Authors: Winston Wang, MD – Lori Roust, MD – Holly Geyer, MD
Role of diet and lifestyle
Diet and lifestyle significantly affect the risk of developing diabetes, particularly type 2 diabetes. Eating a diet high in sugar increases the blood glucose in people with or at risk for type 2 diabetes which may reveal the diagnosis. Conversely, a diet rich in whole grains, fruits, vegetables, and healthy fats can lower blood glucose and prevent type 2 diabetes.
Physical inactivity is another major risk factor. Regular exercise helps the body use insulin more effectively, which can prevent diabetes. The American Diabetes Association (ADA) recommends at least 150 minutes of moderate-intensity physical activity per week to reduce diabetes risk.
Next, maintaining a healthy weight is crucial. Obesity is a significant risk factor for type 2 diabetes, and weight loss can substantially reduce this risk. The ADA emphasizes that even a modest weight loss of 5-7% of body weight can have a significant impact.
Smoking increases risk of complications of diabetes. Excessive alcohol consumption may damage the pancreas and increase the risk of diabetes. Quitting smoking and moderating alcohol intake are also important preventive measures.
Can Diabetes be prevented?
Teplizumab is a new medication which can delay type 1 diabetes in selected patients known to be at risk of type 1 diabetes. Research is ongoing to better understand the causes of type 1 diabetes and to identify potential prevention strategies, such as therapies that could modify the immune response. However, as of now, there are no established methods to prevent the onset of type 1 diabetes in individuals who are genetically predisposed to the disease.
Type 2 Diabetes can be prevented in some cases by making healthy lifestyle changes and, in some cases, using medications. The American Diabetes Association recommends that people at risk for diabetes should aim to lose at least 7% of their body weight and engage in at least 150 minutes of moderate-intensity physical activity, like brisk walking, each week. These changes help the body use insulin better and keep blood sugar levels normal. Eating a balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins, while avoiding sugary foods and drinks and high-fat foods, is also important.
For some people at high risk of developing diabetes, medications like metformin can be helpful. Medications like metformin can be considered for people who are very overweight, have high blood sugar levels, or have had diabetes during pregnancy. Metformin along with moderate diet and exercise helps lower blood sugar levels and can delay the onset of type 2 diabetes.
Who treats Diabetes?
A coordinated interprofessional team approach is recommended for the treatment of both forms of diabetes. Primary care clinicians usually oversee overall management and coordination of care, but occasionally involve specialists in diabetes management called endocrinologists.
Diabetes care and education specialists provide education on self-management and lifestyle changes. Nurses assist with patient education, medication administration, and monitoring. Registered dietitian nutritionists offer dietary counseling to help manage blood glucose levels. Exercise specialists design physical activity programs tailored to individual needs. Pharmacists educate patients on drug interactions and side effects. Dentists monitor and treat oral health issues, which are common in diabetes. Podiatrists manage foot care to prevent complications such as ulcers and infections. Optometrists can perform frequent screening for eye complications of diabetes. Behavioral health professionals address psychological aspects of diabetes, including stress, depression, and diabetes distress.
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