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"Small Steps, Big Rewards": You Can Prevent Type 2 Diabetes

Joanne Gallivan, M.S., R.D., and Dr. Andrew Narva

Joanne Gallivan, M.S., R.D., and Dr. Andrew Narva share notes on treating diabetes and kidney disease.
Photo courtesy of Ernie Branson

The good news is, type 2 diabetes can be prevented or treated. By losing a modest amount of weight, getting 30 minutes of exercise five days a week, and making healthy food choices, people at risk for type 2 diabetes can delay or prevent its onset. Those are the basic facts of "Small Steps. Big Rewards: Prevent type 2 Diabetes," created by the National Diabetes Education Program (NDEP). This first-ever, national diabetes prevention campaign spreads this message of hope to the millions of Americans with pre-diabetes (higher than normal blood glucose levels but not yet diabetes).

"Fifty four million Americans are at risk for type 2 diabetes."

"Fifty four million Americans are at risk for type 2 diabetes," says Joanne Gallivan, M.S, R.D., NDEP director at the National Institute for Diabetes and Digestive and Kidney Disease (NIDDK). "There are steps you can take to prevent it. It boils down to following a healthy lifestyle— not making huge steps, but small steps that can lead to a big reward, such as eating smaller portions and taking the steps instead of the elevator."

The science behind NDEP's campaign is based on the Diabetes Prevention Program (DPP), a landmark study sponsored by the NIH. The study found that people at increased risk for type 2 diabetes can prevent or delay the onset of the disease by losing five to seven percent of their body weight through increased physical activity and a reduced fat, lower calorie diet. That's about a 10 pound weight loss if you weigh 200 pounds.

In the DPP, modest weight loss proved effective in preventing or delaying type 2 diabetes in all high-risk groups. "If you have diabetes in your family, you will want to bring this information to their attention," says Gallivan. "Healthy lifestyles are good for everyone."

Diabetes Medicines-Always Discuss with Your Doctor

If you have diabetes, how low should your blood sugar go?

Because of safety concerns, the National Heart, Lung, and Blood Institute (NHLBI) stopped one part of a large clinical trial in early February. The ACCORD study followed adults with type 2 diabetes and heart disease. In a surprise to researchers, it showed that intensively lowering blood sugar (glucose) below current recommendations increases the risk of death when compared with less-intensive standard treatments. For decades, scientists believed that lowering blood sugar to normal levels helps reduce the risk of dying from heart disease.

But experts were quick to say that diabetics should not change their current treatments.

"People with diabetes should never adjust their treatment plan or goals without consulting their health care providers," said Judith Franklin, M.D., director, Division of Diabetes, Endocrinology, and Metabolic Diseases at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). "The ACCORD [study] findings are important, but will not change therapy for most patients with type 2 diabetes. Few patients with high cardiovascular risk like those studied in ACCORD are treated to blood sugar levels as low as those tested in this study," she added.

Winter 2008 Issue: Volume 3 Number 1 Page 11