Sunday, 26 May 2019

Prevent and Treat Type 2 Diabetes –

Doctors used to think that if you received a diagnosis of type 2 diabetes, you’d have the condition for life. But now ­research shows that’s not the case.

“Many times, type 2 diabetes can be partially or completely reversed by getting down to a normal weight,” says Michael Hochman, M.D., M.P.H., an associate professor of clinical medicine at the Keck School of Medicine at the University of Southern California in Los Angeles and director of the USC Gehr Center for Health Systems Science.

A study published in 2017 in The Lancet, for instance, found that about half of people with type 2 diabetes who underwent an intensive weight-management program went into complete remission.

The same goes for prediabetes. “The majority of cases come from being overweight or obese, so simply losing weight can go a long way in preventing you from progressing to actual diabetes,” says David Lam, M.D., medical director of the Mount Sinai Clinical Diabetes Institute in New York City.

Case in point: People with prediabetes who lose around 7 percent of their body weight by consuming less fat and fewer calories and exercising for 150 minutes a week have a 58 percent lower risk of full-blown diabetes, according to the landmark Diabetes Prevention Program study.

Though it’s more difficult to reverse a diabetes diagnosis if you’ve had it for several years, lifestyle habits can be potent enough to allow you to cut back on medications, even if you can’t eliminate them entirely, Hochman says. Here, several takeaways:

Eat right. Following a Mediterranean diet—rich in healthy fats, whole grains, beans, nuts, and fruits and vegetables, and low in processed meats, sugars, and refined carbohydrates—can help prevent or even reverse type 2 diabetes, according to a 2016 Tufts University study published in the journal PLOS Medicine.

In another study, researchers at the Harvard T.H. Chan School of Public Health found that eating a healthy plant-based diet reduced the risk of devel­op­ing type 2 diabetes by 20 percent.

“The key is a diet rich in minimally processed plant foods and high levels of healthy fats found in foods like nuts, olive oil, and fatty fish like salmon,” says Dariush Mozaffarian, M.D., Dr.P.H., a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University in Boston.

Though a serving (3 to 4 ounces) of lean, unprocessed chicken or meat once or twice a week is fine, think of it “as a side and not as the core of your plate,” Mozaffarian says. Red meat is high in heme iron; eating too much is associated with an increased risk of type 2 diabetes.

Be wise about carbs. Carbohydrates—starches, sugars, and fiber—are the nutrients that have the biggest impact on blood glucose levels. But people with diabetes (or those at risk for it) don’t have to shun them.

Nor do you have to obsessively track the grams of carbohydrates in your diet, which some experts recommend for people with diabetes, especially if they use insulin. “It can be overwhelming, especially for older patients,” says David Lam, M.D., of the Mount Sinai Clinical Diabetes Institute.

In addition, certain carbs are rich in fiber, which helps your body metabolize blood glucose better, says Mozaffarian. Minimize your intake of refined carbs, such as white bread and white rice, and added sugars, but note that the following higher-carb foods can be part of a healthy diet for people with diabetes.

Beets, carrots, sweet potatoes, and winter squash are higher in sugars than green vegetables but are still considered relatively low-carb foods. Fruit is rich in nutrients and fiber, and studies show no link to type 2 diabetes. Stick to fresh or frozen fruit, or canned fruit in water. Juice can raise blood glucose levels.

Many studies show a strong link between whole grains (such as buckwheat, bulgur, oatmeal, and quinoa) and a lower type 2 diabetes risk. The majority of the grains you eat should be in whole form. When it comes to potatoes, a few servings a week may be okay, but frequent consumption could raise type 2 diabetes risk. Mashed or boiled are far less likely to do so than french fries.

Move as much as possible. Regular exercise—150 weekly minutes of moderate to vigorous activity, such as brisk walking—can help you manage type 2 diabetes.

Even if you aren’t overweight, exercise is important. A 2017 University of Florida study found that being sedentary is linked to higher blood glucose, even for those at a healthy weight.

“We think that sitting for prolonged periods of time affects glucose and fat metabolism, increasing risk for type 2 diabetes,” says Betul Hatipoglu, M.D., an endocrinologist at the Cleveland Clinic.

To break up sedentary time, the American Diabetes Association recommends at least 3 minutes of light activity, such as walking, leg extensions, or overhead arm stretches, every 30 minutes.

Get enough sleep and reduce stress. When you’re stressed, your body ramps up production of the hormone cortisol, which increases your body’s blood glucose levels, Hatipoglu says. The same thing happens when you get too little sleep.

What’s more, a study of almost 5,000 Japanese adults with type 2 diabetes, published in the journal Diabetes Care, found that those who got between 6½ and 7½ hours of sleep a night had slightly lower HbA1c levels—a measurement of average blood glucose levels over three months—than those whose levels were less than 5 or more than 8. ­

Another 2015 study published in Diabetes Care found that people who got ­between 7 and 8 hours of shut-eye a night had the lowest risk of developing type 2 diabetes.