The statistics speak for themselves: According to the Centers for Disease Control and Prevention, nearly 26 million Americans suffer from diabetes, and 7 million are unaware that they're afflicted. At the current rate, half of the adult U.S. population will develop prediabetes or diabetes by 2020. Of that total, the more-preventable type 2 diabetes accounts for 90 to 95 percent of all cases.
The good news: If you've received test results showing you have prediabetes, or you're concerned that you're at risk for diabetes, making lifestyle changes now can prevent or greatly delay the onset of diabetes. Studies have shown that such changes reduced the development of type 2 diabetes by as much as 71 percent in adults 60 years and older.
The key is preventing your blood glucose level from rising higher. Fasting blood glucose below 100 mg/dl is considered normal; if your fasting blood glucose is between 100 and 125 mg/dl, you have prediabetes. (If your blood sugar rises above 125 mg/dl, you're among the one in ten adults in North America who have type 2 diabetes.)
Prediabetes doesn't have to turn into diabetes. With early intervention, some people with prediabetes can actually turn back the clock and return elevated blood glucose levels to the normal range. Others can delay the onset of diabetes by 10 years or more. But once it sets in, diabetes is a lifelong disease. So now's the time to take steps to prevent diabetes from progressing. Here's what to do.
1. Peel off the pounds.
Getting to or maintaining a healthy weight is the number-one way to prevent the onset of diabetes, since extra weight makes it harder for the body to use insulin to control blood sugar. According to the expert panel of the American Diabetes Association, for those at high risk for diabetes and who are overweight, losing 5 to 10 percent of your body weight through moderate exercise and healthy eating is the best way to treat prediabetes.
Instead of going on a severe diet, make minor changes that you can stick with over time. Make the calories you eat count in terms of packing a nutritional punch. For someone who weighs between 100 and 200 pounds, losing just 5 or 10 pounds can have a dramatic effect, so choose a realistic goal, give yourself plenty of time, and celebrate your success when you get there.
2. Focus on fiber.
Fiber is essential to preventing diabetes, because it takes your body longer to digest high-fiber foods. Read labels and count up grams of fiber, with a goal of eating 45 to 50 grams of fiber a day. For most people, eating a healthy breakfast that features oatmeal or some type of bran cereal is one way to achieve that high-fiber goal, since a bowl of the right kind of cereal can net you as much as a third of your daily fiber.
Keeping track of fiber content is also a handy way to distinguish between "bad" and "good" carbohydrates. With high-fiber (good) carbs, glucose is released slowly, preventing the typical blood sugar spike.
3. Count on coffee and tea.
In the past few years, researchers have uncovered a fascinating link between consumption of coffee and tea and lower rates of diabetes. The results of 18 different studies found that drinking three to four cups of coffee per day was associated with a 25 percent lower risk of diabetes than drinking no coffee or just one cup. Tea -- green or black -- was found to be beneficial as well; drinking three to four cups of tea daily lowered risk of diabetes by 18 percent.
There's good news for the caffeine-phobic, too: Drinking three to four cups of decaf coffee was associated with a whopping 36 percent reduction in diabetes risk. And the benefit was cumulative; each additional cup of coffee consumed was associated with a 7 percent reduction in the excess risk of diabetes.
Researchers are still exploring why coffee and tea are so beneficial in warding off diabetes. Because decaf was found to be as or even more beneficial than regular coffee, the researchers can't attribute the benefits to caffeine. Instead, it now seems likely the benefits come from phytonutrients -- natural, plant-based chemicals that slow the release of sugar into the blood after a meal.
Bear in mind, however, that upping your java intake requires something of a balancing act, as caffeine has negative effects as well, such as it's apparent ability to leach calcium from bones.
4. Move, move, move.
Get more exercise, and you'll strengthen your body's machinery for handling blood glucose, the key to preventing diabetes. Studies have also shown that exercise increases insulin sensitivity, providing long-lasting blood sugar benefits. One study found that a single bout of exercise increases insulin sensitivity for as long as 16 hours afterwards.
Happily, all kinds of physical activity lowers blood sugar levels by taking glucose from the blood and muscle to use as fuel. Choose an activity you like enough to continue until you raise your heart rate and break a sweat. In the Nurses' Health Study, researchers found that women who worked up a sweat just once a week reduced their risk of developing diabetes by a whopping 30 percent. The National Diabetes Education Program recommends getting 30 minutes -- even in three ten-minute sessions -- of moderate physical activity five days a week. That might include walking, biking, swimming, jogging, even dancing.
In addition to aerobic exercise, include some type of strength training. Glucose is stored in the muscles, so by lifting weights, you use that glucose as fuel and also build and tone muscle, which then provides additional glucose storage capacity.
5. Eat three squares.
Eating regularly throughout the day is important for regulating your blood sugar and avoiding blood sugar spikes that tax your pancreas by stimulating it to produce insulin. Space your meals at regular intervals throughout the day, and if you have to go more than four hours between meals, eat a healthy snack to tide you over.
Diabetes experts strongly favor a "Mediterranean" diet, which means lots of different fruits and vegetables, whole grains, beans and legumes, healthy fats such as olive oil, and lean protein such as fish and poultry. Snacks should include protein, complex carbohydrates, and healthy fats; think whole wheat toast and peanut butter rather than a bagel and cream cheese.
As much as possible, avoid simple carbohydrates such as sugary treats and white flour baked goods -- and don't overeat at any meal. Some people with prediabetes or diabetes find it helpful to eat a small high-fat/high-protein snack, such as a handful of almonds, before bed to help blood sugar levels remain stable overnight.
6. Get heart healthy.
If you have prediabetes, make sure other aspects of your cardiovascular health are under control. High blood pressure, or hypertension, is associated with a higher risk of diabetes, so it's a good idea to work with your doctor to make sure your blood pressure is within the preferred range -- ideally under 120/80 for those under age 65.
Cholesterol is equally important. Ask your doctor to check your cholesterol and make sure your total cholesterol is under 200 mg/dL, your LDL is under 130 mg/dL, and your HDL (or "good" cholesterol) is at least 40 mg/dL for men and 50 mg/dL for women.
If any of your tests are out of range, talk to your doctor about whether you should be on blood pressure or cholesterol-lowering medication. Make sure your doctor knows you have prediabetes, as this may influence treatment choices.