Diabetes and the Family
A healthy lifestyle can delay and even prevent diabetes, even if it is your family and you have inherited the 'diabetic' genes (Lancet 09).
- Regular exercise such as swimming, cycling, or walking helps to delay or prevent diabetes: 30 minutes a day is the recommended minimum, but 90 minutes a day is needed to lose weight. Exercise is proven to prevent diabetes. Gaining weight increases the risk of diabetes 2-3 times at least.
- A healthy diet helps to delay or prevent diabetes (see below). Losing weight, and having a healthy diet with regular exercise, can reduce the risk of type 2 diabetes by more than 50%. here study
- Smoking is harmful; it damages the arteries and can double the problems that diabetes can itself cause.
- Smoking doubles the risk of developing type 2 diabetes. Even passive smoking increase the risk. See
- Sunlight also prevents diabetes, mainly type 2, but also to a lesser degree type 1. Thus Bangladeshi immigrants to the UK are thought to be very prone to type 2 diabetes partly because they get too little vitamin D or sunlight exposure (lack or exercise and unhealthy diets are other risk factors). See Diabetes Care 2011
- Stress increases the risk of diabetes: BMJ BMJ Pubmed
- Keep you blood pressure down. Risks increase above the level 115/65, and this should be your target if you are well. Optimal blood pressure for diabetes.
- Television viewing increases obesity, so children should not watch too much. Being overweight doubles the risk of death.
- avoiding risk factors and sticking to a healthy lifestyle reduces problems to 20%. A high risk lifestyle is 5 times more like to cause medical problems. BMJ 2008 BMJ
- a driving job increases the risk of diabetes 2010
- New antipsychotic drugs increase the risk of diabetes, as does osteoarthritis.
- Cycling keeps you fit BMJ 11
- Linked to urban poverty and communities etc NEJM 11 .
- High blood pressure (in people who are not diabetic) increases the risk of diabetes 2012.
- Taking metformin for those at highest risk nearly halves the risk of developing diabetes BMJ14
- the risk for you BMJ 15 Prediabetes is harmful BMJ 16
- how to cure diabetes (type 2, recent onset) see 2021
enlarge healthy lifestyle...20% of medical problems
Check ups for those at risk
Risk factors include:
- being overweight
- having hypetension/high blood pressure
- first degree blood relative with adult onset diabetes
- certain ethnic groups such as African-Americans, Hispanics, certain Native American groups, and Asians
- delivery of a baby weighing more than 9 lbs or a history of diabetes during pregnancy ("gestational diabetes")
- over 45y
- less than 2 hours exercise a day
- do you have pre-diabetes?
This is most important, summarised here, in detail here.
- vegetables/fruit: 7-9 x 100gm portions a day. This is not as hard as it sounds (e.g. a salad with lunch & supper, and an apple/orange/banana is 9). A Mediterranean diet has been proven to reduce the risk of diabetes. If cooked, steaming is preferable as it preserves more vitamins. A portion is 100gm, the size of a small apple. Brightly coloured vegetables will have more vitamins, such as red cabbage, lettuce, green beans, carrots.
- have a diet with very little saturated fat and transfats (these are in butter, some margarines, cakes and pastry, and often start as 'hard' fats.) Some margarines are more helpful that others..Flora is helpful. Flora pro-active and Benecol lower cholesterol. Many other margarines or butter substitutes are harmful. Some oils, such as sunflower and olive oil, are ideal in moderate amounts..latest reports indicate olive oil reduces breast cancer. Some fats such as these oils in your diet is essential. Live oil is the preferred oil when cold, sunflower or rapeseed when used for cooking. (Olive oil 'saturates' when cooked.)
- fish twice a week, especially oily fish such as sardines salmon, mackerel, tuna, will be helpful (similar DC 90)
- Salt will be harmful, including sea salt. Avoid processed food
- 9 (men) 7 (women) 5 (children) portions of vegetables & fruit a day.
- Pulses, such as lentils, can provide protein, replacing some red meat. Red meat should be lean and in small amounts. Chicken and turkey are acceptable in small amounts ( the same size of a piece of weetabix).
- Meals should be balanced..some carbohydrate (rice, potato etc), vegetables, and protein such as fish or lentils (which may be made into a dahl or stew), many herbs and spices, and fruit. The amount you eat depends on your energy requirements...if you are a builder you will need to eat a lot more than someone with a desk job. Energy should come from carbohydrate such as rice, potatoes, pasta, bread , but in diabetes brown rice is safest. Ultraprocessed food is very harmful (it encourages obesity etc).
- Processed meat increases the risk of diabetes by 91%, & red meat also by 41%. Cinnamon may decrease risk. If you are disabled you need specialist advice...indeed professional advice is important for all people with diabetes.
- See NHS
- Fibre prevents heart disease BMJ 14
- Fish twice a week is very helpful, protecting the circulation, see.
- there are diets that lower cholesterol that should be tried, eg more soya. see evidence
- Sugar...more heart and stroke problems BMJ 14
Diabetes is not being prevented: there is too little action, too late, see. Do you have pre-diabetes? An HbA1c test every 1-3 years will detect this. Being overweight can increase the risk many times:
See if you are at risk with a computer simulation of risk
- type 2 diabetes does run in families
- even some types of insulin dependent type 1 diabetes may run in families. If your type 1 diabetes started at a very young age, and especially if it runs in the family, you need genetic testing. There are rare patients who can replace their insulin with other treatment.
- There are MODY types of diabetes. Genetic testing may be advisable. An excellent review BMJ 2011