Don’t get us wrong: There’s nothing easy about reversing a chronic illness. Especially an illness like type 2 diabetes that more than 1 million Americans are newly diagnosed with every year. But new research shows it is possible to stop T2D in its tracks. In fact, up to 40% of diabetic patients—in a recent small study—who cut calories, exercised and took drugs to control their blood sugar were able to reverse the disease. (And, yes, they got off their meds.) “Lifestyle is very powerful in preventing diabetes, even if you have risk factors like a family history or being overweight,” explains Andrea Dunaif, MD, chief of the division of endocrinology, diabetes and bone disease at the Icahn School of Medicine at Mount Sinai in New York City.
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1. Find your chill
Parent-teacher conferences, Thanksgiving planning and, well, everyday life are no trip to the spa. But when you’re stressed, your body ramps up production of the hormone cortisol, which in turn increases your body’s blood glucose level, says Betul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic. While this was helpful back in caveman days for short-term energy when fleeing saber-toothed tigers, over the long term it sets you up for insulin resistance and weight gain, both of which increase risk for T2D. Sign up for yoga classes (which can lower your blood sugar level) or find time for taking a daily walk in a park or relaxing in your backyard.
2. Lose just a little
“My patients get intimidated because they assume they have to drop 20, 30, even 50 pounds to see benefits, but taking off far less can do a lot,” says Susan Tibuni-Sanders, MD, a Kaiser Permanente physician with specialty training in endocrinology and diabetes. Case in point: People with pre-diabetes who lose just 5% of their body weight (that’s 7.5 pounds for a 150-pound woman) more than halve their chances of getting diabetes. If you can lose more, even better—shedding 10% of their weight reduced risk by 85%.
3. Get on up
Each extra hour on your duff is linked to upping your risk of type T2D by 22%, says one study. Experts think it’s because sedentary time affects your sugar and fat metabolism. The easy fix is to get up and move! People who took a three-minute break from sitting every 30 minutes, either to walk or do moves like half squats and knee raises, had better blood sugar control than people who stayed sedentary, according to Australian research published in the medical journal Diabetes Care.
4. Check your D
Research shows that low levels of vitamin D are more likely to result in a T2D diagnosis, even if you aren’t overweight and don’t have other risk factors. “Your body needs vitamin D so your pancreas can produce insulin,” explains Hatipoglu. “If you’re low, you increase the risk of becoming insulin resistant, which is a precursor to type 2 diabetes.” Ask your MD to check your level at your next physical, and if it’s less than 12 ng/ml, see whether you should start taking a supplement. (Most experts recommend 600 to 800 IU daily.)
5. Say goodnight
Getting a decent night’s rest is more important than you may realize. “You can deprive someone with normal blood sugar of sleep and cause them to become pre-diabetic,” says Dunaif. Chronically skimping on rest may trigger insulin resistance. Lack of sleep also affects levels of hunger hormones, causing you to eat more and gain weight. Aim for around seven to eight hours, which appears to be the magic number for prevention. If you’re getting enough sleep and still feel tired, ask your doctor about obstructive sleep apnea, which has been linked to increased risk of diabetes.
6. Go semi-vegetarian
We know it can be tough. Luckily, a little goes a long way and the more plant protein you eat (think foods like edamame, tofu, lentils and chickpeas), the lower your risk of developing T2D, according to new research. “With my patients, the ones who lower their blood sugar the most are the ones who adopt plant-based diets, which tend to be lower in both carbohydrates and fat,” says Tibuni-Sanders. But you don’t have to go cold turkey: Opting for a smaller piece of animal protein like chicken or fish and an additional spoonful of plant protein like quinoa or beans daily could reduce risk by about 18%. Or add in a serving of lentils weekly to cut your chances of developing T2D by about a third.
7. Do sweat it
“Working out is the strongest drug we have to prevent type 2 diabetes,” says Hatipoglu. “Each bout of exercise improves your blood sugar for the next 18 to 24 hours.” Getting your sweat on for 30 to 60 minutes daily slashes the risk of developing T2D by 26% to 40%. Even going for a stroll has its benefits. People with T2D who took a 10-minute walk right after they finished each meal had lower blood sugar levels than those who walked for 30 minutes whenever they wanted, according to a study published last year.
8. Don’t shy away from meds
If you’re pre-diabetic, your first move should be lifestyle changes, such as losing weight, watching what you eat and exercising. “There’s often only a short window of time before people progress to diabetes, so if we don’t see results within six months, then it’s probably time to try medication,” says Tibuni-Sanders. Sometimes, despite your best efforts, that’s what’s needed to get your blood sugar back on track.
Everyone should get screened for type 2 diabetes starting at age 45, and the test should be repeated every three years if normal, according to the American Diabetes Association. If you have risk factors such as a family history of diabetes, being overweight or obese, past gestational diabetes or high blood pressure, talk to your doctor about starting screenings sooner. You can get tested with either the fasting plasma glucose (FPG) test, which checks your blood sugar after not eating and drinking for at least eight hours, or the hemoglobin A1C test, which checks your average blood sugar level over the past two to three months.
What Not to Do
You might think the following strategies will help reduce your risk of type 2 diabetes, but they can backfire.
→ Mistake #1: Going on a gluten-free diet
Low-gluten diets may be associated with a higher risk of developing T2D, according to a study presented this past March at an American Heart Association annual meeting. “It’s most likely because when manufacturers take out gluten, they add fat and sugar, which can increase type 2 diabetes risk,” says Jacqueline Lonier, MD, an endocrinologist at the Naomi Berrie Diabetes Center in NYC.
→ Mistake #2: Shunning fruit
It’s easy to shy away from fruit due to the low-carb craze, but fruit is rich in fiber, which helps you lose weight and may also be protective against T2D. In one study, people who consumed the most fruit had the lowest risk of developing diabetes. Best to avoid fruit juice, which has a high sugar content, says Lonier.
→ Mistake #3: Drinking only skim milk
Sure, milk does a body good, but research has found that the full-fat variety is actually even more protective against T2D. In fact, people who eat mostly full-fat dairy are 46% less likely to develop diabetes than those who skip it, according to a Tufts University study. One theory is that people compensate for the missing fat by eating more carbohydrates.
Originally appeared in our November 2017 edition.