Prevention of type 2 diabetes can be achieved with both lifestyle changes and use of medication. The American Diabetes Association categorizes people with

prediabetes Prediabetes is a component of the metabolic syndrome and is characterized by elevated blood sugar levels that fall below the threshold to diagnose diabetes mellitus. It usually does not cause symptoms but people with prediabetes often have obesit ...

, who have glycemic levels higher than normal but do not meet criteria for diabetes, as a high-risk group. Without intervention, people with prediabetes progress to type 2 diabetes with a 5% to 10% rate. Diabetes prevention is achieved through weight loss and increased physical activity, which can reduce the risk of diabetes by 50% to 60%. __TOC__

Lifestyle

Many interventions to promote healthy lifestyles have been shown to prevent diabetes. A combination of diet and physical activity promotion through counselling and support programs decrease weight, improve systolic blood pressure, improve

cholesterol Cholesterol is any of a class of certain organic molecules called lipids. It is a sterol (or modified steroid), a type of lipid. Cholesterol is biosynthesized by all animal cells and is an essential structural component of animal cell mem ...

levels and decrease risk of diabetes. Increasing physical activity may be helpful in preventing type 2 diabetes, particularly if undertaken soon after a carbohydrate-rich meal that increases blood sugar levels. The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least hours of exercise per week (several brisk sustained walks appear sufficient), having a modest fat intake (around 30% of energy supply should come from fat), and eating sufficient fiber (e.g., from

whole grain A whole grain is a grain of any cereal and pseudocereal that contains the endosperm, germ, and bran, in contrast to refined grains, which retain only the endosperm. As part of a general healthy diet, consumption of whole grains is associated ...

s). Numerous clinical studies have shown that

resistant starch Resistant starch (RS) is starch, including its degradation products, that escapes from digestion in the small intestine of healthy individuals. Resistant starch occurs naturally in foods, but it can also be added as part of dried raw foods, or use ...

increases insulin sensitivity, independent of the glycemic response of the food and may reduce the risk of

type 2 diabetes Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urinatio ...

. The U.S. Food and Drug Administration requires claims that

can reduce the risk of type 2 diabetes to be qualified with a declaration that scientific evidence in support of this claim is limited. Foods with low

glycemic index The glycemic (glycaemic) index (GI; ) is a number from 0 to 100 assigned to a food, with pure glucose arbitrarily given the value of 100, which represents the relative rise in the blood glucose level two hours after consuming that food. The GI of ...

, rich in fiber and other important nutrients, are recommended, notwithstanding insufficient evidence. Study group participants whose "physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes". Various sources suggest an influence of dietary fat types. Positive effects of unsaturated fats have been asserted on theoretical grounds and observed in animal feeding studies. Hydrogenated fats are universally considered harmful, mainly because of their well-known effect on cardiovascular risk factors. Numerous studies suggest connections between some aspects of type 2 diabetes with ingestion of certain foods or with some drugs.

Breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that br ...

may also be associated with the prevention of type 2 diabetes in mothers. Some evidence relates consumption of

coffee Coffee is a drink prepared from roasted coffee beans. Darkly colored, bitter, and slightly acidic, coffee has a stimulating effect on humans, primarily due to its caffeine content. It is the most popular hot drink in the world. Seeds of ...

with prevention of type 2 diabetes. However, it is unclear if coffee causes any change in the risk of diabetes. This is true regardless of if it is caffeinated/decaffeinated, consumed with/without sugar, or potboiled or not.

Medications

Some studies have shown delayed progression to diabetes in predisposed patients through prophylactic use of

metformin Metformin, sold under the brand name Glucophage, among others, is the main first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight. It is also used in the treatment of polycystic ovary syndrome. ...

rosiglitazone Rosiglitazone (trade name Avandia) is an antidiabetic drug in the thiazolidinedione class. It works as an insulin sensitizer, by binding to the PPAR in fat cells and making the cells more responsive to insulin. It is marketed by the pharmaceutica ...

, or

valsartan Valsartan, sold under the brand name Diovan among others, is a medication used to treat high blood pressure, heart failure, and diabetic kidney disease. It belongs to a class of medications referred to as angiotensin II receptor blockers (ARB ...

. Lifestyle interventions are, however, more effective than metformin alone at preventing diabetes regardless of weight loss, though evidence suggests that lifestyle interventions and metformin together can be effective treatment in patients who are at a higher risk of developing diabetes. A Cochrane systematic review assessed the effect of alpha-glucosidase inhibitors in people with impaired

glucose tolerance Prediabetes is a component of the metabolic syndrome and is characterized by elevated blood sugar levels that fall below the threshold to diagnose diabetes mellitus. It usually does not cause symptoms but people with prediabetes often have obesit ...

, impaired

fasting blood glucose Many types of glucose tests exist and they can be used to estimate blood sugar levels at a given time or, over a longer period of time, to obtain average levels or to see how fast body is able to normalize changed glucose levels. Eating food for ...

, elevated glycated hemoglobin A1c (HbA1c). It was found that acarbose appeared to reduce incidence of diabetes mellitus type 2 when compared to placebo; however, there was no conclusive evidence that acarbose compared to diet and exercise,

placebo A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like saline), sham surgery, and other procedures. In general, placebos can af ...

, no intervention improved

all-cause mortality Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of de ...

, reduced or increased risk of cardiovascular mortality, serious or non-serious adverse events, non-fatal stroke,

congestive heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, ...

, or non-fatal

myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...

. The same review found that there was no conclusive evidence that voglibose compared to diet and exercise or placebo reduced incidence of diabetes mellitus type 2, or any of the other measured outcomes. Many other medications are well known to modify risk of diabetes 2, although in most cases they are prescribed for reasons unrelated to diabetes 2. In patients on

hydroxychloroquine Hydroxychloroquine, sold under the brand name Plaquenil among others, is a medication used to prevent and treat malaria in areas where malaria remains sensitive to chloroquine. Other uses include treatment of rheumatoid arthritis, lupus, an ...

for

rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are invol ...

, incidence of diabetes was reduced by 77%, though causal mechanisms are unclear. Dopamine receptor agonists are also known to improve glycemic control, reduce insulin resistance and help controlling body weight.

Co-morbidities

People with mental health disorders are at a higher risk of developing type 2 diabetes. The most effective way to prevent type 2 diabetes in people with mental disorders is not clear; considerations include pharmacological interventions, behavior changes, and organizational interventions.

Programmes

Several countries have established more and less successful national programmes to improve prevention and treatment of diabetes. In the UK, the

NHS The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...

's diabetes prevention programme ''Healthier You'' offers personalised face-to-face and digital services. Assessment of the programme is ongoing, but based on the first 36,000 patients, it seems that those who complete the programme manage to reduce their blood sugar levels and lose weight. At the same time, only 1 in 5 people complete the whole 9-month programme. A study of 18,470 people who had been referred to the programme found that they had a 20% reduced risk of developing diabetes.

References

{{DEFAULTSORT:Prevention of Diabetes Mellitis Type 2 Diabetes Medical conditions related to obesity