How to Prevent Diabetes

By many estimates as many as 40 million Americans, or one in 5 of us has pre-diabetes.  Many of these people will develop diabetes.  The obvious question is how can we delay or prevent the development of diabetes in this vast group.  The good news is we know how to accomplish this.  As long ago as 2002 the Diabetes Prevention Program did a very elegant study of the effect of moderate weight loss and exercise in pre-diabetic patients.  This was a classic randomized controlled study comparing a group of at risk people who received intensive motivation and training in exercise and diet with a group just being told they should eat better and exercise more.  The goal was loss of 7% of body weight and getting 150 minutes a week of moderate exercise.  The intervention group had a 58% reduction in the rate of developing diabetes compared with the control group.  This was twice as effective at preventing diabetes as the third arm of the study, patients who took the medication metformin to prevent diabetes. To me this is impressive.  We don’t have to get thin, just thinner, and don’t need to run marathons, just get moving.  The study group wore a pedometer, and were urged to get 10.000 steps a day.

How can we use this information to help reduce the epidemic of diabetes in America.  First we need to start early.  By the time we are older, have complications of obesity including serious joint problems and cardiovascular disease, it is difficult to exercise and lose weight.  Starting in childhood or early adulthood to get into a lifestyle of daily exercise and good eating has the best chance of making a difference, but starting where you are at is the key.  7% of body weight loss is not sensational.  A 5’6” 190 lb woman would need to lose only 13 pounds.  5’10” 250 lb man would need to lose only 18 lbs.  Certainly a greater degree of weight loss is better, but major health improvements come from modest weight loss.

Resource: Metformin side effects