Information from several clinical trials strongly supports the idea that type 2 diabetes is preventable. The Diabetes Prevention Program examined the effect of weight loss and increased exercise on the development of type 2 diabetes among men and women with high blood sugar readings that hadn’t yet crossed the line to diabetes. In the group assigned to weight loss and exercise, there were 58 percent fewer cases of diabetes after almost three years than in the group assigned to usual care. (10) Even after the program to promote lifestyle changes ended, the benefits persisted: The risk of diabetes was reduced, albeit to a lesser degree, over 10 years. (11) Similar results were seen in a Finnish study of weight loss, exercise, and dietary change, and in a Chinese study of exercise and dietary change. (12–15)
Imagine our bodies to be a sugar bowl. A bowl of sugar. When we are young, our sugar bowl is empty. Over decades, we eat too much of the wrong things – sugary cereals, desserts and white bread. The sugar bowl gradually fills up with sugar until completely full. The next time you eat, sugar comes into the body, but the bowl is full, so it spills out into the blood.

Like refined grains, sugary beverages have a high glycemic load, and drinking more of this sugary stuff is associated with increased risk of diabetes. In the Nurses’ Health Study II, women who drank one or more sugar-sweetened beverages per day had an 83 percent higher risk of type 2 diabetes, compared to women who drank less than one sugar-sweetened beverage per month. (26)


In addition, many sugar-containing foods also contain a lot of fat. Foods such as cookies, pastries, ice cream and cakes should be avoided largely because of the fat content and because they don't contribute much nutritional value. If you do want a "sweet," make a low-fat choice, such as low-fat frozen yogurt, gingersnaps, fig bars, or graham crackers and substitute it for other carbohydrates on your meal plan.
Two large studies - one in Finland and the other one U.S. (the Diabetes Prevention Program- DPP) have shown the benefit of weight loss in diabetes prevention. In the Finnish study, more than 500 men and women with impaired glucose tolerance were assigned to a control group or an exercise/weight loss group. By the end of the study, the weight loss group had lost about 8 pounds, and the control group about 2 pounds. The weight loss group had significantly less participants develop diabetes than the control group.

The role of diet in the etiology of T2DM was proposed by Indians as mentioned earlier, who observed that the disease was almost confined to rich people who consumed oil, flour, and sugar in excessive amounts.30 During the First and Second World Wars, declines in the diabetes mortality rates were documented due to food shortage and famines in the involved countries such as Germany and other European countries. In Berlin, diabetes mortality rate declined from 23.1/100,000 in 1914 to 10.9 in 1919. In contrast, there was no change in diabetes mortality rate in other countries with no shortage of food at the same time period such as Japan and North American countries.31 Whereas few studies have found strong association of T2DM with high intake of carbohydrates and fats. Many studies have reported a positive association between high intake of sugars and development of T2DM.32 In a study, Ludwig33 investigated more than 500 ethnically diverse schoolchildren for 19 months. It was found that for each additional serving of carbonated drinks consumed, frequency of obesity increased, after adjusting for different parameters such as dietary, demographic, anthropometric, and lifestyle.

If you are like me, going to the gym is not your favorite pass time. Physical activity with diabetes is so beneficial. Being active, however, does not mean having to work out. There are tons of ways to sneak in exercise in your everyday activities. For example, when grocery shopping, park at the end of the lot so you have to walk a longer distance to and from the store. If you enjoy watching tv, stand up and walk in place during the commercials. Take the stairs instead of the elevator as often as you can. If you enjoy dancing, instead of at- home work out videos, put on your favorite tunes and dance away! There are so many different ways to be active without “working out”!


Obesity: Obesity is probably the most impressive risk factor and in most situations the most controllable. This is in part due to the fact that obesity increases the body's resistance to insulin. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar. However, the distribution of fat is important. The classic "pear" shaped person (smaller waist than hips) has a lower risk of developing diabetes than the "apple" shaped person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of the fat tissue in different areas of the body.
The data on dairy products seems to vary. In a study of over 289,000 health professionals, Harvard researchers showed that consumption of yogurt, in contrast to other dairy products, was associated with a reduced risk for diabetes. In a pooled analysis of 17 studies about dairy products and diabetes risk, those who consumed more dairy products had a lower risk than those who consumed few dairy products, A Swedish study found that high-fat dairy products, but not low-fat dairy products, lowered the risk for type 2 diabetes.
More than half of the dialysis patients I see are type 2 diabetic – a few are type 1 (maybe 5 in a hundred) – it’s scary because when I see overweight people I think to myself if they don’t die first of heart disease they will be on dialysis. My advice now is to get our children outside playing and exercising – and watching their diets. Often fat kids grow up to be fat adults – AMEN – Peggy Harum RD, LD renal dietitian for more than 40 years
Choose lean sources of protein. Lean sources of protein include: eggs, egg whites, chicken breast, turkey breast, lean beef, pork tenderloin, fish (e.g., cod, tilapia, orange roughy), beans, or tofu. Adding protein to your daily intake helps to control spikes in blood sugar and helps with fullness to prevent unnecessary snacking on poor choices later.
This is the advice that diabetics received a hundred years ago. Even in Sweden, with the high fat-Petrén diet that included fatty pork cuts, butter and green cabbage. And when diabetics start eating this way today the same thing happens as it did in the past. Their blood sugar levels improve dramatically from day one. This makes sense, as they avoid eating what raises blood sugar.
One of the key factors in Joslin’s treatment of diabetes is tight blood glucose control, so be certain that your treatment helps get your blood glucose readings as close to normal as safely possible. Patients should discuss with their doctors what their target blood glucose range is. It is also important to determine what your goal is for A1C readings (a test that determines how well your diabetes is controlled over the past 2-3 months). By maintaining blood glucose in the desired range, you’ll likely avoid many of the complications some people with diabetes face.
You also might hear about alternative treatments for diabetes, such as herbal remedies and vitamin or mineral supplements. These practices can be risky, especially when people stop following the treatment plan their doctor has given them. So get the facts by talking to your diabetes health care team. They keep track of the latest research developments, and will introduce new products as they become available.
Diabetes is a disease that is increasingly making its way into the public consciousness, and not in a good way. In fact, according to this article from USA Today, diabetes has a greater health impact on Americans than heart disease, substance use disorder or COPD, with 30.3 million Americans diagnosed with the illness — and many more who are at risk for developing it.
The risk factors for developing diabetes actually vary depending on where a person lives. This is in part due to the environment the person lives in, and in part due to the genetic makeup of the family. In the United States, it is estimated that one in three males and two out of every five females born in the year 2000 will develop diabetes (the lifetime risk). It has also been calculated that for those diagnosed with diabetes before the age of 40, the average life expectancy is reduced by 12 years for men, and 19 years for women.

Obesity: Obesity is probably the most impressive risk factor and in most situations the most controllable. This is in part due to the fact that obesity increases the body's resistance to insulin. Studies have shown that reversal of obesity through weight reduction improves insulin sensitivity and regulation of blood sugar. However, the distribution of fat is important. The classic "pear" shaped person (smaller waist than hips) has a lower risk of developing diabetes than the "apple" shaped person (larger around the waist). The exact reason for this difference is unknown, but it is thought to have something to do with the metabolic activity of the fat tissue in different areas of the body.

If you have type 2 diabetes and the blood sugar is controlled during treatment (diet, exercise and medications), it means that the treatment plan is working. You are getting the good blood sugar because of the treatment – NOT because diabetes predisposition has gone away. You will need to continue your treatment; otherwise your blood sugar will go back up.


But some pleasant news: When consumed in moderation and made with whole ingredients and without added sugar, fruit smoothies can be a good food for diabetes. Consider stocking your fridge with unsweetened frozen fruit so you can whip up one in a hurry for breakfast. Adding ingredients with protein, such as yogurt or a small amount of nut butter, will also help your body break down the carbohydrates more slowly, leading to less of a spike in blood sugar.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Fasting and after meal blood glucose numbers, along with A1C levels, are important because they show how much sugar circulates through your system and how your body deals with it after meals. What the research showed was amazing! Fasting and post-meal blood sugars improved by an impressive 23% and 24% respectively with hintonia. And glycosylated hemoglobin decreased by a remarkable average of 0.8 points! (about 11%). This means many people went from being diabetic to no longer being diabetic.
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