EDITOR’S NOTE: This is the second article in AFMC’s year-long series on diabetes. It explains ways to prevent diabetes and tips to get started.  

Arkansas has one of the highest rates of diabetes in the nation and most of it could be prevented.

Considering the annual cost of diabetes in the United States – $245 billion in medical costs, lost work and wages – plus the suffering, illness, disabilities and shortened lives caused by diabetes and prevention becomes an urgent public health priority.

Arkansans spend more than $1.67 billion a year in direct medical costs for diabetes; another $1 billion is spent indirectly.

During their lifetime, one in three Americans will have diabetes. Another 86 million currently have prediabetes; yet 90 percent don’t know it. People with prediabetes have a significantly higher chance of developing type 2 diabetes. Without treatment and lifestyle changes, one third of prediabetics will have type 2 diabetes within five years.

The good news is the vast majority of type 2 diabetes can be prevented. Diagnosing prediabetes can lower a person’s chances of developing type 2 diabetes by almost half, if the person starts eating healthier and exercising more. Making certain lifestyle changes can actually reverse the disease.

In a large prevention study of people at high risk for diabetes, losing weight and increasing physical activity reduced the development of type 2 diabetes by 58 percent over three years. This was true for all racial and ethnic groups. The reduction was 71 percent among adults over age 60.

Weight control is the single most important factor to prevent diabetes. If you are overweight, your risk for diabetes or prediabetes is significantly higher. Being overweight or obese makes your body resistant to using insulin. Consult a BMI chart to find out if you are overweight. It includes both height and weight, separately for women and men. A BMI greater than 25 increases your risk for diabetes.

Start with diet

The National Institutes of Health recommends a diet for people with diabetes that is low in fat, cholesterol, salt and added sugar. It should include lots of complex carbohydrates (whole-grain breads, cereals and pasta), fruits and vegetables. This type of diet will help control blood sugar, blood pressure and cholesterol levels.

While diet certainly affects your blood glucose levels, it can also help control weight. Most experts agree that the obesity epidemic is fueling the diabetes epidemic.

If you have diabetes or prediabetes, try these tips to make sure that what you eat works for you, not against you.

  • Watch portion sizes to help control blood sugar and maintain a healthy weight.
  • To keep blood sugar at a healthy, steady level, eat at least three meals a day and never skip meals.
  • Eat at about the same time every day. This helps keep your insulin or medicine and sugar levels steady.
  • Eat plenty of fiber, including green leafy vegetables, whole grains and fruits. Fiber helps you feel full and helps with digestion and elimination.
  • Banish empty calories – foods high in sugar, fat, salt and low in nutritional value – from your regular diet. An occasional treat is okay, but not on a regular or daily basis. Empty-calorie foods also include soft drinks, beer, wine and alcohol.
  • Even small changes can make a difference. A large study linked soft drinks and flavored milk beverages with an increased risk of type 2 diabetes. Researchers found that swapping one soda a day for water or unsweetened coffee or tea lowered diabetes risk by 25 percent. The researchers said sweetened drinks cause a rapid spike in blood sugar and thus in insulin level. Over time, spikes in blood sugar can cause loss of sensitivity to insulin, causing the insulin resistance that leads to type 2 diabetes. Reducing added sugars in your diet is an important step in prevention. But substituting artificially sweetened beverages has become controversial and more and more research is linking artificial sweeteners to a greater risk of obesity and type 2 diabetes.

Get moving

Exercise provides several benefits: it helps insulin work better in your body, lowers blood pressure, gives you more energy, and helps with weight loss and maintaining a healthy weight.

If you’re overweight, start today to lose weight. Make a personal commitment to lose five to 15 pounds to lower your blood glucose level and blood pressure, and make insulin work better in your body, thus decreasing your risk of heart disease.

If you’ve lead a sedentary lifestyle, be sure your doctor is okay with the types and intensity of the activities you’re considering. Start slow, working up to 30 minutes of moderately strenuous physical activity every day. Three, 10-minute activity breaks work just as well as 30 minutes all at one time. Try to include strength (use dumbbells or weight machines) and balance training, as well as flexibility exercises several times a week.

Research has found that, for people over age 45, taking a 15-minute walk after every meal significantly improves their blood glucose levels. A 15-minute walk, about 30 minutes after each meal, was more effective in controlling blood sugar than one 45-minute walk in the morning or evening. Walking after the evening meal was the most effective walking period for older people to control blood glucose.  To effectively lower blood glucose, you must walk every day.

Other risk factors

Age is a risk factor for type 2 diabetes, especially after age 45.

Family history can increase your risk if either or both parents and siblings have diabetes. Some ethnic groups are more likely to have diabetes and include Native Americans, Alaskans, Hispanics, African Americans and Pacific Islanders.

While you cannot change the risk factors of age and family history, the lifestyle choices you make actually have a greater impact on your health. Your genes account for less than one-third of your chances of surviving to age 85.

For more information about an overview of diabetes, information about treatment options and complications of diabetes.