Prevention of type 2 diabetes
Prevention of type 2 diabetes can be achieved with both lifestyle changes and use of medication. The American Diabetes Association categorizes prediabetes as a high-risk group that has glycemic levels higher than normal but does not meet criteria for diabetes. Without intervention people with prediabetes progress to type 2 diabetes with a 5% to 10% rate. Diabetes prevention is achieved through weight loss and increased physical activity, which can reduce the risk of diabetes by 50% to 60%.
Many interventions to promote healthy lifestyles have been shown to prevent diabetes. A combination of diet and physical activity promotion through counselling and support programs decrease weight, improve systolic blood pressure, improve cholesterol levels and decrease risk of diabetes.
Increasing physical activity may be helpful in preventing type 2 diabetes, particularly if undertaken soon after a carbohydrate rich meal that increases blood sugar levels. The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least 2½ hours of exercise per week (several brisk sustained walks appear sufficient), having a modest fat intake (around 30% of energy supply should come from fat), and eating sufficient fiber (e.g., from whole grains).
Numerous clinical studies have shown that resistant starch increases insulin sensitivity independent of the glycemic response of the food  and may reduce the risk of type 2 diabetes. The U.S. Food and Drug Administration requires claims that resistant starch can reduce the risk of type 2 diabetes to be qualified with a declaration that scientific evidence in support of this claim is limited.
Study group participants whose "physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes".
Various sources suggest an influence of dietary fat types. Positive effects of unsaturated fats have been asserted on theoretical grounds and observed in animal feeding studies. Hydrogenated fats are universally considered harmful mainly because of well known effect on cardiovascular risk factors.
There are numerous studies which suggest connections between some aspects of type 2 diabetes with ingestion of certain foods or with some drugs. Breastfeeding may also be associated with the prevention of type 2 diabetes in mothers.
There is evidence relating consumption of coffee with prevention of type 2 diabetes. However, it is unclear if coffee causes any change in the risk of diabetes. This is true regardless of if it is caffeinated/decaffeinated; with/without sugar, or potboiled or not.
Some studies have shown delayed progression to diabetes in predisposed patients through prophylactic use of metformin, rosiglitazone, or valsartan. Lifestyle interventions are, however, more effective than metformin alone at preventing diabetes regardless of weight loss, though evidence suggests that lifestyle interventions and metformin together can be effective treatment in patients who are at a higher risk of developing diabetes.
Many other medications are well known to modify risk of diabetes 2 although in most cases they are prescribed for reasons unrelated to diabetes 2. In patients on hydroxychloroquine for rheumatoid arthritis, incidence of diabetes was reduced by 77% though causal mechanisms are unclear. Dopamine receptor agonists are also known to improve glycemic control, reduce insulin resistance and help controlling body weight.
- Li G (December 2008). "Lifestyle interventions reduced the long-term risk of diabetes in adults with impaired glucose tolerance". Evidence-Based Medicine. 13 (6): 173. doi:10.1136/ebm.13.6.173. PMID 19043031.
- Balk, Ethan M.; Earley, Amy; Raman, Gowri; Avendano, Esther A.; Pittas, Anastassios G.; Remington, Patrick L. (15 September 2015). "Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task Force". Annals of Internal Medicine. 163 (6): 437–51. doi:10.7326/M15-0452. ISSN 1539-3704. PMC 4692590. PMID 26167912.
- Lindström J, Ilanne-Parikka P, Peltonen M, et al. (11 November 2006). "Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study". The Lancet. 368 (9548): 1673–79. doi:10.1016/S0140-6736(06)69701-8. PMID 17098085.
- Knowler WC, Barrett-Connor E, Fowler SE, et al. (7 February 2002). "Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin". The New England Journal of Medicine. 346 (6): 393–403. doi:10.1056/NEJMoa012512. PMC 1370926. PMID 11832527.
- Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, Brown-Friday JO, Goldberg R, Venditti E, Nathan DM (14 November 2009). "10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study". Lancet. 374 (9702): 1677–86. doi:10.1016/S0140-6736(09)61457-4. PMC 3135022. PMID 19878986.
- Bindels, Laurie; Walter, Jens; Ramer-Tait, Amanda (November 2015). "Resistant starches for the management of metabolic diseases". Curr Opin Clin Nutr Metab Care. 18 (6): 559–65. doi:10.1097/mco.0000000000000223. PMC 4612508. PMID 26406392.
- Keenan, M.J.; Zhou, J.; Hegsted, M.; Pelkman, C.; Durham, H.A.; Coulon, D.B.; Martin, R.J. (March 2015). "Role of resistant starch in improving gut health, adiposity, and insulin resistance". Adv Nutr. 6 (2): 198–205. doi:10.3945/an.114.007419. PMC 4352178. PMID 25770258.
- Maki KC, Phillips AK (January 2015). "Dietary substitutions for refined carbohydrate that show promise for reducing risk of type 2 diabetes in men and women". J. Nutr. 145 (1): 159S–63S. doi:10.3945/jn.114.195149. PMID 25527674.
- Balentine, Douglas (13 December 2016). "Letter announcing decision for a health claim for high-amylose maize starch (containing type-2 resistant starch) and reduced risk of type 2 diabetes mellitus (Docket Number FDA-2015-Q-2352)". www.regulations.gov. U.S. Food and Drug Administration. Retrieved 16 December 2016.
- American Diabetes Association, Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, Hoogwerf BJ, Lichtenstein AH, Mayer-Davis E, Mooradian AD, Wheeler ML (January 2008). "Nutrition Recommendations and Interventions for Diabetes: A position statement of the American Diabetes Association". Diabetes Care. 31: S61–78. doi:10.2337/dc08-S061. PMID 18165339.
- Bantle JP, Wylie-Rosett J, Albright AL, et al. (September 2006). "Nutrition recommendations and interventions for diabetes – 2006: a position statement of the American Diabetes Association". Diabetes Care. 29 (9): 2140–57. doi:10.2337/dc06-9914. PMID 16936169.
- Mozaffarian D, Kamineni A, Carnethon M, Djoussé L, Mukamal KJ, Siscovic D (April 2009). "Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study". Archives of Internal Medicine. 169 (8): 798–807. doi:10.1001/archinternmed.2009.21. PMC 2828342. PMID 19398692.
- Risérus U, Willett WC, Hu FB (January 2009). "Dietary fats and prevention of type 2 diabetes". Progress in Lipid Research. 48 (1): 44–51. doi:10.1016/j.plipres.2008.10.002. PMC 2654180. PMID 19032965.
- Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB (23 November 2005). "Duration of lactation and incidence of type 2 diabetes". JAMA. 294 (20): 2601–10. doi:10.1001/jama.294.20.2601. PMID 16304074.
- Muley, A; Muley, P; Shah, M (May 2012). "Coffee to reduce risk of type 2 diabetes?: a systematic review". Current Diabetes Reviews. 8 (3): 162–68. doi:10.2174/157339912800564016. PMID 22497654.
- Sussman, J. B.; Kent, D. M.; Nelson, J. P.; Hayward, R. A. (19 February 2015). "Improving diabetes prevention with benefit based tailored treatment: risk based reanalysis of Diabetes Prevention Program". BMJ. 350 (feb19 2): h454–h454. doi:10.1136/bmj.h454. ISSN 1756-1833. PMC 4353279. PMID 25697494.
- Gerstein HC, Yusuf S, Bosch J, et al. (23 September 2006). "Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial". Lancet. 368 (9541): 1096–105. doi:10.1016/S0140-6736(06)69420-8. PMID 16997664.
- Kjeldsen SE, Julius S, Mancia G, et al. (July 2006). "Effects of valsartan compared to amlodipine on preventing type 2 diabetes in high-risk hypertensive patients: the VALUE trial". Journal of Hypertension. 24 (7): 1405–12. doi:10.1097/01.hjh.0000234122.55895.5b. PMID 16794491.
- Knowler WC, Fowler SE, Hamman RF, et al. (14 November 2009). "10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study". Lancet. 374 (9702): 1677–86. doi:10.1016/S0140-6736(09)61457-4. PMC 3135022. PMID 19878986.
- Wasko MC, Hubert HB, Lingala VB, et al. (11 July 2007). "Hydroxychloroquine and risk of diabetes in patients with rheumatoid arthritis". JAMA. 298 (2): 187–93. doi:10.1001/jama.298.2.187. PMID 17622600.
- "Medscape Log In". www.medscape.com. Retrieved 30 January 2018.