The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease. -- Thomas A. Edison
As a physician, the best advice I can give when it comes to type 2 diabetes is to take strides to prevent the disease’s onset. We should all strive for a diet with high levels of monounsaturated and polyunsaturated fatty acids, limited saturated fatty acids, and no trans fats. We should also work to reach optimal weight; those who are obese (a BMI greater than or equal to 30 kg/m2) or overweight (a BMI between 25 and 29.9 kg/m2) should consider cutting their caloric intake to reduce their body weight by 5% to 10%.
Those with prediabetes who lost 5% to 7% of their body weight with increased exercise and positive diet changes greatly lowered their risk of developing diabetes.1 In one study, the Diabetes Prevention Program (DPP), participants followed a low-calorie, low-fat diet and exercise regularly by taking brisk walks for 30 minutes per day, five days a week. Those involved in the study reported dramatic improvements, and these strategies worked well for all, regardless of gender, ethnicity, or race. Following this initial study, a follow-up Diabetes Prevention Program Outcome Study (DPPOS) reported that regular physical activity and weight loss resulted in long-term success. On average, the onset of type 2 diabetes was delayed by 4 years for those who participated in the DPP study and who saw modest weight loss.2 3
One diabetes medication, Metformin, has also had success in lowering prediabetic people’s risk of developing type 2 diabetes, particularly among women who have had gestational diabetes and younger and heavier prediabetic patients. Studies have shown metformin delays the onset of type 2 diabetes. So, if you’re at high risk for developing type 2 diabetes, consider speaking with your health care provider about starting metformin for prevention.4
The main cause of weight loss is lowered caloric intake. By focusing on foods that don’t promote metabolic disease or complications and instead promote health, patients can improve and offset their risk factors. Dining-out, meal planning, and grocery shopping strategies are necessary for success. Adjusting insulin dosage to mirror carbohydrate intake, consuming carbohydrates consistently day-to-day, and limiting high glycemic index foods and foods containing sucrose should all be addressed in medical nutrition therapy and education provided to diabetic patients.
References
D. P. P. R. Group, "Reduction in the Incidence of Type 2 Diabetes with ...," The New England Journal of Medicine, vol. 346, no. 6, p. 393–403.
Available:http://diabetes.niddk.nih.gov/Diabetes prevention program.
R. N. Goldberg, E. M. Venditti, P. Nathan, K. J. Friday, C.A. Christophi, J. Hoffman, A. E. Fowler, R. F. Hamman, A. T. Brenneman and M. Gnant, "10-year follow- up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study," The Lancet, vol. 374, no. 9702, p. 1677-1686, 2009.
D. M. Nathan, E. Barrett-Connor, J. P. Crandall, S. L. Edelstein, R. B. Goldberg, E. S. Horton, W. C. Knowler, K. J. Mather, T. J. Orchard, X. Pi-Sunyer, D. S. Schade and M. Temprosa, "Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study," The Lancet Diabetes & Endocrinology , vol. 3, no. 11, p. 866-875, 2015.
