Managing Your Diabetes Risk

By now, most people know that diabetes is a significant and growing public health problem. Here are some of the major risk factors for this disorder, along with some tips you can put into play right now to reduce your risk of developing type 2 diabetes mellitus, the most common form of diabetes.

Treat the cause by controlling your weight. The most common and most treatable cause of type 2 diabetes, by far, is being overweight or obese. Losing weight is an effective way to reduce your risk of diabetes; but don't forget that you can get diabetes without being overweight.

Prevent or treat it with exercise. Exercise is the most important thing you can do to prevent or treat diabetes because it helps regulate blood sugar, even in people who remain overweight or obese. During exercise, you burn energy and reduce blood sugar levels. More importantly, however, regular exercise improves your body's ability to respond to insulin and to maintain normal glucose levels even between episodes of physical activity.

Watch your carbohydrate intake. Most people realize that sweets will quickly raise the blood sugar level. Don't forget that soft drinks (not just sodas, but fruit juices, sweetened tea, and lemonade as well) are all loaded with sugar. In addition, simple starches -- such as bread, rice, noodles (pasta), potatoes, cookies, crackers, and chips -- get converted to sugar rapidly as they are digested, and thus are a major cause of high blood-glucose levels. On the other hand, foods made up of complex fibers, like beans and whole grains, take longer to digest, and so don't affect blood sugar as much.

One way to tell which starches are usually (but not always) better for sugar control is to remember that white foods are typically higher in simple starch, while brown ones often have more fiber. Another simple rule is that starchy foods that can be swallowed after only 2-3 chews are generally higher in simple starch, while those requiring many more chews tend to be rich in fiber. You can also check the Nutrition Facts Panel on the labels of food packages. You'll find information on "Total Carbohydrate" and subsections on "Dietary Fiber" and "Sugar." Only the dietary fiber component of the total carbohydrates is the health-promoting complex fiber -- much of the rest is likely to raise your blood glucose level. 

Cut down on your alcohol intake. No matter whether you drink beer, wine, or hard liquor, the alcohol is quickly converted to sugar as it is digested. Cutting down on your alcohol intake can significantly reduce your blood glucose level.

Watch your calories. Simply consuming too many calories can also increase blood sugar levels. Note that words like "excess," "too much," and "too many" are subjective, depending as they do on your metabolism, your exercise level, and whether you have other risk factors for diabetes. If you've significantly reduced how much you eat and your glucose level is still too high, you are to be congratulated on making those difficult changes, but you should continue to look for other ways to cut down even further.

Know the risk from medications. Some medications can cause diabetes. Steroids are among the most common culprits, but there are several others, too. If you have high blood sugar, it's worth checking with your doctor to see if any of your medications might be contributing to the problem, and, if so, whether a different treatment can be substituted.

All of the risk factors above are modifiable. Unfortunately, other risk factors cannot be altered, but it is still important to know about them:

History of gestational diabetes. Some women develop diabetes or elevated blood sugar levels during pregnancy. This condition usually goes away after delivery, but if you had gestational diabetes, you are at increased risk for type 2 diabetes later in life.

Aging. As we grow older, blood sugar levels tend to rise.

Genetics. Family history is the best tool for assessing your genetic risk of developing diabetes. If just one of your first-degree relatives (parent or sibling) has type 2 diabetes, your risk of developing it is great -- approximately 50 percent (a 50-50 chance). With two or more affected parents or siblings, the risk is even higher (but usually not 100 percent). Currently, genetic testing to identify people at risk for diabetes is not ready for prime time, but with recent scientific advances, such testing might become important in the next few years.

Although you can't change your genes or avoid getting older, you do have the ability to modify your diet and activity level. If you have some of the risk factors listed here, and especially if your blood sugar level is already high, I strongly suggest that you try to exercise more and cut down on your total calorie intake, especially the calories coming from sugars, simple starches, and alcohol.