Can Diabetes Be Prevented?

Not Paula Deen

Paula Deen’s recent announcement of her type 2 diabetes got me to thinking about diabetes prevention again.  If you’re at high risk of developing diabetes you can reduce your risk of full-blown type 2 diabetes by 58% with intensive lifestyle modification.  Here’s how it was done in a 2002 study:

The goals for the participants assigned to the intensive lifestyle intervention were to achieve and maintain a weight reduction of at least 7 percent of initial body weight through a healthy low-calorie, low-fat diet and to engage in physical activity of moderate intensity, such as brisk walking, for at least 150 minutes per week. A 16-lesson curriculum covering diet, exercise, and behavior modification was designed to help the participants achieve these goals. The curriculum, taught by case managers on a one-to-one basis during the first 24 weeks after enrollment, was flexible, culturally sensitive, and individualized. Subsequent individual sessions (usually monthly) and group sessions with the case managers were designed to reinforce the behavioral changes.

Although the Diabetes Prevention Program encouraged a low-fat diet, another study from 2008 showed that a low-fat diet did nothing to prevent diabetes in postmenopausal women

I don’t know Paula Deen.  I’ve never watched one of her cooking shows.  She looks overweight and I’d be surprised if she’s had a good exercise routine over the last decade.  I’m sorry she’s part of the diabetes epidemic we have in the U.S.  I wish her well.  Amy Tenderich posted the transcript of her brief interview with Paula, who calculates her sweet tea habit gave her one-and-a-half cups of sugar daily).

  • Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
  • Half of Americans 65 and older have prediabetes
  • 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
  • 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

I think excessive consumption of concentrated sugars and refined carbohydrates contribute to the diabetes epidemic.  Probably more important are overweight, obesity, and physical inactivity.

The Mediterranean diet has also been linked to lower rates of diabetes (and here).  Preliminary studies suggest the Paleo diet may also be preventative (and here).

Greatly reduce your risk of type 2 diabetes by eating right, keeping your weight reasonable, and exercising.

Steve Parker, M.D.

PS: Paula, if you’d like a copy of Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet, have your people contact my people.

Reference:  Diabetes Prevention Program Research Group.  Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or MetforminNew England Journal of Medicine, 346 (2002): 393-403.


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9 responses to “Can Diabetes Be Prevented?

  1. From my own experience, my doctor advised me it is easier to reverse course when you are still pre-diabetic (or have “metabolic syndrome”) than it is to wait until you are diabetic.

    For me, a low carb diet resulted in both reduction of triglycerides (my original goal), and the loss of enough weight to go from an “obese” to “overweight” BMI category. I no longer have pre-diabetes. I responded rapidly and well to low carb, but realize it is not the same for everyone. Looking back, it was much easier than my earlier forays into the low fat diet regime. And the reason may be that most of those low fat pre-prepared foods are high in sugar, so even if you aren’t consuming candy bars, that low fat yogurt may have nearly as much sugar in it.

  2. Judi O

    I use a low carb diet to manage my prediabetes. I have always been fit and at my ideal weight which is 134 1bs. at 5’6″. I have had a regular workout routine for over 25 years. I worked hard at my health and ate what would be considered a nutritious diet. No fast food, junk food, sugary products, etc. Genetics plays a strong role, at least for me! All of my hard work did not prevent me from getting it. At least I have the tools to manage it fairly well. The last A1c was 5.5 and it has been steady for the last two years. I was 54 when I found out (on my own) that I had “sugar issues.”

  3. jim snell

    My own experience is most suggestive that addressing the problem early in pre – diabetes mode has best chance of remission. As one ages, the liver seems to increase and dumpr more glucose in the loop that sets the body’s setpoint to point whereby this excess glucose and reduced pancrease action cause the skeletal cells to top off and turn on maximum insulin resistance.

    In my case metformin is critical to get that excess release nailed back so body can regulate again with extra heart exercise.

    My read is that as long as the body still has room to store more glucose on insulin command, the body can regulate. Once saturation is hit, the BG climbs up and out of control.

    At this level, drugs, plus carbs control and hearty exercise are critical to get mess under control.

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