What Steps Can I Take to Reduce or Reverse Diabetes?

Type 2 diabetes is most often referred to as “lifestyle diabetes” because of the many controllable factors such as healthy eating, weight management, and exercise, which can help prevent, manage, and even reverse diabetes progression. It is estimated that 80% of the overweight will develop diabetes. According to the Diabetes Prevention Program Outcomes Study, diet and exercise are more effective than medications in delaying diabetes. These results demonstrate that prevention or delay of diabetes achieved through lifestyle change can persist for at least 10 years. By making changes such as adding exercise and improving your diet, blood sugar levels will return to normal and thus reverse your condition.

Exercise
Exercise is perhaps the single most important lifestyle intervention in diabetes because it is associated with improved blood sugar control, insulin sensitivity, cardiovascular fitness and remodeling. Both aerobic exercise and resistance/strength training have a positive impact on blood sugar control. Physical activity can help manage blood sugar levels as well as improve HDL (good) and lower LDL (bad) cholesterol levels for overall heart health.

Exercise recommendations:
• At least 150 minutes per week of moderate-intensity aerobic physical activity (50-70% of maximum heart rate) such as briskly walking, swimming, biking or dancing
• In absence of contraindications, resistance training for type 2 diabetics at least three times per week

Remember to start out slow and work your way up to suggested levels of exercise and intensity. Frequency is more important than intensity and duration in diabetes management.

Diet
The best mix of carbohydrates, protein and fat appears to vary depending on individual circumstances. Dietary recommendations include:

• Diet tailored to individual:
  o 20-40% carbohydrates
  o 25-45% protein
  o 15-35% fat
• Select low glycemic index (GI) foods
• Eat at least 30-35 grams of fiber per day and whole foods
• Adequate spacing between meals
• Moderate portions and modest caloric restrictions
• Protein intake should be limited to the recommended dietary allowances of 0.8 g/kg in those with any degree of chronic kidney disease
  o 20-40% of persons with diabetes will develop kidney disease
• Cinnamon: 1.5 – 3 grams (approximately ½ teaspoon) per day.
• Increase healthy fats (omega 3). Dose: 200-300 mg per day or 1,000 mg up to 4,000 mg per day to lower triglyceride levels
• Avoid caloric beverages

Weight loss
Weight loss is highly effective as it can reduce insulin resistance and provide blood sugar control. Check with your physician prior to starting a weight loss plan as your medications, supplements, insulin and/or blood sugar may need to be adjusted as you lose weight and change your diet. Research shows that a 5% to 10% reduction in weight can significantly lower blood sugar levels, blood pressure and improve blood fats. You can succeed by setting healthy weight loss goals for yourself. Learn about emotional and situational eating habits to avoid overeating. Begin to cultivate healthful attitudes about food.

Increased fat around your waist versus hips (apple vs pear shape) puts you at greater risk for type 2 diabetes and heart disease. Measure your waist and if your waist is the same or bigger than the numbers below, you are at an increased risk for type 2 diabetes:

Waist Circumference:

Measure and monitor your body mass index (BMI) – a comparison of your height and weight. You can find your BMI through any online BMI calculator: http://www.nhlbisupport.com/bmi . Once you find your personal BMI, you can begin to set a healthy weight loss goal.

BMI:

• Below 18.5 Underweight
• Between 18.5 - 24.9 Healthy Weight
• Between 25 - 29.9 Overweight
• Over 30 Obese