Over 30 million people in the U.S. live with type 2 diabetes, a chronic disease that results from insulin resistance and decreased levels of insulin secretion from the pancreas. Because the body is unable to properly use and secrete enough insulin to regulate blood sugar levels, high blood sugar is common in people with type 2 diabetes. This can cause long-term negative effects on organs like the eyes, kidneys, blood vessels and heart, and lead to nerve damage and even death. Type 2 diabetes is treatable, but it’s also largely preventable if certain risk factors are controlled.

Type 2 Diabetes and Family History

“As family history is the single most important risk factor for type 2 diabetes, it is best if you try to prevent this disease from childhood, especially if there is family history of type 2 diabetes,” says Srividya Kidambi, MD, endocrinologist with the Froedtert & the Medical College of Wisconsin health network. “But that’s not always the easiest thing to do, and you cannot change your family history. So other risk factors that you can change, like weight, diet and physical activity are important things to modify to prevent type 2 diabetes.”

Obesity and Type 2 Diabetes

Although there can be some exceptions, overweight and obese individuals are more prone to insulin resistance, meaning they require more insulin than their body can create to maintain a normal blood sugar level. It’s unknown exactly why overweight and obese individuals develop insulin resistance at a higher rate than those with a lower body mass index, but it is thought to happen due to certain substances secreted by the fat tissue as weight increases. When someone is unable to increase insulin secretion to match the needed amount when they are insulin resistant, blood sugar levels start increasing.

“We know that there are certain inflammatory markers that go up, and there are certain types of fat that are more common in patients with insulin resistance, but we don’t know if these are a cause or effect of diabetes,” Dr. Kidambi said. “However, what we do know, is that when people lose weight, these factors that lead to insulin resistance diminish. If insulin resistance lessens, the amount of insulin the body creates can be enough to keep blood sugars in a normal range.”

Why is Weight Management so Important for Those With Diabetes?

As insulin resistance lessens with weight loss, watching what you eat and increasing physical activity can play a vital role in decreasing your diabetes risk. Trendy diets like low-carbohydrate, alkaline and intermittent fasting can work at first, but as the body adapts to the changes it’s undergoing, the diets can lose their effectiveness and weight will either plateau or come back. That’s why endocrinologists at the Froedtert & MCW health network promote moderation over any specific diet.

“It doesn’t necessarily matter what type of diet you do,” Dr. Kidambi said. “It’s really the calorie restriction that brings weight down, which is what brings down diabetes risk. Diets can be hard to keep up after a few months, so I recommend portion control. I will never say ‘don’t eat ice cream,’ but I will say that everything needs to be in moderation, because that is what people can sustain.”

Combined with portion control, being physically active can also cause you to shed pounds and lessen your risk for diabetes. Going for walks, practicing yoga, exercising, or doing anything to elevate your heart rate can be a good way to stay active and help you lose weight. Losing 7% of body weight from lifestyle modification, which includes eating in moderation and increased physical activity, can reduce the incidence of diabetes by 58%. As you can’t change your family history and age, it’s important to control the factors that you can control – weight and physical activity – to lessen your chance at a diabetes diagnosis.

Other Risk Factors for Diabetes: Sleep, Food and Socioeconomic Status

Overweight or obese individuals who do not meet physical activity guidelines often have additional risk factors for type 2 diabetes that tend to happen naturally. Sleep quality, for example, is commonly poor for obese individuals, and therefore, is a risk factor for type 2 diabetes. Going hand in hand with diet and feeding into obesity, extensive consumption of sugar sweetened beverages (soda, juice, energy drinks, etc.) is also a risk factor that can lead to type 2 diabetes.

Another risk factor is socioeconomic status, something that is often difficult to change. If an individual is working two jobs to make ends meet, they may be tired when they get home from work, which could lead to limited physical activity, poor food choices and poor sleep quality – all risk factors for type 2 diabetes.

“Low socioeconomic status, which is usually not a choice, has been associated with a significant increase in obesity and type 2 diabetes,” Dr. Kidambi said. “So when stacked up, all of these factors – socioeconomic status, fatigue, sleep quality and duration, physical activity, food choices – are interdependent on one another and accumulative. That is why it’s called lifestyle modification – you have to change the way you live.”

If you’re interested in changing the way you live and getting help from Froedtert & MCW endocrinologists to prevent type 2 diabetes, contact our team at 414-777-7700 or visit froedtert.com/endocrinology/diabetes.

Lalith Boteju

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