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Diet and Exercise Prevent Diabetes as Well as Medication Does

People at risk of diabetes were assigned to change their diet and increase their exercise; over 15 years, they were able to prevent diabetes.

Is There a Way to Prevent Diabetes?

Fifteen years ago, a study called the Diabetes Prevention Program showed that diet and exercise work as well to prevent diabetes among high-risk individuals as taking a drug called metformin.

In the original study conducted between 1996 and 2001, volunteers who were overweight, with elevated blood sugar that didn’t quite reach the cut-off for type 2 diabetes took metformin, a placebo, or followed a low-fat diet and did 15 minutes of moderate intensity exercise every day. Researchers assigned the groups randomly. Those in the lifestyle group were 58 percent less likely to have developed diabetes than those in the placebo group. Metformin also worked, though it was slightly less effective.

Fifteen Years Later, the Benefits of Lifestyle Change Hold Up:

When the researchers followed up with the participants after about 15 years, 62 percent of those in the placebo group had developed diabetes (The Lancet Diabetes and Endocrinology, online Sept. 13, 2015). That compares to 56 percent of those who took metformin and 55 percent of those watching their diet and exercising.

What Diet Can Help Prevent Diabetes?

What diet might a person follow to prevent diabetes? There is evidence that either the DASH diet or the Mediterranean diet is useful in this regard. Both are rich in vegetables, fruits and whole grains and have little red meat or high-fat dairy products such as cheese or ice cream. Such diets appear to reduce inflammation, especially together with regular exercise (Nutrients, July 27, 2020). Research has also shown that diets with lots of white bread, potatoes and processed foods put people at greater risk of developing diabetes.

How Can You Monitor Your Blood Sugar?

Most people who are motivated to measure their blood sugar have diabetes or have been told they are very likely to develop it. One reader decided to start collecting blood sugar data proactively in an effort to prevent diabetes. 

Q. Could you suggest a good blood sugar meter that I could purchase without a prescription? I will turn 65 in November, am normal weight and am trying to watch my sugar. Diabetes runs in my family, and I realize that folks become more susceptible to diabetes when they are older. I hope to monitor my blood sugar periodically at home. Anything you can suggest would be helpful.

A. Given your family history, it makes sense to monitor your blood sugar periodically. OTC blood glucose meters are relatively affordable, running between $30 and $60. The strips, however, get pricey. Since you won’t have to test your blood sugar multiple times a day, that should not be a problem.

Consumer Reports has rated several brands as recommended. They include FreeStyle Freedom Lite, True Metrix and Accu-Chek Aviva Plus.

What Numbers Indicate Problems?

In your effort to prevent diabetes, you will want to measure your fasting blood sugar. That will give you the best information for detecting prediabetes or type 2 diabetes. The most convenient time might be first thing in the morning before breakfast.  A normal level is 99 mg/dL or below; if your level is 100 to 125 mg/dL, you may have prediabetes and should discuss this with your doctor. They may want to test your hemoglobin A1c, a way of determining blood sugar levels over several weeks rather than just in the moment. On lab tests, you’ll see it listed as HbA1c.

According to the CDC, fasting blood sugar of 126 mg/dL or above is a red flag for diabetes. Hopefully, your regular monitoring will show you how much exercise and which foods help you keep your blood sugar under control. That makes it an important tool in your effort to prevent diabetes.

Learn More:

For more information on how you can prevent diabetes, you may wish to read our eGuide to Preventing and Treating Diabetes. This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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