How can you prevent type 2 diabetes?

By Dr. Austin Smith

One of the most important first steps one can take to prevent type 2 diabetes mellitus (T2DM) is to reach out to a primary care provider.

By doing so, it will be possible to undergo basic screening tests for type 2 diabetes.

For example, the US Preventive Services Task Force (USPSTF)—which issues guidance on a variety of issues based on medical experts’ review of all relevant scientific studies—recommends screening for abnormal blood sugars in adults aged 40 to 70 years who are considered overweight (that is, having a Body Mass Index of 25-29.9) or obese (that is, having a Body Mass Index of 30 or above).

This isn’t a hard-and-fast rule, however. And there are other similar organizations that issue guidelines for screening that differ slightly. The bottom line is that even if one doesn’t meet the above-mentioned criteria from USPSTF, a simple discussion with one’s primary care provider can lead to a personalized approach to screening that’s sensible.

Screening tests for type 2 diabetes will reveal one of three possible outcomes: 1) normal blood sugar, 2) somewhat elevated blood sugar (prediabetes), or 3) significantly elevated blood sugar (type 2 diabetes).

In the event that screening doesn’t reveal type 2 diabetes, then there are options available that can help prevent or at least delay the onset of diabetes.

For all patients, smoking cessation, physical activity, and dietary changes are recommended to help bring blood sugar levels closer to the normal range.

Evidence from scientific studies has shown that 150 minutes a week of either moderate aerobic exercise or weight training can help prevent type 2 diabetes.

Diet and Preventing Type 2 Diabetes
A growing body of evidence shows that a well-formulated ketogenic diet can improve and even reverse T2DM. Please see our related post on the best diet for type 2 diabetes.

Ongoing scientific work has shown that Virta’s treatment, which includes a well-formulated ketogenic diet, helps significantly lower blood sugars in those with T2DM. In Virta’s clinical trial, the Virta treatment has been found to reverse T2DM in 60% of patients at one year. At present, Virta cares for patients with T2DM and those with prediabetes. Patients living with prediabetes are excited by the prospect that Virta will help prevent T2DM.

There is also evidence that a Mediterranean diet can help prevent type 2 diabetes. Although there’s no single, universally agreed-upon definition of a Mediterranean diet, it’s typically comprised mostly of nuts, whole grains, fruits, olive oil, vegetables, beans, and seeds.

One medication, metformin, has been shown in multiple studies to be effective at preventing the onset of T2DM. Metformin is both inexpensive and without long-term safety concerns.

The most prudent way to get on track toward preventing T2DM is to have a discussion with one’s primary care provider about the above-mentioned options to help craft an individualized approach that will suit your values and needs best.
Citations:

Bloomfield, H. E., Koeller, E., Greer, N., Macdonald, R., Kane, R., & Wilt, T. J. (2016). Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake. Annals of Internal Medicine,165(7), 491. doi:10.7326/m16-0361

Salas-Salvado, J., Bullo, M., Babio, N., Martinez-Gonzalez, M. A., Ibarrola-Jurado, N., Basora, J., . . . Ros, E. (2010). Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet: Results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care, 34(1), 14-19. doi:10.2337/dc10-1288

Salas-Salvadó, J., Bulló, M., Estruch, R., Ros, E., Covas, M., Ibarrola-Jurado, N., . . . Martínez-González, M. A. (2014). Prevention of Diabetes With Mediterranean Diets. Annals of Internal Medicine,160(1), 1-10. doi:10.7326/m13-1725

Smith, A. D., Crippa, A., Woodcock, J., & Brage, S. (2016). Physical activity and incident type 2 diabetes mellitus: A systematic review and dose–response meta-analysis of prospective cohort studies. Diabetologia,59(12), 2527-2545. doi:10.1007/s00125-016-4079-0

U.S. Preventive Services Task Force Final Recommendation Statement — Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Screening. (2015, October). Retrieved October 9, 2018, from https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/screening-for-abnormal-blood-glucose-and-type-2-diabetes

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