Of the more than 34 million people who have diabetes in the U.S., the vast majority have type 2 diabetes, according to the Centers for Disease Control and Prevention (CDC). But unlike type 1, this version of diabetes can be prevented in many cases.
It comes down to risk factors that you can control vs. those you can't, Katherine Araque, MD, an endocrinologist and director of endocrinology at the Pacific Neuroscience Institute at Providence Saint John's Health Center, tells LIVESTRONG.com.
Risk factors that you can modify include things such as your level of physical activity and diet, while those you can't include things like your race and certain medical conditions. The following are uncontrollable risk factors that can increase your risk of type 2 diabetes:
- Hispanic or African-American background
- Close relative with diabetes
- Polycystic ovary syndrome (PCOS)
- History of gestational diabetes during pregnancy
Some people are born with the genetic predisposition to develop type 2 diabetes, and then certain environmental exposures and lifestyle factors further increase their risk, according to an August 2019 paper in Diabetologia.
Regardless of your risk factors, though, there are things you can do to help prevent type 2 diabetes.
1. Eat a Healthy, Well-Balanced Diet
What does that look like, exactly?
"A healthy diet includes daily intakes of whole grains, an abundance of vegetables, colorful fruits, probiotic and prebiotic foods, and foods rich in omega-3 fatty acids," Pamela Wooster, RDN, MEd, clinical dietitian and diabetes program coordinator with UCHealth Yampa Valley Medical Center, tells LIVESTRONG.com.
While nutrition and food choices are critically important to managing type 2 diabetes, Dr. Araque says she recommends following healthy dietary habits in general as opposed to one specific diet plan.
"I don't like to call things a 'diet,' because diets come with an expiration date," she says.
Limit Processed Foods
Try to avoid processed foods containing large amounts of omega-6 polyunsaturated fatty acids (PUFAs), trans-fatty acids, saturated fats, cholesterol and salt, as they are strongly associated with the development of diabetes, insulin resistance and obesity, Wooster says.
Indeed, a study published December 2019 in JAMA Internal Medicine found that a larger proportion of ultra-processed foods in the diet was associated with a higher risk of developing type 2 diabetes regardless of other lifestyle factors.
Swap Your Carbs
Swapping simple, processed carbs (think: white bread and pasta, baked goods, sweetened drinks) for fresh produce can help reduce insulin resistance, Dr. Araque says.
She notes that berries in particular, such as strawberries and raspberries, are a great choice because they have a low glycemic index — meaning that they won't cause a spike in your blood sugar.
Dr. Araque also recommends choosing complex carbs over simple carbs whenever you have the chance, as these are broken down more slowly, helping keep blood sugar at an even keel.
Examples of complex carbs include the following, according to the U.S. National Library of Medicine:
- Brown rice
Fill Half Your Plate With Non-Starchy Vegetables
These types of veggies are also high in fiber, a nutrient that can help control blood sugar, per the Mayo Clinic.
The ADA recommends aiming for 25 to 30 grams of fiber a day.
Examples of non-starchy vegetables include:
- Brussels sprouts
- Leafy greens (spinach, Swiss chard, collard greens)
Choose Lean Proteins
Opt for lean cuts of chicken, pork, turkey, lamb or beef, and incorporate eggs fortified with omega-3 fatty acids. "A diet rich in omega-3 fatty acids may decrease insulin resistance by reducing inflammation," says Wooster.
For this reason, you should also aim to eat at least two servings of fish a week, particularly salmon, trout, herring, tuna or mackerel, which serve up a good amount of omega-3s, according to the USDA, which recommends baking or grilling over frying.
A serving of fish is 3 to 4 ounces, or about the size of a checkbook.
You can also get plant-based omega-3s from the following foods, according to Wooster:
- Nuts and seeds, such as walnuts and flaxseeds
- Dark green leafy vegetables
- Legumes, such as beans, peas, lentils and soybeans
Indeed, Wooster encourages eating small portions of nuts and seeds daily. "Nut consumption has been associated with the decreased prevalence of type 2 diabetes and metabolic syndrome," she says, citing a June 2018 study in Nutrition & Metabolism. "Nuts have a low glycemic index, and when consumed along with carbohydrate-containing foods such as fruit or oatmeal, they can slow the absorption of those carbs and lower the post-meal blood sugar peek."
Swap Your Fats
Instead of saturated fats like butter, cream, lard or cheese, choose vegetable oils rich in monounsaturated fatty acids like olive oil, canola, soybean and flaxseed.
"Increasing monounsaturated fats and omega-3 fatty acids may help to prevent insulin resistance and the development of diabetes," Wooster says.
2. Make Exercise a Regular Part of Your Life
Physical activity is especially important in preventing diabetes, says Dr. Araque, because it decreases the insulin resistance state in our bodies. In other words, the less active you are, the more your body will be resistant to insulin.
Walking at least 10,000 steps daily is associated with a decrease in type 2 diabetes, she says, citing a February 2018 study in Diabetology International.
The Physical Activity Guidelines for Americans recommend adults get at least 150 minutes a week of moderate-intensity aerobic activity (think: walking, biking) and perform muscle-strengthening activities at least two days each week. In general, too, you should aim to move more and sit less throughout the day.
But what's most important, Dr. Araque says, is that you choose a physical activity you enjoy, because staying active through movement you like means you will be more likely to continue it. So, get creative — anything from hiking to biking to dancing in your basement can be an effective way to stay moving.
3. Maintain — or Get to — a Healthy Weight
Being overweight is a big risk factor for type 2 diabetes, Dr. Araque says.
If you're above a healthy weight and body mass index, dropping a few pounds (10 to 15 percent of your body weight) can help increase your insulin sensitivity and optimize blood sugar management.
One possible reason? The chronic, low-grade inflammation associated with obesity is thought to trigger insulin resistance, Wooster says.
"At a lower body weight, the pancreas can produce enough insulin to cover the lower carbohydrate intake, and insulin resistance goes away, allowing insulin to work properly," she says.
The overall goal, adds Dr. Araque, is to normalize blood sugar and stabilize blood glucose levels by getting to a healthy BMI.
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4. Get Regular Check-Ups
Most people don't just develop type 2 diabetes overnight. Instead, they move through stages of worsening insulin resistance. Before a person develops full-blown type 2 diabetes, they will usually exhibit signs of prediabetes.
The ADA defines prediabetes as one or more of the following:
- A1C of 5.7% to 6.4%
- Fasting blood sugar level of 100 mg/dl to 125 mg/dl
- Oral glucose test of 140 mg/dl to 199 mg/dl
In many cases, if you have prediabetes, you may not have any other apparent symptoms — in fact, more than 80 percent of people with the condition don't know they have it, according to the CDC.
That's why it's so important to schedule a yearly health check-up so your doctor can monitor your numbers. If there is a problem with your blood sugar, it's possible to catch it early and act to reverse the condition.
- The Journal of Clinical Endocrinology & Metabolism: “Development and Risk Factors of Type 2 Diabetes in a Nationwide Population of Women With Polycystic Ovary Syndromez”
- Diabetologia: “Racial/Ethnic Differences in the Burden of Type 2 Diabetes Over the Life Course: A Focus on the USA and India”
- Centers for Disease Control and Prevention: "Type 2 Diabetes"
- American Diabetes Association: "Diagnosis"
- Journal of Diabetes and Metabolic Disorders: “Improvement of Glucose and Lipid Profile Status with Aloe Vera in Pre-Diabetic Subjects: A Randomized Controlled Trial”
- Journal of Traditional and Complementary Medicine: “The Effect of Cinnamon on Glucose of Type II Diabetes Patients”
- Molecules: “Review of Ginseng Anti-Diabetic Studies”
- Avicenna Journal of Medical Biotechnology: “Hypoglycemic Effect of Aquatic Extract of Stevia in Pancreas of Diabetic Rats: PPARγ-dependent Regulation or Antioxidant Potential”
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- Food & Nutrition Research: ““Effect of Garlic Supplement in the Management of Type 2 Diabetes Mellitus (T2DM): a Meta-analysis of Randomized Controlled Trials”
- Ayu: “A Simple Dietary Addition of Fenugreek Seed Leads to the Reduction in Blood Glucose Levels: A Parallel Group, Randomized Single-Blind Trial”
- U.S. National Library of Medicine: "Carbohydrates"
- JAMA Internal Medicine: "Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort"
- American Diabetes Association: "Non-Starchy Vegetables"
- American Diabetes Association: "Get to Know Carbs"
- USDA: "Eat Fish! Which Fish? That Fish! Go Fish!"
- U.S. Department of Health & Human Services: "Physical Activity Guidelines for Americans"
- Diabetology International: "Increasing walking steps daily can reduce blood pressure and diabetes in overweight participants"
- Centers for Disease Control and Prevention: "Prediabetes - Your Chance to Prevent Type 2 Diabetes"