Can you change your diabetes fate?
It's key to understand that type 2 diabetes is a progressive illness often preceded by years of elevated blood glucose (also known as blood sugar) levels high enough to be diagnosed as prediabetes. When most people with type 2 diabetes are finally diagnosed, experts believe they've been on this path for five to 10 years and have lost more than half of their natural insulin-making capability in the beta cells of their pancreas.
While you cannot undo your lifestyle habits of the last decade or more, you can take steps to put your diabetes in remission. Don't despair and don't give up.
Research shows that losing weight and keeping it off can help delay the onset of prediabetes, delay progression of prediabetes to type 2 diabetes, or slow the progression of type 2. The keys to diabetes prevention and preventing diabetes complications include: Eat healthfully, exercise often, seek out knowledge and support, and create an environment that fosters healthful living.
Losing even just a few pounds early on when glucose begins to rise can dramatically improve your blood sugar levels, cholesterol levels, triglycerides, blood pressure, and more.
"People should get to their ideal weight if they have prediabetes or type 2," says Robert Huizenga, M.D., associate professor of medicine at the University of California, Los Angeles and doctor for The Biggest Loser, where he is known as Dr. H. "People should have no excess fat and be athletically fit. Ninety minutes of exercise six days a week and a steady diet of healthy eating is the best prescription to manage type 2 diabetes without medications."
That's easier said than done for most people, who have to adopt a healthier lifestyle outside the bubble of the ranch where The Biggest Loser is filmed or the jump-start of a stomach-shrinking surgery. Commitment, perseverance, and a positive attitude can help you achieve a healthy weight. Set small, achievable goals first; experience success of meeting those goals; and then add new goals. Over time, all your small successes will add up right before your eyes.
Many research studies suggest setting a goal of losing 5-7 percent of your starting weight to lower blood sugar and improve health, with the imperative to keep the pounds off.
Major research findings offer hope
A decade-plus of research from the National Institutes of Health's Diabetes Prevention Program (DPP) studied people at risk for or with prediabetes. The study showed that people who were involved in the intensive-lifestyle group and lost about 7 percent of their initial weight and kept off some of that weight, initiated exercise, and engaged in support delayed the onset of type 2 diabetes by nearly 60 percent at the end of the three-year phase of the study.
After 10 years, those in the original intensive-lifestyle group continued to reduce their progression to type 2 diabetes the most -- about 35 percent -- and those in the initial metformin group saw about a 20 percent reduction versus standard care. At the 2014 American Diabetes Association annual meeting, 15-year data from the ongoing follow-up study to the DPP, the DPP Outcomes Study, was revealed. This showed a continued reduction in the onset of type 2 diabetes. The original lifestyle group had a 27 percent greater reduction and the metformin group a 17 percent reduction versus standard care.
The conclusions: It appears that losing weight and keeping off as much of it as possible over the years is the main predictor of slowing disease progression. People who lost the most weight had the best chance of preventing type 2. With every 2.2 pounds lost, people reduced the progression to type 2 diabetes by 16 percent. They experienced other benefits, too, including lower blood pressure and improved cholesterol levels, while taking less medication to control them.
People who do progress to type 2 diabetes must pair a healthy lifestyle with glucose-lowering medications to control blood sugar over years. On the upside, M. Sue Kirkman, M.D., endocrinologist and professor of medicine at the University of North Carolina at Chapel Hill, says there are overall health benefits to having normal glucose levels for as many years as possible, such as delaying the onset of complications like heart disease.