Diabetes - Minimising risk / Prevention

Type 1 diabetes

It is difficult to take steps to prevent type 1 diabetes because any possible contributing factors, such as being given cow's milk early in infancy rather than being breastfed,[1] are influential early in life.

Because of this, most of the research into prevention has focused on the more common type of diabetes, type 2 diabetes.

Type 2 diabetes

Type 2 diabetes is believed to be a preventable disease.[2]

Diet and exercise

As both abdominal obesityObesity centred around the abdomen, resulting in a high waist circumference. and general obesityExcess accumulation of fat in the body. increase the risk of type 2 diabetes, weight loss can prevent or delay this condition. Changing the composition of your diet, for example, by avoiding foods that are high in refined carbohydratesA group of compounds that are an important energy source, including sugars and starch. and fatOne of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body., can also reduce the risk.[1]

Lifestyle changes are more effective than medication in reducing your risk of developing diabetes

One study of dietary patterns in women found that those with a 'healthy' pattern, such as high levels of fruit and vegetable intake and a higher ratio of white to red meat, were less likely than those with unhealthy diets to develop diabetes. Women whose dietary patterns improved during the study reduced their risk of diabetes within just a few years.[3]

Other studies suggest that healthy diet and exercise habits can more than halve the likelihood of type 2 diabetes developing in people at high risk.[4]

Lifestyle changes, with dietary counselling and increased physical activity, can result in weight loss and improvements in glucoseA simple sugar that is an important source of energy in the body. and lipidOne of a group of compounds that are an important energy source. levels.[5]

Becoming more active does not necessarily mean having to go to the gym; simply leading a more active lifestyle can be a benefit in itself.[5] Increasing your activity through a range of activities can protect you against type 2 diabetes.[6]

More about eating for weight loss.

Medication

As well as lifestyle changes, some medicines can help to prevent diabetes. Taking the weight-loss drug orlistat combined with lifestyle adjustments has been shown to reduce the risk of type 2 diabetes developing. Any benefit may be greater in people who are at high risk - for example, in those who are overweight.[2]

Giving people the medication metformin has also been shown to help those at risk of diabetes - it reduces the incidenceThe number of new episodes of a condition arising in a certain group of people over a specified period of time. by almost a third in those with high levels of glucoseA simple sugar that is an important source of energy in the body. who have not yet developed full-blown diabetes.

Even so, lifestyle changes are more effective than medication in reducing your risk of developing diabetes.[4]

Health education and screening

Education about healthy living and highlighting the risk factors has been shown to be effective in preventing type 2 diabetes. Screening for diabetes in those most at risk - for example, first-degree relatives of people with type 2 diabetes - can allow early treatment of abnormal glucoseA simple sugar that is an important source of energy in the body. levels.[1,7]

References: 
  1. Boon NA, Colledge NR and Walker BR. Davidson's Principles and Practice of Medicine Churchill Livingstone Elsevier. 2006; 20th edition.
  2. Orlistat in the prevention of diabetes in the obese patient. Mancini MC and Halpern A. Vascular Health and Risk Management. 2008;4:325-36.
  3. A prospective study of overall diet quality and risk of type 2 diabetes in women. Fung TT, McCullough M, van Dam RM et al. Diabetes Care. 2007;30:1753-7.
  4. Reduction in the incidenceThe number of new episodes of a condition arising in a certain group of people over a specified period of time. of type 2 diabetes with lifestyle intervention or metformin. The Diabetes Prevention Program Research Group. N Engl J Med. 2002;346:393-403.
  5. The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Lindström J, Louheranta A, Mannelin M et al. Diabetes Care. 2003;26:3230-6.
  6. Physical activity and the incidenceThe number of new episodes of a condition arising in a certain group of people over a specified period of time. of type 2 diabetes in the Shanghai women's health study. Villegas R, Shu XO, Li H et al. International Journal of Epidemiology. 2006;35:1553-62.
  7. Presence of diabetes risk factors in a large US eighth-grade cohort. The STOPP-T2D Prevention Study Group. Diabetes Care. 2006;29:212-7.