Everyone is at risk for diabetes. It is three times more common today than it was 40 years ago and the numbers are rising. Approximately 18 million Americans have type 2 diabetes, the most common form, and another 16 million eventually will get it if they don't take the right steps now.

Good news: Type 2 diabetes almost always can be prevented—and even reversed—with lifestyle changes.

A Harvard University study that followed more than 84,000 people for 16 years found that a healthy lifestyle-including exercising, eating healthful foods, maintaining a healthful weight, etc.-lowered diabetes risk by 91%.

Seven diabetes-prevention strategies…

1. Get tested. Nearly everyone who has diabetes passes through the prediabetes stage first --when blood glucose (sugar) levels are elevated but not yet high enough to be considered diabetes.

Prediabetes causes no outward symptoms but increases the risk of heart attack or stroke by 50% and greatly increases the risk of full-fledged diabetes.

It is prudent to be tested for diabetes every three years starting at age 40. Get tested annually if you have any diabetes risk factors you are overweight...sedentary...have a family history of diabetes...or have a waist circumference of greater than 40 inches in men or 35 inches in women.

Main tests...

  • Fasting plasma glucose (FPG) test. Blood sugar is tested first thing in the morning after an overnight fast. A normal reading is 70 to 99 milligrams of glucose per deciliter (mg/dL) of blood. Anything higher means that you have prediabetes (100 to 125mg/dL) or diabetes (126 mg/dL and higher).
  • Oral glucose tolerance test (OGTT). Blood sugar is tested after an overnight fast and again two hours after you drink a glucose solution. On the second test, a normal reading is below 140 mg/dL. A reading of 140 to 199 mg/dL means you have prediabetes, and anything over 200 mg/dl indicates diabetes.

These two tests are effective in most cases. However, the FPG, which is easier and more convenient, may miss some prediabetes patients. Your doctor can advise you on which test is best for you to take.

2. Lose 10 pounds. The increase in diabetes is directly related to obesity. The link is so strong that doctors have coined the term diabesity for weight-related diabetes.

Excess fat causes cells to become resistant to insulin, the hormone that carries glucose out of the bloodstream. A large study found that an average weight loss of approximately 10 pounds reduces the risk of diabetes by 58%.

Weight loss is particularly important if you have excess abdominal fat. People who store fat mostly around their middles, the so-called "apple" shape, have a higher risk of diabetes and cardiovascular disease than those who store fat in their hips and thighs (the "pear" shape).

Any diet can work as long as you burn more calories than you consume. The currently popular low-carbohydrate diets, such as Atkins, can be effective, but they tend to be too high in fat for long-term health and are hard to sustain.

3. Eat whole grains. Everyone should switch from refined grains (white bread, white flour, white rice) to whole grains (brown rice, oatmeal, whole wheat, etc.). Whole grains slow the absorption of glucose in the bloodstream, thereby minimizing blood-sugar spikes that stimulate appetite and increase the risk of weight gain and diabetes.

4. Fill half your plate with produce. Fruits and vegetables are low in calories and high in fiber. They fill you up, so you're less likely to eat other higher-calorie foods. Aim for seven or more servings daily. This isn't as hard as it may seem. A serving of fresh fruit or vegetables is one-half cup...a serving of leafy greens is one cup. One banana equals two servings...a typical wedge of watermelon is three servings.

Some people think that fresh produce is too expensive, but a US Department of Agriculture (USDA) report showed that the seven recommended daily servings of fruits and vegetables cost $1 or less. The study showed, for example, that consumers who balk at spending 97 cents for a pound of peaches don't realize that they are getting more than four half-cup servings at roughly 24 cents each.

5. Limit fat consumption. Fat has twice the calories of carbohydrates and protein. All fats can lead to weight gain, but saturated fat also increases cholesterol and heart disease risk.

Choose lean meats and low-fat dairy products...avoid trans fatty acids ("hydrogenated" oils)...and use canola, soybean or olive oil for cooking and salad dressing. They contain the beneficial monounsaturated and polyunsaturated fats.

6. Avoid sugar. The average American eats approximately 150 pounds of sugar annually. Sugar is digested and absorbed quickly, promoting spikes in glucose and insulin levels that lead to diabetes and heart disease. It also contributes to obesity.

7. Get moving. Exercise makes the body's cells more responsive to insulin and improves their ability to remove glucose from the blood. Exercise also lowers blood sugar by burning glucose for fuel and promotes weight loss—especially from the abdomen.

The landmark Diabetes Prevention Program sponsored by the United States government found that walking for 30 minutes a day at a moderate pace, along with weight loss and a healthful diet, reduces the risk of diabetes by more than 50%.

A combination of aerobic exercise and strength-training is optimal. Approximately 75% of glucose disposal takes place in the muscles. Weight lifting increases muscle size and promotes more efficient glucose metabolism.

Spotting Hidden Sugar

Many people have a reason to avoid sweets. IV Some are trying to maintain a healthy weight; others are trying to prevent cavities. To diabetics, keeping track of sugar consumption can be a matter of life or death.

Unfortunately, finding all the different types of sugar on food ingredient labels can often be difficult, the US Department of Agriculture (USDA) warns.

A food is likely to contain significant amounts of sugar if its ingredient list shows one or more of these items: sucrose, honey, syrup, corn sweetener, glucose, dextrose, high-fructose corn syrup, fructose, molasses, maltose, fruit juice concentrate or lactose.

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