Type 2 diabetes is the most common form of diabetes (there are many!) and is likely the one you are familiar with. This occurs when your body is no longer able to use the insulin it produces and, because of this, blood sugar builds up and cannot be used as energy. Insulin is the key that lets cells access the energy (sugar/glucose) from food so not being able to use it causes big issues.
Pre-diabetes is developing resistance to insulin and blood sugar begins to accumulate but is not yet high enough to be classified as type 2. It’s what develops into type 2 diabetes if not treated.
Gestational diabetes which occurs during pregnancy and typically resolves after birth. It can increase the risk for the mother to develop type 2 later in life.
Type 1 diabetes is an autoimmune disease where insulin is no longer produced at all. Type 1 is not reversible and is only treatable with insulin (shots or in a continual pump attached to the body).
Since 95% of diabetes cases are type 2 diabetes, this is what we will focus on.
Causes of Pre- and Type 2 Diabetes
Oftentimes, people think that type 2 diabetes is a guarantee if a family member has it. While there are risks associated with having family with type 2 diabetes, it’s more often that passed down family habits are to blame. We often eat, move, stress, and sleep like the adults who raised us. Unfortunately, some of those habits increase our risk of many chronic diseases including pre- and type 2 diabetes.
Lifestyle Habits Leading to Type 2 Diabetes Risk
A diet high in saturated fat
A diet high in simple carbohydrate
A diet low in fiber
Low to no purposeful movement/exercise throughout the day
High stress with poor coping techniques
Chronically poor sleep / rest
Substance use (excessive alcohol, smoking, drug use, etc.)
Little to no social connectivity or purposeful feelings around life
Turning off the Genes
Your genes may be primed for type 2 diabetes, but it’s not a guarantee that you will get it: lifestyle is the determiner of whether those primed risks are triggered. This switching on/off of our genes is called epigenetics and it’s related to many chronic diseases. The better care we take care of ourselves, the longer we keep that switch off. Even a little bit of effort can start to move the dial so taking steps right away can be helpful. It takes time to build a healthy lifestyle but it’s worth it: long-term, uncontrolled chronic disease will decrease the quality and length of life.
Nutrition
The Best Approach: Adopt a whole food, plant-based diet. You can find a guide on doing that here. Diets high in protein and fat from animals are associated with damaging metabolic health, higher death rates, and worsening A1C control (A1C is the measure of average blood sugar readings over 3 months). Studies show that even one high-fat meal causes inflammatory markers in our blood to double within 6 hours of eating so more plant foods (veggies, grains, fruits) and fewer animal and processed foods can make an immediate difference. Simple sugars are also on the radar as they can cause immediate spikes. Both matter.
The Next Best Approach: adopt a whole food diet with many plants. Reducing or avoiding processed foods will reduce your exposure to excessive saturated fats and simple sugars. Making sure there are plenty of plants will increase your fiber.
Add These Nutrients Daily
Fiber: aim for 25 grams of fiber daily until you can meet that consistently, then slowly work up to 40+ grams per day
Omega 3 Fatty Acids: get these from walnuts, flaxseed, chia seeds, plant oils, seaweed
Plant Sterols and Stanols: You can get small, beneficial amounts of these nutrients from nuts, whole grains like oats, barley, brown rice, etc., seeds, veggies and some fruits. If you have elevated cholesterol, you may benefit from a sterol/stanol supplement but do not jump to a supplement if your cholesterol is in range; there is no benefit.
Flaxseed: 2 TBSP daily. Choose ground flaxseed meal and sprinkle on oatmeal, in smoothies, or add to baked goods.
Limit These Foods
Dairy including cream, cheese, butter and milk
Coconut Oil and coconut vegan / plant-based products (creamer, yogurt, ice cream)
Hydrogenated vegan / plant-based butters
Mayonnaise
Eggs
Meat
Fried Foods
Junk Foods
Ultra-processed snack foods (see my guide here on processed foods)
Sugary foods
Fake Sugar / Sugar Substitutes
Sweetened milks, sodas, tea
Processed desserts
It can be tough to swap these things out all at once, but I encourage you to identify one that you use often and make a switch. Here are some examples:
Instead of | Choose This |
Dairy Creamer | Soy, Almond or Oat Creamer (unsweetened) |
Cheese | Creamy Hummus Guacamole DIY from nuts! Check out these recipes (SO GOOD) https://www.noracooks.com/easy-stretchy-vegan-mozzarella-cheese/ https://okonomikitchen.com/melty-vegan-mozzarella-cheese/ |
Eggs | Tofu Scramble Just Egg for transitioning (very processed) |
Butter | Olive Oil or Another Plant Oil |
Meat | Tempeh Seitan Mycoprotein (Quorn) Tofu Beans Lentils Post a comment if you want a suggestion for a specific recipe |
Traditional Desserts | |
Processed Snacks |
Movement / Exercise & Stress
First, start where you are. If you do 0 minutes of activity / exercise per week, then the goal is to add 60 minutes to the whole week. That could be four 15-minute sessions. Or three 20-minute sessions. Even six 10-minute sessions count! Seriously. It’s about building it into a habit. Exercise helps reduce blood sugar without insulin because muscle fibers can use the sugar as a fuel when it is in motion. Exercising can also increase sensitivity to insulin.
What you can do right away: pair low intensity movement after a large meal to help reduce its overall impact on your blood sugar.
If you already exercise, do an assessment of your routine:
Are you hitting at least 150 minutes per week?
Do you have two sessions that incorporate weights or body weight (like squats, push-ups, etc.)
Does it feel at least moderately challenging? Moderate is subjective – you should be sweating a bit; heart rate elevated; and can talk but not in long sentences.
The most important aspect of incorporating an exercise routine is to find something you enjoy and that you can maintain. If you hate the treadmill, try swimming. Not motivated to go to the gym without a friend? Try a group class and introduce yourself to the instructor and other people. Dancing, running, jumping, exercise videos, in a group, alone – it all counts.
Studies show that even just ten minutes of exercise improves mood and wellbeing. Imagine what 30 minutes can do! It’s also a wonderful stress reducer. Stress increases heart rate, sweat production, and flustered feelings – there’s a lot of chemical signaling going on that is priming it for movement! This ties back to our early evolution when fight or flight was a matter of survival. Nowadays, we lounge about when stressed rather than expending any energy which means that all those fight or flight chemicals go unused. This can cause a spike in blood sugar, as well. Doing a little bit of movement every day can be helpful for mental and physical health.
Sleep
Sleep recovers, heals, and rejuvenates our body and mind. Chronic poor sleep can lead to irritation, reduced productivity, poor focus, moodiness, food cravings, and other side effects. It's important to practice good sleep hygiene by following a simple checklist:
Sleeping space and bedding is relatively clean and calming
Room is a cool temperature
Room is very dark (light blocking mask or blackout curtains)
White noise or other calming noise playing
Blue light sources (phones, laptops, TVs) are turned off at least 60 minutes before sleep
Other helpful things for troubled sleep
Follow a routine to get ready for sleep
Meditation in bed
Reading a book (not a phone) in bed
Low doses of Melatonin
Magnesium Citrate Supplementation
Preventing type 2 diabetes is possible; it just takes some work and building up the support around you. I have worked directly with people who have successfully reversed their type 2 and pre-diabetes so it's not just a wish or something that others can do. You can do it. Lifestyle changes work but they work better when you go together. Bring your family, friends and kids along. If you need help making adjustments, enlist the help of a supportive lifestyle physician, dietitian and/or counselor.