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Diabetes Lifestyle Changes

The Most Powerful Tools Against Type 2 Diabetes

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Updated January 28, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

We hear a lot about diabetes lifestyle changes. But what exactly does that mean and how much of a difference can it make? Why is it better to try to make lifestyle changes first rather than just take medications? Can improving your health be made easier? The answers might surprise you.

We'll uncover a lesser-known diabetes condition that may be undermining weight loss attempts - hyperinsulinemia. Learn how to deal with this condition and use the knowledge to make it easier to transform your life with positive changes to achieve a better quality life.

What Does "Diabetes Lifestyle Changes" Mean?

  • Type 2 Diabetes: A form of diabetes mellitus that occurs most often in older overweight individuals and features hyperglycemia (high blood sugar levels) and insulin resistance.

  • Lifestyle: The way of life of a person or group.

  • Change: To undergo transformation.

In other words, change means to undergo transformation in your lifestyle to minimize hyperglycemia and insulin resistance – and hyperinsulinemia.

The Lesser-Known Diabetes Condition: Hyperinsulinemia

Most people know about the problem of high blood sugar levels with diabetes and how syrupy blood thickened with microscopic sugar crystals do damage to your body. However, people with type 2 diabetes usually have hyperinsulinemia (high levels of insulin) as well.

Insulin is like a janitor that takes trash (sugar) to the incinerator (cells) to be burned (for energy). In people with diabetes the cells are resistant. The sugary trash builds up and more janitorial insulin is produced in an attempt to clean up the mess.

Insulin has other functions besides helping sugar get into cells. High levels of insulin can make weight loss, blood sugar control and attaining optimal levels of blood fats more challenging. Increased insulin levels can also cause weight gain and increase risk for stroke and heart disease.

Using lifestyle changes to lower insulin levels may help you experience less fatigue, carbohydrate and sugar cravings, among many other benefits.

Learn More About Hyperinsulinemia

Learn How Hyperinsulinemia can be Mistaken for Low Motivation

Why Shouldn't I Just Use Medications?

Diabetes medications help lower blood sugar levels. Ironically, some diabetes medications lower blood sugar levels but also increase insulin levels. At least one diabetes drug (metformin) helps both high blood sugars and insulin resistance. There has been a surge in research lately into how to treat hyperinsulinemia. However, lifestyle changes have been found to be more powerful than medications with many more health benefits, and they can eliminate or reduce the need for medications and possible side effects.

Knowledge Is Power

It is helpful for me to think about my levels of insulin as well as blood sugar. I visualize the basic progression of events in my body and the consequences. I eat carbohydrates, my blood sugar levels go up and a lot of ineffective insulin is released. High levels of insulin can cause fatigue and extreme hunger. My body craves carbohydrates and my urges for sugar increase. They can be strongest right after meals. My body switches get set to become a fat-producing and fat-retaining machine.

To lessen this, I try to eat smaller amounts of high-fiber, low-glycemic carbs throughout the day to avoid big spikes in both levels. I use exercise to bring the levels down.

Proven and Effective Diabetes Lifestyle Changes

Work with your healthcare team to have a diet, exercise and weight-loss plan tailored to your needs. There is no magic diet. The key to success is adherence. The information below includes what has been found to be effective, and they are generally accepted guidelines.

Diet: Insulin sensitivity can improve just a few days after starting a diet with lower calories. Studies have shown that the Mediterranean diet has worked well for people with diabetes. Try to eat whole fresh foods that are low on the glycemic index and are high fiber. Good choices are vegetables, beans, fruit, and whole grains. Eat plenty of vegetables, especially green vegetables. Try to get an assortment of colors in your fruits and vegetables to help fill all your nutritional bases and minimize cravings due to nutritional deficiencies. Eat small frequent meals throughout the day.

  • Carbs: Aim for a moderately low-carb diet (45%-65% of total calories). How many carbs are good for you? Work with your doctor or dietician. Listen to your body. If you experience carb cravings after a meal or snack, it might be worth your effort to try fewer carbs next time.

  • Fats: Avoid bad saturated fats and aim for moderate amounts of healthy monounsaturated fats and omega-3 fats (25%-35% of daily calories). Good monounsaturated choices are olive oil, avocados and nuts. Examples of omega-3 fats are fish and walnuts. Limit saturated fat to less than 7% of daily calories and trans-fats to less than 1%.

  • Protein: Opt to get protein (12%-20% of daily calories) from legumes, fish, and chicken. Make sure and talk to your doctor about how much protein you can consume. Some conditions, such as kidney disease, may put limitations on how much protein you can have.

Exercise: Exercise helps make cells more receptive to insulin. Every year the Diabetes Hands Foundation hosts an Internet event in November called The Big Blue Test. The event leads up to a World Diabetes Day where you are asked to test your blood sugar, exercise, test again and share your results. The results posted on the site are an amazing testament to the power of exercise.

Exercise delivers a triple whammy to diabetes: lowering blood sugar levels, lowering insulin levels and increasing insulin sensitivity. Overall health is improved. Even a person with a less-than-ideal body mass index (BMI) who is fit improves their quality of life and lessens the chances of diabetes-related death.

Try to get at least 30 minutes of moderate-intensity cardiovascular exercise most days of the week. Every day is better. Cardiovascular exercise lowers risk for heart disease. If you have not exercised in a while, start slowly. For optimal results include resistance and flexibility exercises. Make sure to get your doctor's approval and guidance before starting an exercise regimen. Hard exercise is not recommended if you have uncontrolled diabetes.

  • To reduce health risk: To improve blood sugar levels, maintain weight and reduce risk for heart disease, get 150 minutes per week of moderate cardiovascular exercise. Exercise at least three days a week with no more than two days in between.

  • Even better: For increased risk reduction for heart disease, get at least four hours a week of moderate-to-vigorous cardiovascular exercise or resistance exercises or both.

  • To lose weight or for maintenance: For major weight loss or long-term maintenance, get at least seven hours a week of moderate-to-vigorous cardiovascular exercise.

Weight loss: Even a small amount of weight loss can help improve insulin sensitivity. The invaluable benefits are improved fitness and reduction in overall mortality. The ultimate goal is to try to achieve a healthy BMI. However, weight loss may be more difficult for people who already have type 2 diabetes, so focus on realistic goals and the priceless rewards of improved fitness and a better quality of life.

Lower stress. Did you know chronic stress can raise your blood sugar levels, which also raise your insulin levels? Try to remove sources of stress or lean how to deal with them. Learn more about stress relievers that may work for you.

Two More Tips

  • Get more sleep, limit alcohol to moderate amounts and stop smoking.

  • Regularly check your blood sugar levels and keep records of your levels, diet, and exercise.



Sources:

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Li MD PHD, Chaoyang; Ford MD MPH, Earl; Zhao MD PHD, Guixiang; Mokdad PHD, Ali H. Prevalence of Pre-Diabetes and Its Association with Clutering of Cardiometabolic Risk Factors and Hyperinsulinemia Among U.S. Adolescents. Diabetes Care Feb 2008 3(2):342-347

Insulin Resistance Syndrome. American Family Physician. Accessed: January 12, 2010 http://www.aafp.org/afp/2001/0315/p1159.html

Karimzadeh, Mohammad Ali; Javedani, Mojgan. An Assessment of Lifestyle Modification Versus Medical Treatment with Clomiphene Citrate, Metformin, and Clomiphene Citrate-Metformin in Patients with Polycystic Ovarian Syndrome. Fertility and Sterility Jun 2008 94(1):216-220.

Sigal MD MPH, Ronald; Kenny PHD, Glen; Wasserman PHD, David H; Castaneda-Sceppa MD PHD; White MD, Russell. Physical Activity/Exercise and Type 2 Diabetes. Diabetes Care June 2006 29(6):1433-1438

Shai RD, Iris; et. al. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. N Engl J Med 17 July 2008 359:229-241

Shanik MD, Michael H; Xu MD, Yuping; Skrha MD DSC, Jan; Dankner MD MPH, Rachel; Zick PHD, Yehiel; Roth MD, Jesse. Insulin Resistance and Hyperinsulinemia. Diabetes Care Feb 2008 31(2):5262-5268.

Solomon, Thomas PJ; Haus, Jacob M; Kelly, Karen R; Cook, Marc D; Filion, Julianne; Rocco, Michael; Kashyap, Sangeeta R; Watanabe, Richard M; Barkoukis, Hope; Kirwan, John P. A Low-Glycemic Diet Combined with Exercise Reduces Insulin Resistance, Postprandial Hyperinsulinemia, and Glucose-Dependent Insulintropic Polypeptide Responses in Obese, Prediabetic Humans. Am J Clin Nutr Dec 2010 92(6)/1359-1368.

Willett, WC. The Mediterranean Diet: Science and Practice. Public Health Nutr Feb 2006 9(1A):105-10

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