QUESTION: How can I prevent diabetes naturally? Can changes in diet, weight, exercise and lifestyle really reduce my risk, especially if diabetes runs in my family?
Yes. Type 2 diabetes can often be prevented or delayed. The most effective steps are maintaining a healthy weight, losing a modest amount of weight if you are overweight, exercising regularly, eating a balanced diet, avoiding smoking and having your blood sugar checked when you are at increased risk.
Family history increases your risk, but it does not mean that you will definitely develop type 2 diabetes.
Answer by Dr. Albana Greca, MD, MMedSc
Hi there,
When we talk about preventing diabetes, we mainly mean preventing or delaying type 2 diabetes. Type 1 diabetes is an autoimmune condition and cannot currently be prevented through diet, exercise or other lifestyle measures.
The encouraging part is that there are several things you can do to substantially reduce your risk of developing type 2 diabetes.
One of the most important modifiable risk factors for type 2 diabetes is excess body fat, particularly fat stored around the abdomen. Excess weight can make the body's cells less responsive to insulin, a condition called insulin resistance.
If you are overweight, you do not necessarily need to reach an “ideal” weight before seeing benefits. Losing even around 5% to 7% of your starting body weight can improve insulin sensitivity and reduce your risk of progressing from prediabetes to type 2 diabetes.
You can check your BMI and waist-to-height ratio, although these measurements should be considered together with your overall health and other risk factors.
You do not need to eliminate all carbohydrates. Instead, I recommend concentrating on the quality, quantity and portion size of the carbohydrates you eat.
Try to base most meals around:
At the same time, reduce sugary drinks, highly processed foods, excessive portions, refined carbohydrates and foods high in saturated fat.
You can read my complete guide to the best diabetes diet and practical meal planning for more examples.
No single calorie target is suitable for everyone. A 1,200-calorie diet may be appropriate for some people under professional guidance, but it may be too restrictive for others.
Your calorie needs depend on your age, sex, body size, activity level, medical conditions and weight-loss goals. The better approach is to create a moderate calorie deficit that you can maintain safely rather than following an unnecessarily restrictive diet.
Physical activity improves the way your muscles use glucose and increases insulin sensitivity. You do not have to spend an hour in the gym every day to obtain these benefits.
A practical target for many adults is at least 150 minutes of moderate-intensity physical activity each week, such as brisk walking, cycling or swimming. This can be divided into about 30 minutes on five days of the week.
Adding resistance exercises, such as weights or body-weight exercises, can provide additional benefits.
If you have been inactive for a long time or have heart, joint or other medical problems, discuss a new exercise program with your healthcare professional first.
If you smoke, quitting is another important preventive step. Smoking is associated with a higher risk of developing type 2 diabetes and can contribute to inflammation and insulin resistance.
Smoking also substantially increases cardiovascular risk, which is particularly important because diabetes itself raises the risk of heart and blood-vessel disease.
Family history matters. Having a parent or sibling with type 2 diabetes increases your risk because both genetic and shared environmental factors are involved.
However, having diabetes-related genes does not mean that diabetes is inevitable.
Weight management, physical activity, a healthy diet and avoiding smoking can still make an important difference. This is why I encourage people with a strong family history to act early rather than waiting until their glucose becomes clearly abnormal.
You can also use our Type 2 Diabetes Risk Calculator to review some of the major factors associated with diabetes risk.
Healthy lifestyle changes are important, but prevention should also include appropriate screening.
Ask your doctor about a fasting glucose or HbA1c test if you have important risk factors such as overweight or abdominal obesity, a strong family history of diabetes, previous gestational diabetes, high blood pressure, abnormal cholesterol or previous borderline blood sugar results.
If you already have prediabetes, lifestyle treatment is usually central to prevention. In selected people at particularly high risk, a doctor may also consider medication such as metformin. Therefore, “natural prevention” does not mean that medication should never be used when it is medically appropriate.
I would concentrate on changes that you can maintain for years rather than trying an extreme diet for several weeks.
Start with regular walking, improve the quality and portions of your meals, lose some weight if necessary, stop smoking, sleep adequately and have your glucose checked according to your individual risk.
Even if diabetes runs strongly in your family, these steps can help reduce your risk and improve your cardiovascular and metabolic health at the same time.
All the best,
Dr. Albana Greca