment plans include:

  • Twice-daily insulin: using both short-acting and intermediate-acting insulin.
  • Basal bolus regimen: short-acting insulin taken with main meals (usually three times a day) and intermediate-acting insulin given once or twice daily (evening or morning and evening).
Self-monitoring

People with diabetes who require insulin need to check their blood glucose levels regularly to inform insulin dosage. Self-monitoring of blood glucose (SBMG) is the name given to the process of blood glucose testing by people with diabetes at home, school, work or elsewhere. SMBG helps people with diabetes and their healthcare providers understand how their blood glucose levels vary during the day so that their treatment can be adjusted accordingly.

People with type 1 diabetes are usually advised to measure their blood glucose level at least four times a day. 

Healthy nutrition

Healthy nutrition — knowing what and when to eat — is an important part of diabetes management as different foods affect your blood glucose levels differently.

A healthy diet for all people with diabetes includes reducing the amount of calories if you are overweight, replacing saturated fats (eg. cream, cheese, butter) with unsaturated fats (eg. avocado, nuts, olive and vegetable oils), eating dietary fibre (eg. fruit, vegetables, whole grains), and avoiding tobacco useexcessive alcohol and added sugar.

Physical activity

Regular physical activity is essential to help keep blood glucose levels under control. It is most effective when it includes a combination of both aerobic (eg. jogging, swimming, cycling) exercise and resistance training, as well as reducing the amount of time spent being inactive.

Prevention of type 1 diabetes

No effective and safe intervention currently exists to prevent type 1 diabetes despite a large number of clinical trials aimed at halting the on-going autoimmune destruction of pancreatic beta cells. However, there is some evidence that overweight and a high growth rate in children are weak risk factors, indicating that a healthy lifestyle that avoids both over-eating and a sedentary lifestyle is recommended for high-risk groups such as the siblings of children with type 1 diabetes. However, this is just one of a number of factors that have also been implicated. These include not being breast-fed, being the first-born, being born by caesarean section and having an older or obese mother.

Although a ‘cure’ for type 1 diabetes is being actively sought, preventing or delaying it in those known to be at risk or, in those already diagnosed, slowing down the auto-immune destruction of beta cells and protecting those cells that are still active are likely to be more achievable goals in the foreseeable future. Neither has been convincingly achieved as yet. However, several studies are underway using interventions such as oral insulin in people known to have markers of islet autoimmunity, trialing drugs already used, for example in psoriasis, to prolong beta cell life and the use of peptide immunotherapies to ‘retrain’ killer T cells, the lymphocytes that are closely involved in the underlying mechanism of type 1 diabetes.

Type 2 diabetes

Type 2 diabetes is the most common type of diabetes, accounting for around 90% of all diabetes cases.

It is generally characterized by insulin resistance, where the body does not fully respond to insulin. Because insulin cannot work properly, blood glucose levels keep rising, releasing more insulin. For some people with type 2 diabetes this can eventually exhaust the pancreas, resulting in the body producing less and less insulin, causing even higher blood sugar levels (hyperglycemia).

Type 2 diabetes is most commonly diagnosed in older adults, but is increasingly seen in children, adolescents and younger adults due to rising levels of obesity, physical inactivity and poor diet.

The cornerstone of type 2 diabetes management is a healthy dietincreased physical activity and maintaining a healthy body weight. Oral medication and insulin are also frequently prescribed to help control blood glucose levels.

Risk factors

Several risk factors have been associated with type 2 diabetes and include:

  • Family history of diabetes
  • Overweight
  • Unhealthy diet
  • Physical inactivity
  • Increasing age
  • High blood pressure
  • Ethnicity
  • Impaired glucose tolerance (IGT)*
  • History of gestational diabetes
  • Poor nutrition during pregnancy

*Impaired glucose tolerance (IGT) is a category of higher than normal blood glucose, but below the threshold for diagnosing diabetes.

Changes in diet and physical activity related to rapid development and urbanization have led to sharp increases in the numbers of people living with type 2 diabetes.

Symptoms of type 2 diabetes

The symptoms of type 2 diabetes are similar to those of type 1 diabetes and include:

  • Excessive thirst and dry mouth
  • Frequent urination
  • Lack of energy, tiredness
  • Slow healing wounds
  • Recurrent infections in the skin
  • Blurred vision
  • Tingling or numbness in hands and feet.

These symptoms can be mild or absent and so people with type 2 diabetes may live several years with the condition before being diagnosed.

Management of type 2 diabetes

The cornerstone of managing type 2 diabetes is a healthy lifestyle, which includes a healthy diet, regular physical activity, not smoking, and maintaining a healthy body weight.

Over time, a healthy lifestyle may not be enough to keep blood glucose levels under control and people with type 2 diabetes may need to take oral medication. If treatment with a single medication is not sufficient, combination therapy options may be prescribed.

When oral medication is not sufficient to control blood glucose levels, people with type 2 diabetes may require insulin injections.

Medications for type 2 diabetes

The most commonly used oral medications for type 2 diabetes include:

  • Metformin: reduces insulin resistance and allows the body to use its own insulin more effectively. It is regarded as the first-line treatment for type 2 diabetes in most guidelines around the world.
  • Sulfonylureas: stimulate the pancreas to increase insulin production. Sulfonylureas include gliclazide, glipizide, glimepiride, tolbutamide and glibenclamide.

Prevention of type 2 diabetes

There are a number of factors that influence the development of type 2 diabetes. The most influential are lifestyle behaviours commonly associated with urbanisation. Research indicates that a majority of cases of type 2 diabetes could be prevented through healthy diet and regular physical activity. A healthy diet includes reducing the amount of calories if you are overweight, replacing saturated fats (eg. cream, cheese, butter) with unsaturated fats (eg. avocado, nuts, olive and vegetable oils), eating dietary fibre (eg. fruit, vegetables, whole grains), and avoiding tobacco use, excessive alcohol and added sugar.

Regular physical activity is essential to help keep blood glucose levels under control. It is most effective when it includes a combination of both aerobic (eg. jogging, swimming, cycling) exercise and resistance training, as well as reducing the amount of time spent being inactive.

Know your risk of type 2 diabetes

Brief questionnaires are simple, practical and inexpensive ways to quickly identify people who may be at a higher risk of type 2 diabetes and who need to have their level of risk further investigated.

The Finnish Type 2 Diabetes Risk Assessment Form, developed in 2001, is an example of an effective questionnaire that can be used as the basis for developing national questionnaires which take into account local factors. It has eight scored questions, with the total test score providing a measure of the probability of developing type 2 diabetes over the following 10 years. The reverse of the form contains brief advice on what the respondent can do to lower their risk of developing the disease, and whether they should seek advice or have a clinical examination. The test takes only a couple of minutes to complete and can be done online, in pharmacies or at various public campaign events.

IDF has developed a type 2 diabetes online diabetes risk assessment that aims to predict an individual’s risk of developing type 2 diabetes within the next ten years. The test is based on the Finnish Diabetes Risk Score (FINDRISC) developed and designed by Adj. Prof Jaana Lindstrom and Prof. Jaakko Tuomilehto from the National Institute for Health and Welfare, Helsinki, Finland. 

Diabetes complications

People with diabetes have an increased risk of developing a number of serious health problems. Consistently high blood glucose levels can lead to serious diseases affecting the heart and blood vesselseyeskidneysnerves and teeth. In addition, people with diabetes also have a higher risk of developing infections. In almost all high-income countries, diabetes is a leading cause of cardiovascular diseaseblindnesskidney failure, and lower limb amputation.

Maintaining blood glucose levels, blood pressure, and cholesterol at or close to normal can help delay or prevent diabetes complications. Therefore people with diabetes need regular monitoring.

Cardiovascular disease: affects the heart and blood vessels and may cause fatal complications such as coronary artery disease (leading to heart attack) and stroke. Cardiovascular disease is the most common cause of death in people with diabetes. High blood pressure, high cholesterol, high blood glucose and other risk factors contribute to increasing the risk of cardiovascular complications. 

Kidney disease (diabetic nephropathy): caused by damage to small blood vessels in the kidneys leading to the kidneys becoming less efficient or to fail altogether. Kidney disease is much more common in people with diabetes than in those without diabetes. Maintaining near normal levels of blood glucose and blood pressure can greatly reduce the risk of kidney disease. 

Nerve disease (diabetic neuropathy): diabetes can cause damage to the nerves throughout the body when blood glucose and blood pressure are too high. This can lead to problems with digestion, erectile dysfunction, and many other functions. Among the most commonly affected areas are the extremities, in particular the feet. Nerve damage in these areas is called peripheral neuropathy, and can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations.

People with diabetes carry a risk of amputation that may be more than 25 times greater than that of people without diabetes. However, with comprehensive management, a large proportion of amputations related to diabetes can be prevented. Even when amputation takes place, the remaining leg and the person’s life can be saved by good follow-up care from a multidisciplinary foot team. People with diabetes should regularly examine their feet. 

Eye disease (diabetic retinopathy): most people with diabetes will develop some form of eye disease (retinopathy) causing reduced vision or blindness. Consistently high levels of blood glucose, together with high blood pressure and high cholesterol, are the main causes of retinopathy. It can be managed through regular eye checks and keeping glucose and lipid levels at or close to normal. 

Pregnancy complications: Women with any type of diabetes during pregnancy risk a number of complications if they do not carefully monitor and manage their condition. To prevent possible organ damage to the fetus, women with type 1 diabetes or type 2 diabetes should achieve target glucose levels before conception. All women with diabetes during pregnancy, type 1, type 2 or gestational should strive for target blood glucose levels throughout to minimize complications.

High blood glucose during pregnancy can lead to the foetus putting on excess weight. This can lead to problems in delivery, trauma to the child and mother, and a sudden drop in blood glucose for the child after birth. Children who are exposed for a long time to high blood glucose in the womb are at higher risk of developing diabetes in the future.

Oral complications: People with diabetes have an increased risk of inflammation of the gums (periodontitis) if blood glucose is not properly managed. Periodontitis is a major cause of tooth loss and is associated with an increased risk of cardiovascular disease (CVD). Regular oral check-ups should be established to ensure early diagnosis, particularly among people with previously undiagnosed diabetes and prompt management of any oral complications in people with diabetes. Annual visits are recommended for symptoms of gum disease such as bleeding when brushing teeth or swollen gums.

Diabetes prevention

At present, type 1 diabetes cannot be prevented. The environmental triggers that are thought to generate the process that results in the destruction of the body’s insulin-producing cells are still under investigation.

While there are a number of factors that influence the development of type 2 diabetes, it is evident that the most influential are lifestyle behaviours commonly associated with urbanization. These include consumption of unhealthy foods and inactive lifestyles with sedentary behaviour. Studies from different parts of the world have established that lifestyle modification with physical activity and/or healthy diet can delay or prevent the onset of type 2 diabetes.

Modern lifestyles are characterized by physical inactivity and long sedentary periods. Community-based interventions can reach individuals and families through campaigns, education, social marketing and encourage physical activity both inside and outside school and the workplace. IDF recommends physical activity at least between three to five days a week, for a minimum of 30-45 minutes.

Taking a life course perspective is essential for preventing type 2 diabetes and its complications. Early in life, when eating and physical activity habits are established and when the long-term regulation of energy balance may be programmed, there is an especially critical window to prevent the development of overweight and reduce the risk of type 2 diabetes. Healthy lifestyles can improve health outcomes at later stages of life as well.

Population based interventions and policies allow healthy choices through policies in trade, agriculture, transport and urban planning to become more accessible and easy. Healthy choices can be promoted in specific settings (school, workplace and home) and contribute to better health for everyone. They include exercising regularly and eating wisely which will help to maintain normal levels of blood glucose, blood pressure and lipids.

Learn more about cost-affection solutions for the prevention of type 2 diabetes.

Type 2 diabetes prevention studies

There is overwhelming evidence from studies in the USA, Finland, China, India and Japan that lifestyle changes (achieving a healthy body weight and moderate physical activity) can help prevent the development of type 2 diabetes in those at high risk.

  • The Da Qing Study examined the effect of a 6-year diet and exercise intervention in Chinese individuals with Impaired Glucose Tolerance (IGT) and an average age of 45. The diet intervention alone was associated with a 31% reduction in the risk of developing type 2 diabetes, while the exercise intervention alone showed a 46% reduction. The combined diet and exercise group had a similar 42% reduction in the risk of developing type 2 diabetes during a 6-year follow-up period.
  • The Finnish Diabetes Prevention Study (DPS) was the first randomized controlled trial to specifically examine the effect of a lifestyle intervention in preventing type 2 diabetes. This study randomly assigned 522 overweight or obese individuals with IGT to either a lifestyle intervention or a control group and followed them for approximately 3 years. The lifestyle intervention provided individualized counseling focused on achieving and maintaining healthy body weight, reducing fat intake, increasing fiber intake and increasing physical activity. After two years, the incidence of type 2 diabetes in the intervention group was less than half that observed within the control group.
  • The Diabetes Prevention Program (DPP) was conducted in 3234 US adults with IGT. Unlike most previous studies, the cohort was diverse and included a large proportion of women (68%) and ethnic minorities (45%), and compared lifestyle intervention versus drug intervention (metformin) and a placebo control group over 2.8 years. The DPP reported that both lifestyle intervention and metformin had positive effects on the prevention of type 2 diabetes and restoring normal glucose tolerance. The lifestyle intervention was more effective in preventing type 2 diabetes, particularly in older adults.
  • The Indian Diabetes Prevention Program (IDPP) was a prospective community-based study, that examined whether the progression to type 2 diabetes could be influenced by interventions in native Asian Indians with IGT who were younger, leaner and more insulin resistant than in multiethnic American, Finnish and Chinese populations Results showed that progression of IGT to type 2 diabetes is high in native Asian Indians. Both lifestyle modification and metformin significantly reduced the incidence of type 2 diabetes in Asian Indians with IGT.

IDF recommendations for a healthy diet for the general population

  1. Choosing water, coffee or tea instead of fruit juice, soda, or other sugar sweetened beverages.
  2. Eating at least three servings of vegetable every day, including green leafy vegetables.
  3. Eating up to three servings of fresh fruit every day.
  4. Choosing nuts, a piece of fresh fruit, or unsweetened yoghurt for a snack.
  5. Limiting alcohol intake to a maximum of two standard drinks per day.
  6. Choosing lean cuts of white meat, poultry or seafood instead of red or processed meat.
  7. Choosing peanut butter instead of chocolate spread or jam.
  8. Choosing whole-grain bread, rice, or pasta instead of white bread, rice, or pasta.
  9. Choosing unsaturated fats (olive oil, canola oil, corn oil, or sunflower oil) instead of saturated fats (butter, ghee, animal fat, coconut oil or palm oil.

A particular threat in terms of the associated risk of developing type 2 diabetes is the consumption of high sugar foods, particularly sugar-sweetened beverages, In 2014, the World Health Organization (WHO) issued new recommendations to limit sugar intake. IDF fully supports these recommendations and in response published the IDF Framework for Action on Sugar.

13 Ways to Prevent Type 2 Diabetes

Type 2 diabetes is a chronic disease that affects millions of people worldwide. Uncontrolled cases can cause blindness, kidney failure, heart disease and other serious conditions.

Before diabetes is diagnosed, there is a period where blood sugar levels are high but not high enough to be diagnosed as diabetes. This is known as prediabetes.

It’s estimated that up to 70% of people with prediabetes go on to develop type 2 diabetes. Fortunately, progressing from prediabetes to diabetes isn’t inevitable (1).

Although there are certain factors you can’t change — such as your genes, age or past behaviors — there are many actions you can take to reduce the risk of diabetes.

Here are 13 ways to avoid getting diabetes.

1. Cut Sugar and Refined Carbs From Your Diet

Eating sugary foods and refined carbs can put at-risk individuals on the fast track to developing diabetes.

Your body rapidly breaks these foods down into small sugar molecules, which are absorbed into your bloodstream.

The resulting rise in blood sugar stimulates your pancreas to produce insulin, a hormone that helps sugar get out of the bloodstream and into your body’s cells.

In people with prediabetes, the body’s cells are resistant to insulin’s action, so sugar remains high in the blood. To compensate, the pancreas produces more insulin, attempting to bring blood sugar down to a healthy level.

Over time, this can lead to progressively higher blood sugar and insulin levels, until the condition eventually turns into type 2 diabetes.

Many studies have shown a link between the frequent consumption of sugar or refined carbs and the risk of diabetes. What’s more, replacing them with foods that have less of an effect on blood sugar may help reduce your risk.

A detailed analysis of 37 studies found that people with the highest intakes of fast-digesting carbs were 40% more likely to develop diabetes than those with the lowest intakes .

2. Work Out Regularly

Performing physical activity on a regular basis may help prevent diabetes.

Exercise increases the insulin sensitivity of your cells. So when you exercise, less insulin is required to keep your blood sugar levels under control.

One study in people with prediabetes found that moderate-intensity exercise increased insulin sensitivity by 51% and high-intensity exercise increased it by 85%. However, this effect only occurred on workout days .

Many types of physical activity have been shown to reduce insulin resistance and blood sugar in overweight, obese and prediabetic adults. These include aerobic exercise, high-intensity interval training and strength training .

Working out more frequently seems to lead to improvements in insulin response and function. One study in people at risk of diabetes found that burning more than 2,000 calories weekly via exercise was required to achieve these benefits .

Therefore, it’s best to choose physical activity that you enjoy, can engage in regularly and feel you can stick with long-term.

3. Drink Water as Your Primary Beverage

Water is by far the most natural beverage you can drink.

What’s more, sticking with water most of the time helps you avoid beverages that are high in sugar, preservatives and other questionable ingredients.

Sugary beverages like soda and punch have been linked to an increased risk of both type 2 diabetes and latent autoimmune diabetes of adults (LADA).

LADA is a form of type 1 diabetes that occurs in people over 18 years of age. Unlike the acute symptoms seen with type 1 diabetes in childhood, LADA develops slowly, requiring more treatment as the disease progresses.

One large observational study looked at the diabetes risk of 2,800 people.

Those who consumed more than two servings of sugar-sweetened beverages per day had a 99% increased risk of developing LADA and a 20% increased risk of developing type 2 diabetes .

Researchers of one study on the effects of sweet drinks on diabetes stated that neither artificially sweetened beverages nor fruit juice were good beverages for diabetes prevention .

By contrast, consuming water may provide benefits. Some studies have found that increased water consumption may lead to better blood sugar control and insulin response .

One 24-week study showed that overweight adults who replaced diet sodas with water while following a weight loss program experienced a decrease in insulin resistance and lower fasting blood sugar and insulin levels .

4. Lose Weight If You’re Overweight or Obese

Although not everyone who develops type 2 diabetes is overweight or obese, the majority are.

What’s more, those with prediabetes tend to carry excess weight in their midsection and around abdominal organs like the liver. This is known as visceral fat.

Excess visceral fat promotes inflammation and insulin resistance, which significantly increase the risk of diabetes.

Although losing even a small amount of weight can help reduce this risk, studies show that the more you lose, the more benefits you’ll experience .

One study of more than 1,000 people with prediabetes found that for every kilogram (2.2 lbs) of weight participants lost, their risk of diabetes reduced by 16%, up to a maximum reduction of 96%.

There are many healthy options for losing weight, including low-carb, Mediterranean, paleo and vegetarian diets. However, choosing a way of eating you can stick with long-term is key to helping you maintain the weight loss.

One study found that obese people whose blood sugar and insulin levels decreased after losing weight experienced elevations in these values after gaining back all or a portion of the weight they lost.

5. Quit Smoking

Smoking has been shown to cause or contribute to many serious health conditions, including heart disease, emphysema and cancers of the lung, breast, prostate and digestive tract .

There’s also research linking smoking and second-hand smoke exposure to type 2 diabetes .

In an analysis of several studies totaling over one million people, smoking was found to increase the risk of diabetes by 44% in average smokers and 61% in people who smoked more than 20 cigarettes daily .

One study followed the risk of diabetes in middle-aged male smokers after they quit. After five years their risk had reduced by 13%, and after 20 years they had the same risk as people who had never smoked .

Researchers stated that even though many of the men gained weight after quitting, after several smoke-free years, their risk of diabetes was lower than if they’d continued smoking.

6. Follow a Very-Low-Carb Diet

Following a ketogenic or very-low-carb diet can help you avoid diabetes.

Although there are a number of ways of eating that promote weight loss, very-low-carb diets have strong evidence behind them.

They have consistently been shown to lower blood sugar and insulin levels, increase insulin sensitivity and reduce other diabetes risk factors .

In a 12-week study, prediabetic individuals consumed either a low-fat or low-carb diet. Blood sugar dropped by 12% and insulin dropped by 50% in the low-carb group.

In the low-fat group, meanwhile, blood sugar dropped by only 1% and insulin dropped by 19%. Thus, the low-carb diet had better results on both counts .

If you minimize your carb intake, your blood sugar levels won’t rise very much after you eat. Therefore, your body needs less insulin to maintain your blood sugar within healthy levels.

What’s more, very-low-carb or ketogenic diets may also reduce fasting blood sugar.

In a study of obese men with prediabetes who followed a ketogenic diet, average fasting blood sugar decreased from 118 to 92 mg/dl, which is within the normal range. Participants also lost weight and improved several other health markers .

For more info, check out this Guide to Healthy Low-Carb Eating With Diabetes.

7. Watch Portion Sizes

Whether or not you decide to follow a low-carb diet, it’s important to avoid large portions of food to reduce the risk of diabetes, especially if you are overweight.

Eating too much food at one time has been shown to cause higher blood sugar and insulin levels in people at risk of diabetes .

On the other hand, decreasing portion sizes may help prevent this type of response.

A two-year study in prediabetic men found that those who reduced food portion sizes and practiced other healthful nutrition behaviors had a 46% lower risk of developing diabetes than the men who made no lifestyle changes .

Another study looking at weight loss methods in people with prediabetes reported that the group practicing portion control lowered their blood sugar and insulin levels significantly after 12 weeks .

8. Avoid Sedentary Behaviors

It’s important to avoid being sedentary if you want to prevent diabetes.

If you get no or very little physical activity, and you sit during most of your day, then you lead a sedentary lifestyle.

Observational studies have shown a consistent link between sedentary behavior and the risk of diabetes.

A large analysis of 47 studies found that people who spent the highest amount of time per day engaged in sedentary behavior had a 91% increased risk of developing diabetes .

Changing sedentary behavior can be as simple as standing up from your desk and walking around for a few minutes every hour.

Unfortunately, it can be hard to reverse firmly entrenched habits.

One study gave young adults at risk of diabetes a 12-month program designed to change sedentary behavior. Sadly, after the program ended, the researchers found that participants hadn’t reduced how much time they sat .

Set realistic and achievable goals, such as standing while talking on the phone or taking the stairs instead of the elevator. Committing to these easy, concrete actions may be the best way to reverse sedentary tendencies.

9. Eat a High-Fiber Diet

Getting plenty of fiber is beneficial for gut health and weight management.

Studies in obese, elderly and prediabetic individuals have shown that it helps keep blood sugar and insulin levels low .

Fiber can be divided into two broad categories: soluble and insoluble. Soluble fiber absorbs water, whereas insoluble fiber does not.

In the digestive tract, soluble fiber and water form a gel that slows down the rate at which food is absorbed. This leads to a more gradual rise in blood sugar levels .

However, insoluble fiber has also been linked to reductions in blood sugar levels and a decreased risk of diabetes, although exactly how it works is not clear .

Most unprocessed plant foods contain fiber, although some have more than others. Check out this list of 22 high-fiber foods for many excellent sources of fiber.

10. Optimize Vitamin D Levels

Vitamin D is important for blood sugar control.

Indeed, studies have found that people who don’t get enough vitamin D, or whose blood levels are too low, have a greater risk of all types of diabetes .

Most health organizations recommend maintaining a vitamin D blood level of at least 30 ng/ml (75 nmol/l).

One study found that people with the highest blood levels of vitamin D were 43% less likely to develop type 2 diabetes than those with the lowest blood levels.

Another observational study looked at Finnish children who received supplements containing adequate levels of vitamin D.

Children who took the vitamin D supplements had a 78% lower risk of developing type 1 diabetes than children who received less than the recommended amount of vitamin D .

Controlled studies have shown that when people who are deficient take vitamin D supplements, the function of their insulin-producing cells improves, their blood sugar levels normalize and their risk of diabetes reduces significantly .

Good food sources of vitamin D include fatty fish and cod liver oil. In addition, sun exposure can increase vitamin D levels in the blood.

However, for many people, supplementing with 2,000–4,000 IU of vitamin D daily may be necessary to achieve and maintain optimal levels.

11. Minimize Your Intake of Processed Foods

One clear step you can take to improve your health is to minimize your consumption of processed foods.

They’re linked to all sorts of health problems, including heart disease, obesity and diabetes.

Studies suggest that cutting back on packaged foods that are high in vegetable oils, refined grains and additives may help reduce the risk of diabetes.

This may be partly due to the protective effects of whole foods like nuts, vegetables, fruits and other plant foods.

One study found that poor-quality diets that were high in processed foods increased the risk of diabetes by 30%. However, including nutritious whole foods helped reduce this risk .

12. Drink Coffee or Tea

Although water should be your primary beverage, research suggests that including coffee or tea in your diet may help you avoid diabetes.

Studies have reported that drinking coffee on a daily basis reduced the risk of type 2 diabetes by 8–54%, with the greatest effect generally seen in people with the highest consumption.

Another review of several studies that included caffeinated tea and coffee found similar results, with the largest risk reduction in women and overweight men .

Coffee and tea have antioxidants known as polyphenols that may help protect against diabetes .

In addition, green tea contains a unique antioxidant compound called epigallocatechin gallate (EGCG) that has been shown to reduce blood sugar release from the liver and increase insulin sensitivity .

13. Consider Taking These Natural Herbs

There are a few herbs that may help increase insulin sensitivity and reduce the likelihood of diabetes progression.

Curcumin

Curcumin is a component of the bright gold spice turmeric, which is one of the main ingredients in curries.

It has strong anti-inflammatory properties and has been used in India for centuries as part of Ayurvedic medicine.

Research has shown it can be very effective against arthritis and may help reduce inflammatory markers in people with prediabetes .

There’s also impressive evidence that it may decrease insulin resistance and reduce the risk of diabetes progression.

In a controlled nine-month study of 240 prediabetic adults, among the group who took 750 mg of curcumin daily, no one developed diabetes. However, 16.4% of the control group did .

In addition, the curcumin group experienced an increase in insulin sensitivity and improved functioning of insulin-producing cells in the pancreas.

Berberine

Berberine is found in several herbs and has been used in traditional Chinese medicine for thousands of years.

Studies have shown that it fights inflammation and lowers cholesterol and other heart disease markers .

In addition, several studies in people with type 2 diabetes have found that berberine has strong blood-sugar-lowering properties .

In fact, a large analysis of 14 studies found that berberine is as effective at lowering blood sugar levels as metformin, one of the oldest and most widely used diabetes medications .

Because berberine works by increasing insulin sensitivity and reducing the release of sugar by the liver, it might theoretically help people with prediabetes avoid diabetes.

However, at this point there are no studies that have looked at this.

In addition, since its effects on blood sugar are so strong, it should not be used in conjunction with other diabetes medications unless authorized by a doctor.

The Bottom Line

You have control over many of the factors that influence diabetes.

Rather than viewing prediabetes as a stepping stone to diabetes, it may be helpful to see it as a motivator for making changes that can help reduce your risk.

Eating the right foods and adopting other lifestyle behaviors that promote healthy blood sugar and insulin levels will give you the best chance at avoiding diabetes.

Source :-

Healthline & IDF

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