How to prevent diabetes, according to a doctor

(CNN) — More than 800 million adults worldwide are living with diabetes, according to a new study in the journal The Lancet.

The global rate of diabetes was about 14% in 2022, the study found. Nearly 60% of adults age 30 or older who had diabetes did not receive treatment in 2022.

On World Diabetes Day, it’s important to understand this chronic disease, especially what we can do to prevent it. What are the health consequences? What steps can people take to prevent diabetes? How is it diagnosed? If someone is diagnosed, what treatments are available? And what lifestyle changes help everyone — both people diagnosed with diabetes and those who want to prevent it?

To help us with these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner.

CNN: Why is it important to prevent diabetes? What are the health consequences of having this condition?

Dr. Leana Wen: Diabetes is a chronic disease that has many health repercussions. Diabetes is the eighth leading cause of death in the United States, according to the US Centers for Disease Control and Prevention. It is the No. 1 cause of kidney failure and adult-onset blindness, the CDC reports. People with diabetes are two to four times more likely to develop cardiovascular disease compared with those who do not. It is also a top cause of lower limb amputations.

CNN: How common is diabetes? Are some groups at higher risk than others?

Wen: To answer this question, you need to know that there are three main types of diabetes.

Type 1 diabetes is believed to be due to an autoimmune response that stops the body from making insulin. This hormone is crucial to managing blood glucose levels. People with type 1 diabetes have to take insulin every day. Most cases are diagnosed in childhood, though some can occur later in life. Risk factors include having a parent or sibling with type 1 diabetes. Doctors don’t know how to prevent people from developing this form of diabetes.

Type 2 diabetes is by far the most common type of diabetes. In the US, about 90% to 95% of cases of diabetes are type 2. In this form, the body doesn’t respond to insulin as well and cannot keep blood sugars at normal levels. Unlike type 1 diabetes, which typically develops quickly, type 2 diabetes generally emerges over multiple years, and many people may not know that they have it until they are tested for it.

In addition, type 2 diabetes is typically diagnosed in people 35 and older, though in recent years, there have been more cases in younger individuals — including children and adolescents. Risk factors for developing type 2 diabetes include being overweight or obese and living a sedentary lifestyle. Certain ethnic groups are also more likely to have type 2 diabetes, including African Americans, American Indians, Hispanics/Latinos and Asian Americans/Pacific Islanders, and a family history of first-degree relatives with type 2 diabetes is a risk factor, too.

Another risk factor for developing type 2 diabetes is the third form of diabetes, which is gestational diabetes. This type is diagnosed during pregnancy in women who have never had the chronic disease before. It usually goes away after the birth of the child, but having gestational diabetes increases the risk of the woman later developing type 2 diabetes as well as the risk of the child developing type 2 diabetes.

CNN: What steps can people take to prevent developing diabetes?

Wen: Here’s how to prevent the most common form of diabetes, type 2 diabetes.

The first step is to understand your risk of developing prediabetes, which is a condition that precedes being diagnosed with diabetes. The CDC has a useful calculator that will help you quickly assess your risk. Individuals at higher risk should speak with their primary care providers to see if they should be screened for diabetes and prediabetes, while individuals at lower risk should aim for healthy lifestyle choices to prevent these conditions.

These lifestyle choices include getting at least 150 minutes of physical activity a week. Those who cannot reach 150 minutes should keep in mind that some is better than none. Studies have shown that even half of the recommended amount can reduce the risk of developing chronic diseases.

Everyone should work to reduce their consumption of ultraprocessed food. Aim to switch to whole foods such as fruits, vegetables, nuts and legumes, and to cut out sugary drinks. People uncertain about the best foods can ask their physician for a referral to speak with a nutritionist.

Keeping your weight in the healthy range also helps to reduce the risk of developing diabetes. Hypertension is twice as common in patients with diabetes compared with those without, and it’s also important to know if you have high blood pressure.

Another chronic condition that often accompanies diabetes is high cholesterol, and it’s important to know your cholesterol numbers, too. Thankfully, the same lifestyle changes that help to reduce the risk of diabetes also help to reduce the risk of developing these other ailments that, together, raise the chance of heart attacks and strokes.

CNN: How is diabetes diagnosed?

Wen: Several different tests can help diagnose diabetes. An A1C test can measure your average blood sugar over the past few months, while blood sugar tests can be taken at random or after fasting for the night. All of these tests are readily available and should be started, for most people, at age 35. Some individuals may need to begin earlier depending on their risk factors. Your physician can order these tests; if that has not been done, consider bringing it up during your next clinical visit.

CNN: Once someone is diagnosed with prediabetes or diabetes, what treatments are available?

Wen: To prevent prediabetes from progressing to diabetes, individuals should aim to lose excess weight, become more active and eat healthier foods. They should also treat medical conditions like hypertension or high cholesterol that can increase diabetes risk.

Those diagnosed with diabetes should work with their medical provider to identify the best treatments for them. There are a variety of medications available, which can be adjusted based on response and side effects. And they need to continue lifestyle modifications.

CNN: What lifestyle changes help everyone — both people diagnosed with diabetes and those who want to prevent it?

Wen: We’ve already spoken about exercise. I want to underscore that it’s especially important for people who engage in mostly desk jobs; studies have shown that desk-bound workers need additional exercise to make up for their prolonged sitting.

We’ve also talked about the role of diet, maintaining a healthy weight, and keeping other medical conditions under control.

Another key lifestyle change to keep in mind is to stop smoking. People who smoke are 30% to 40% more likely to develop type 2 diabetes compared with those who don’t. Cutting smoking helps to reduce the risk of developing diabetes, and it also is very important for those who are already diagnosed with diabetes to stop smoking to decrease their chance of having heart attacks and stroke.

Finally, understanding your personal risk factors is crucially important, as you may need more frequent and earlier onset of screenings depending on your risk factors. Considering bringing up diabetes on the next visit with your health care provider. Together, you can work out your risk and the steps you can take to prevent and to manage diabetes.

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