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10 steps to reduce your risk of type 2 diabetes

More than half of all cases of type 2 diabetes could have been prevented or delayed, find out what you could be doing to reduce your risk of developing this lifelong disease. 

Approximately 415 million people in the world are living with diabetes [1], and yet more than half of all cases of type 2 diabetes could have been prevented or delayed [2]. So where are we going wrong? Here we take a look at how diabetes affects the body, the symptoms to look out for, and which simple changes you can make to reduce your risk of developing this preventable disease.  

What is diabetes?

Diabetes is a condition that causes your blood sugar levels to become too high for your body to process correctly. Here’s the science behind it: 

Your blood sugar levels are controlled by insulin - a hormone that is produced by your pancreas. When you digest food, glucose is produced and used in your cells for energy. Insulin moves the glucose out of the blood and into the cells. Diabetes causes the body not to produce enough insulin or the present insulin not to work correctly, leaving higher levels of glucose in the bloodstream.

The two types of diabetes are:

  • Type 1 – the body’s immune system destroys the cells that produce insulin.
  • Type 2 – the body does not produce enough insulin or react to the insulin that is created.

In the UK, 90% of diabetes cases are type 2 [3]; if left uncontrolled, type 2 diabetes can cause serious health issues such as blindness, heart disease and kidney failure. 

What are the symptoms?

It's important to identify type 2 diabetes early and receive the correct treatment. Some of its symptoms are: 

  • Excessive thirst
  • Frequent urination (particularly at night)
  • Tiredness
  • Weight loss
  • Genital itching
  • Blurred vision
  • Cuts/injuries taking longer to heal

If you’re experiencing any of these symptoms or are concerned about your status, our Diabetes (HbA1c) Blood Test can diagnose type 2 diabetes. Your doctor can use your results to prescribe the appropriate treatment. 

However, before diabetes even develops, your body enters a stage where its blood sugar levels are higher than the norm, but not high enough to be considered diabetic. This stage is called pre-diabetes and is where action needs to be taken. 

Pre-diabetes does not show any symptoms, and most people are unaware that they are becoming resistant to insulin. Here are some targets to look out for when testing your blood sugar levels:

  • HbA1c levels over 48 mmol/mol = diabetes 
  • HbA1c levels between 42 - 47.9 mmol/mol = pre-diabetic

If your results are showing pre-diabetic levels, the good news is that it’s still possible to prevent this from developing into full-fledged diabetes. Although you can’t control factors such as age or genetics, there are many lifestyle changes that you can take control of. 

How can I reduce my risk?

This is your chance to delay or prevent a lifelong condition, and the answer can be very simple. Here are our top 10 steps to reduce your risk of developing type 2 diabetes: 

1. Lose excess weight

The majority of people that develop type 2 diabetes are overweight, particularly in the midsection where the fat covers the abdominal organs (known as visceral fat). Excess body weight can cause inflammation and insulin resistance and may lead to the development of diabetes.

Losing excess fat brings multiple benefits into all aspects of your life, but sometimes the path to do so is not easy. Start by adopting a healthy and balanced diet, and exercising regularly, experiment with different routines until you find what works best for you. Weight loss planners are a great way of tracking your progress and staying accountable for your goals. 

However, if you feel like this isn’t working for you, there may be some underlying health issues. Speak to your doctor or dietician about your concerns so they can complete a thorough health examination.

2. Reduce your fat intake

After learning about how diabetes is caused, you can understand why people often think that a diet high in refined sugar is the main culprit of diabetes. But dig a little deeper, and you will learn that a high intake of unhealthy fats from processed junk foods can also play a major part. It is very important to be mindful of this when selecting “low sugar” or “sugar-free” versions of foods in the supermarket where there may be added unhealthy fats to compensate. 

Studies have shown that people with an overall dietary pattern that emphasises meat, dairy products, and fatty foods (aided with sugary foods also) are more at risk of developing diabetes than those who emphasise sugar alone [4]. 

Many studies show a plant-based diet with a focus on vegetables and whole grains has helped in reducing the risk of diabetes, including Medichecks own study (2019) of 21,000 UK residents which showed that vegans have better blood glucose control markers compared to non-vegans.

So, while cutting out refined sugar is the most obvious to consider in reducing your chances of developing type 2 diabetes, it should not be your only dietary concern. Don’t worry, if you’re a foodie there are plenty of healthy recipes that you’ll still be able to enjoy, Diabetes UK has an excellent guide for you to browse and gain inspiration. 

3. Avoid sweet and fizzy drinks 

Water should be your primary beverage; it's by far the most natural and healthy option you'll find. Not only does water have countless health benefits, but it will also help you to avoid other beverages that contain preservatives and high sugar contents [5]. 

Popular beverages such as soda or energy drinks can contribute to the development of type 2 diabetes, but simply swapping them for water will have the reverse effect by decreasing insulin resistance and lowering blood sugar levels [5]. If you find this is too much of a drastic change, you could start by switching to sparkling water. For flavour, try adding a squeeze of lemon or a herbal teabag. Drinking plenty of water through the day can also help in keeping you fuller for longer and therefore prevent any overeating.

The same can be said for alcohol consumption. Alcoholic drinks tend to contain a shocking number of calories and sugar, increase your appetite, and reduce your inhibitions to eat more high sugar/high-fat foods. Long-term drinking can, therefore, lead to weight gain and excessive amounts can be damaging for your pancreas, meaning it can no longer produce insulin correctly. Having the occasional drink is unlikely to cause significant harm but try to avoid any excessive consumption, keeping your intake below 14 units per week. You can visit the Drinkaware website or download their app to track the amount you drink.

4. Optimise your vitamin D levels

Surprisingly, vitamin D has an impact on your blood sugar. Higher levels of the vitamin help the function of your insulin-producing cells and normalise your blood sugar levels. An optimal vitamin D level is 50 nmol/L, or above, anything less would be considered insufficient, and levels below 25 nmol/L would be a deficiency. It’s common in the UK to have insufficient levels of vitamin D; you can find out if that applies to you with our Vitamin D (25 OH) Blood Test

It’s quite easy to increase your levels of vitamin D, either through sun exposure or taking supplements. Diet can also help but only to some extent – good examples of vitamin D food sources include oily fish (e.g. salmon, sardines) cod liver oil, egg yolks and fortified milk and tofu if you are vegan.

5. Avoid a sedentary lifestyle

A sedentary lifestyle means you are sitting for the majority of your day and partake in little to no physical exercise. Multiple studies have found that people with high sedentary behaviours increase their risk of developing diabetes by 91% [6].

Although it can be hard to change deep-rooted habits, don't feel like you need to take up a new sport immediately. You can make improvements to your health with small, simple actions such as walking around the room every hour. Don’t set goals that are too high, start with gradual changes and eventually build up to being more active. 

6. Exercise regularly 

With steps four and five already said, you probably knew this one was coming. Exercise increases your cell’s insulin sensitivity; therefore, less insulin is needed to control your blood sugar levels. Physical activity needs to be performed consistently to have a notable impact, so it’s best to do something you enjoy and can commit to long-term. 

Most types of exercise are shown to reduce insulin resistance, such as aerobic exercise, high-intensity interval training (HIIT) and strength training. Our health hub offers multiple articles and tips for beginners who want to embark on a fitness journey. 

7. Quit smoking

Smoking can cause many serious health conditions such as heart disease, emphysema, and cancers of multiple organs. But there is also research that links smoking to an increased risk of type 2 diabetes [7]. 
By now, we’re all aware of the detrimental impacts smoking has on our health, but sometimes it’s easier said than done when it comes to quitting. The NHS offers multiple support group and self-help articles to encourage you in your journey. Although you may gain weight immediately after quitting, your overall risk of developing diabetes will lower in the longer term. 

8. Adopt a low glycemic-index diet

A healthy, balanced diet is always key to optimising your health, but there are also certain plans that are designed to combat pre-diabetes. Specifically, a low glycaemic-index (GI) diet is shown to have numerous benefits. Low GI diets focus on foods which are more slowly converted into energy by the body. They can help to make blood glucose levels more stable and is, therefore, beneficial in preventing and controlling diabetes. 

The glycemic index ranks food depending on the rate at which the body breaks it down to glucose. High GI foods are quickly broken down into glucose; examples include white bread, sweetened drinks, biscuits, potatoes, and oranges. Some examples of low GI foods are green vegetables, raw carrots, kidney beans, chickpeas, lentils, and bran breakfast cereals.

Minimising your carbohydrates and increasing your fibre intakes also mean your blood sugar levels won’t spike as much after eating, so your body will need less insulin to maintain your blood sugar within healthy levels [5]. Fibre can be found in fruit and vegetables, and wholegrain wheat. 

If you’re interested in researching other specific diet plans, these have been known to decrease your risk of type 2 diabetes:

9. Control the amount you eat

Not only should you monitor what you’re eating, but also how much you’re eating as well. You should try to avoid large portions of food, particularly if you’re overweight. Overeating leads to higher blood sugar levels and therefore, an increased risk of diabetes. 

So, it stands to reason that reduced portion sizes will have the opposite effect. Before you eat, have a glass of water so that you feel full more quickly. You can also try using smaller plates so that less food fits on them, but you still feel like you’re eating a full-sized meal. 

You can also control the amount you eat by following an intermittent fasting diet. The two most popular options for intermittent fasting are the 5:2 diet and the 16:8 diet. In the 5:2, you eat the standard number of calories (1500 to 2500) for five days and only 500-600 calories for two days. For the 16:8, you restrict the time you eat during the day to an eight-hour window. In this fasting state, your blood sugar levels lower, and your body burns your stored fat. While promoting weight loss, this diet can also help improve your body’s insulin sensitivity to blood sugar surges. Clinical studies have shown some promising health benefits for intermittent fasting [8,9], and further trials are in the pipeline to confirm their longer-term safety & benefits.

10. Drink tea or coffee

As mentioned in step two, water should be your primary beverage, but this doesn’t mean you can only drink water for the rest of your life. Unsweetened tea and coffee can also help in reducing your risk of diabetes. These drinks contain antioxidants that help to reduce your blood sugar levels. Green tea is particularly beneficial as it has a unique antioxidant called epigallocatechin gallate that isn’t found in most other drinks. 

Get inspired

Diabetes can be a worrying condition, but you have control over multiple factors that could prevent you from developing it. It can be difficult and daunting to make lifelong changes, but if you make them enjoyable, you’ll be more likely to stick to them. Pre-diabetes can be a motivator for you to make some healthy changes in your life, and with the right support, you can do it!

You're not in this alone, start with small changes, and eventually, it will make a big difference. Most importantly, don’t be hard on yourself on those days you feel most challenged. Congratulate the positive changes you are taking to optimise your health; if you need extra support, your GP can provide information for groups in your local area. 

Medichecks is here to help too. You should test your HbA1c levels every three months, and our Diabetes (HbA1c) Blood Test gives you the ability to do so. Your personal dashboard provides a useful graph so that you can track your improvements over time and celebrate when you make positive changes. 


References

[1] Diabetes.co.uk (2019). Diabetes Prevalence. [online] Available at: https://www.diabetes.co.uk/diabetes-prevalence.html#:~:text=It%20is%20estimated%20that%20415,with%20diabetes%20worldwide%20by%202040. [Accessed 15/06/20]. 

[2] Diabetes.org.uk (2020) How can I reduce my risk of Type 2 diabetes? [online] Available at: https://www.diabetes.org.uk/preventing-type-2-diabetes/can-diabetes-be-prevented [Accessed 15/06/20]. 

[3] NHS (2019). Diabetes. [online] Available at: https://www.nhs.uk/conditions/diabetes/ [Accessed 15/06/20].

[4] Physicians Committee for Responsible Medicine (2017). Does Sugar Cause Diabetes? [online] Available at: https://www.pcrm.org/news/blog/does-sugar-cause-diabetes [Accessed 16/06/20].

[5] Spritzler, F. (2017). 13 Ways to Prevent Type 2 Diabetes. Healthline. [online] Available at: https://www.healthline.com/nutrition/prevent-diabetes#8.-Avoid-Sedentary-Behaviors [Accessed: 16/06/20].

[6] Dempsey, P. et al. (2016). Sitting Less and Moving More: Improved Glycaemic Control for Type 2 Diabetes Prevention and Management. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/27699700/ [Accessed: 16/06/20].

[7] Willi, C. et al. (2007). Active Smoking and the Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/18073361/ [Accessed: 17/06/20]. 

[8] Hutchison A.T., et al., (2019). Time-Restricted Feeding Improves Glucose Tolerance in Men at Risk for Type 2 Diabetes: A Randomised Crossover Trial. Obesity (Silver Spring). 27(5):724-732. Available at https://www.ncbi.nlm.nih.gov/pubmed/31002478 [Accessed: 17/06/20].

[9] Parr EB, Devlin BL, Radford BE, Hawley JA. (2020). A Delayed Morning and Earlier Evening Time-Restricted Feeding Protocol for Improving Glycemic Control and Dietary Adherence in Men with Overweight/Obesity: A Randomized Controlled Trial. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/32079327/ [Accessed: 17/06/20].