Lifestyle Changes For Prevention And Management Of Diabetes

  • Ayesha Bibi Doctor of Pharmacy - Pharm-D, The University of Faisalabad, Pakistan
  • Heather Hyde BSc Biomedical Science, University of Birmingham
  • Richa Lal MBBS, PG Anaesthesia, University of Mumbai, India

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Have you ever wondered how else you can manage your blood sugar other than medication? Did you know that lifestyle modifications like a healthy diet and regular exercise can delay, manage, and even prevent diabetes? Oh yes, that’s possible. The following article will tell you all you need to know about what lifestyle changes you need to make to prevent and manage diabetes, so read on!

Overview

Diabetes is a chronic (long-term) disease that is characterised by high glucose levels in your blood.1 Diabetes affects how your body converts food into energy. Diabetes is not completely curable but it can be managed with the help of weight loss, eating healthy food, and doing physical activity.2,3 According to the Centers for Disease Control and Prevention (CDC):

  • Diabetes is the number 1 cause of kidney failure, lower extremity amputation, and adult blindness
  • Another report by the CDC shows that in the past 20 years, the number of diabetes patients has more than doubled

What are the different types of diabetes?

Diabetes has three main types:1

  • Type 1 diabetes: This type of diabetes happens when your body is not making enough insulin to lower the blood sugar level. About 5 to 10 per cent of people with diabetes have this type. Type 1 diabetes cannot be prevented.
  • Type 2 diabetes: Your body cannot use insulin well and the level of blood sugar increases. About 90-95% of people who are diabetic have type 2 diabetes. You are more likely to get this disease if risk factors are present. It can be prevented by making healthy changes to your lifestyle, which include losing weight, being active, and eating healthily.
  • Gestational diabetes: Diabetes during pregnancy is known as gestational diabetes. It increases your risk of developing type 2 diabetes after pregnancy and also increases the chance of your child getting this disease later on in life.

What is the importance of lifestyle changes for diabetes?

Having prediabetes (higher than normal blood sugar level but not high enough to be diagnosed as diabetes) increases your risk of getting type 2 diabetes. So if you have prediabetes, being active and losing weight by physical activity and eating healthily can reduce the risk of type 2 diabetes.4

Although you cannot prevent type 1 diabetes, type 2 diabetes is preventable and it can be delayed by adopting some healthy lifestyle changes. Having a healthy lifestyle not only controls diabetes, but helps in many other diseases that are caused by high levels of blood sugar, high blood cholesterol, high blood pressure, and increased weight.5 Following are some changes you can make in your lifestyle that can help you manage diabetes:

  • Eat a healthy diet
  • Manage your weight
  • Regular physical activity
  • Stop smoking
  • Limit your alcohol consumption
  • Relieve stress
  • Get regular checkups

Eat healthily

Eating healthily not only regulates your blood sugar levels but also reduces your risk of getting cardiovascular complications later on in life.6, A healthy diet also helps you lose weight and thus further helps to prevent diabetes. A healthy diet consists of not only what you eat, but also how much of it and how often you eat. Here’s what you can do:

Learn about counting carbs and portion size

Carbohydrates have the greatest effect on your blood sugar levels and counting the carbs you take in during each meal is important for diabetes management. Seek help from your physician or dietitian to set the carb limit for each meal. Check out this list of common foods that contain carbs and their serving size. You can plan your meals by noting down the serving size of the foods you like to eat more often. Measure the serving or portion size and ensure the correct carb count using measuring cups.

Eliminate sugar-sweetened beverages

These beverages are rich in calories and possess very little nutritious benefit. They result in a very quick rise in your blood sugar levels and therefore you should avoid them if you have diabetes. Such beverages include sports drinks, energy drinks, coffee drinks, sweetened tea, non-diet sodas, and electrolyte replacement drinks.

Eat a well-balanced diet

A healthy and well-balanced diet for diabetes includes foods that have increased amounts of dietary fibre and decreased quantities of fats and carbohydrates. Foods that are low in carbs include fruits, vegetables, and whole grains, which are your best choices for diabetes. The National Institute for Health and Care Excellence (NICE) recommends the consumption of the following foods for diabetes:

  • Fruits and vegetables: Non-starchy colourful vegetables and fruits are important for diabetes as well as for your overall health. Examples include leafy greens, carrots, bell peppers, tomatoes, and fruits such as berries, apples, and oranges.
  • Lean proteins: Such as fish, chicken, eggs, turkey, nuts, tofu, and beans
  • Whole grains: Whole grains loaded with fibres such as oatmeal, brown rice, barley, whole grain pasta, whole corn and wheat
  • Healthy fats: Such as olive oil and avocados

Foods to avoid or limit

You may want to either avoid or limit the consumption of the following foods if you have diabetes:

  • Avoid having red meat products such as beef, lamb, and pork as they increase your chances of getting type 2 diabetes. Saturated fats in red meat also increase the risk of heart disease and obesity, which can further contribute to diabetes
  • Eat fewer foods with high carb content, such as sugar-sweetened beverages, candy, and desserts
  • Processed meat with high fats, like hot dogs and bacon, should be limited
  • Foods high in saturated fats such as butter, lard, and snacks including chips, crisps, fries, and other fried salty snacks should be taken in reduced amounts.

Get active!

To become active, you don’t have to spend hours at the gym. Being active means spending less time sitting and moving your body more. Type 2 diabetes, as well as obesity, are the result of an inactive or sedentary lifestyle. Physical activity not only lowers your blood sugar levels but also makes your body more responsive to insulin, and thus helps in the management of diabetes.7 

Start slow

You should always start slow. This can be done by adding some simple and easy activities to your day. For example, you could walk your dog, do housework, garden, try an exercise video, or even dance to your favourite song! If you are one of those people who find it hard to make a habit of something, try to create a schedule. Take it slow by starting with about 5 or 10 minutes of activity and work up to 150 minutes a week. Make sure not to overdo it - you should be able to talk while you are doing the activity.

Moderate physical activity

Moderate physical activity should be performed for about 2 and a half hours a week. You can reach this goal by breaking it up into 20 to 25 minutes of physical activity every day. These activities increase your heart rate, make you breathe faster, and work your large muscles, which are the essential aims for fitness. These activities of moderate intensity include the following: 

  • Brisk walking
  • Doing house chores
  • Swimming
  • Dancing
  • Playing sports
  • Cycling

Intense physical activity

NICE advises completing about 2 and a half hours of moderate-intensity exercise or 1 hour and 15 minutes of intense activity. These vigorous activities include:

  • Jogging
  • Skipping
  • Football
  • Gymnastics
  • Rapid cycling

The following precautions should be taken while doing the above-mentioned activities:

  • Drink an adequate quantity of fluids to prevent dehydration (excessive and harmful loss of water from the body)
  • Check your blood sugar levels before starting any physical activity. If your blood sugar level is less than 100 mg/dL, then you should eat a small snack containing about 15 to 30 grams of carbohydrates, or else hypoglycemia (lower than normal blood sugar) may occur, which can be quite serious. If the blood sugar level is higher than 240 mg/dL, you cannot perform the physical activity safely due to high blood sugar levels (hyperglycemia)
  • After the activity, check your feet for blisters, sores, cuts, or any other injury and visit your healthcare provider if the injury does not start to heal after 2 days.

Maintain a healthy weight

Losing weight or maintaining a healthy weight reduces the risk of getting diabetes as well as other obesity-related diseases.8 If you have diabetes, then maintaining a healthy weight makes it easier to manage your blood sugar levels. Two pointers that give you an idea about whether your weight is healthy or not are body mass index (BMI) and waist circumference. BMI is the measure of your height compared to your weight.

Weight statusBMI
UnderweightLess than 18.5
Normal18.5-24.9 
Overweight25-29.9
Obesity30 or more

Measure the waist circumference by placing the measuring tape around your mid portion (right above your hip bones) and measure it right after you exhale. If it is more than 35 inches in women and more than 40 inches in men, it becomes a risk factor for type 2 diabetes. Losing weight reduces this risk. You can lose weight through diet and physical activity.

Food for life

You should create an eating plan that you can follow for your whole life, and it should meet the following criteria:

  • It includes healthy food
  • You can follow it long-term

For instance, some people include foods that are low in carbs and high in protein in their diet, so they stay fuller for a longer time.9.10 Other people eat vegetables and fruits and avoid unhealthy foods. Your eating plan will depend on your likes and lifestyle. Seek the help of a registered dietitian or a diabetes educator if you need ideas and support.

Physical activity

Although physical activity alone may not reduce a lot of weight, combining exercise with a healthy diet speeds up the process of weight loss. Being active has proven effects on your way of life as it improves your sleep, mood, and functioning ability. The CDC gives the following recommendations regarding physical activity:

  • Do about 150 minutes of moderate physical activity every week, such as swimming, brisk walking, and playing sports, or about 75 minutes of intense physical activity, such as jogging or a combination of both
  • For two days a week, perform activities that involve major muscles. These activities include lifting weights and using a resistance band.

Other lifestyle modifications that are important in managing diabetes include:11

Summary

Diabetes is a long-term condition that is characterised by high glucose levels in your blood. There are three main types: type 1, type 2, and gestational diabetes. Along with diabetic medication, lifestyle changes help prevent, delay, and manage diabetes. 

Among these modifications, a healthy diet, weight management, and physical activity are the most important. Other changes include stress management, smoking cessation, limiting alcohol intake, and medication adherence.

References

  1. American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care [Internet]. 2010 [cited 2024 May 3]; 33(Supplement_1):S62–9. Available from: https://diabetesjournals.org/care/article/33/Supplement_1/S62/25777/Diagnosis-and-Classification-of-Diabetes-Mellitus.
  2. Galaviz KI, Narayan KMV, Lobelo F, Weber MB. Lifestyle and the Prevention of Type 2 Diabetes: A Status Report. American Journal of Lifestyle Medicine [Internet]. 2018 [cited 2024 May 3]; 12(1):4–20. Available from: http://journals.sagepub.com/doi/10.1177/1559827615619159.
  3. Uusitupa M, Khan TA, Viguiliouk E, Kahleova H, Rivellese AA, Hermansen K, et al. Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis. Nutrients [Internet]. 2019 [cited 2024 May 3]; 11(11):2611. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893436/.
  4. Glechner A, Keuchel L, Affengruber L, Titscher V, Sommer I, Matyas N, et al. Effects of lifestyle changes on adults with prediabetes: A systematic review and meta-analysis. Primary Care Diabetes [Internet]. 2018 [cited 2024 May 3]; 12(5):393–408. Available from: https://www.sciencedirect.com/science/article/pii/S1751991818301967.
  5. Choe HJ, Rhee E-J, Won JC, Park KS, Lee W-Y, Cho YM. Effects of Patient-Driven Lifestyle Modification Using Intermittently Scanned Continuous Glucose Monitoring in Patients With Type 2 Diabetes: Results From the Randomized Open-label PDF Study. Diabetes Care [Internet]. 2022 [cited 2024 May 3]; 45(10):2224–30. Available from: https://diabetesjournals.org/care/article/45/10/2224/147469/Effects-of-Patient-Driven-Lifestyle-Modification.
  6. Pot GK, Battjes-Fries MC, Patijn ON, Zijl N van der, Pijl H, Voshol P. Lifestyle medicine for type 2 diabetes: practice-based evidence for long-term efficacy of a multicomponent lifestyle intervention (Reverse Diabetes2 Now). BMJ Nutrition, Prevention & Health [Internet]. 2020 [cited 2024 May 3]; bmjnph. Available from: https://nutrition.bmj.com/content/early/2020/08/17/bmjnph-2020-000081.
  7. KIRWAN JP, SACKS J, NIEUWOUDT S. The essential role of exercise in the management of type 2 diabetes. Cleve Clin J Med [Internet]. 2017 [cited 2024 May 3]; 84(7 Suppl 1):S15–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846677/.
  8. Wilding JPH. The importance of weight management in type 2 diabetes mellitus. Int J Clin Pract [Internet]. 2014 [cited 2024 May 3]; 68(6):682–91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238418/.
  9. Chen L, Pei J-H, Kuang J, Chen H-M, Chen Z, Li Z-W, et al. Effect of lifestyle intervention in patients with type 2 diabetes: A meta-analysis. Metabolism [Internet]. 2015 [cited 2024 May 3]; 64(2):338–47. Available from: https://www.sciencedirect.com/science/article/pii/S0026049514003126.
  10. Kaur G, Vaidya R, Arora P, Maan A, Monga G, Kumar A. Dietary and Lifestyle Modifications among Diabetic Patients at a Tertiary Care Hospital in Delhi: A Cross-sectional Study. Journal of Medical Academics [Internet]. 2019 [cited 2024 May 3]; 2(1):20–4. Available from: https://www.jmaacms.com/doi/10.5005/jp-journals-10070-0031.
  11. Zhang Y, Pan X-F, Chen J, Xia L, Cao A, Zhang Y, et al. Combined lifestyle factors and risk of incident type 2 diabetes and prognosis among individuals with type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Diabetologia [Internet]. 2020 [cited 2024 May 3]; 63(1):21–33. Available from: https://doi.org/10.1007/s00125-019-04985-9.

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Ayesha Bibi

Doctor of Pharmacy - Pharm-D, The University of Faisalabad, Pakistan

Ayesha is an undergraduate pharmacy student with strong management and leadership acumen having experience of industrial and hospital pharmacy through internship programs. She has presented at an international conference as a student speaker and also volunteered at a fundraising community.

She is a member of an online international society on telemedicine and aims to contribute to collaborative healthcare as a dedicated pharmacist after graduation.

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