Simple Steps to Prevent and Manage Type II Diabetes

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Concierge Medicine, Internal Medicine
Julie Kline headshot
Oral and Maxillofacial Surgery, Oncology at:
North Memorial Health – Robbinsdale Hospital
Oral and Maxillofacial Surgery, Head and Neck Surgery at:
North Memorial Health – Robbinsdale Hospital
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Internal Medicine, Hospital Medicine at:
North Memorial Health – Robbinsdale Hospital
Ahsan Bhatti headshot
Gastroenterology / Digestive Health at:
North Memorial Health – Robbinsdale Hospital
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Trauma, Acute Care, General Surgery and Bariatric Weight Loss Surgery at:
North Memorial Health – Maple Grove Hospital
North Memorial Health – Robbinsdale Hospital
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Mental Health - Outpatient
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Mental Health - Outpatient
Anshu Sharma headshot
Family Medicine, Obesity Medicine at:
North Memorial Health Clinic - Maple Grove
December 1, 2017
fit woman getting tying shoe laces and getting ready to run

The numbers are here, and it couldn’t be clearer: Americans have a blood-sugar problem. One in three people have either pre-diabetes or diabetes. That’s about 86 million people—and many more are unaware they even have it. “Basically, one in three people have pre-diabetes or diabetes—that’s pretty epidemic,” says Karen Palmer, registered dietitian at North Memorial Health.

So with the statistics exploding, it’s time to raise awareness and understanding—and make the changes necessary to keep Type II diabetes at bay.

“Wishing will not make it change. It’s a lifestyle change,” Palmer says.

Risk factors for Type II Diabetes

A variety of factors contribute to your risk of developing Type II diabetes, some of which you can control, and some are purely part of the genetic lottery. Still, being aware of these factors and/or managing them to the best of your ability will help reduce risk or stop it before it develops further and complications begin.

Risk factors to consider include:

  • Being overweight.
  • Aging: Your risk increases at ages 45 and older.
  • Having a family history of diabetes.
  • Developing gestational diabetes while pregnant.
  • Belonging to certain ethnic groups, who are at higher risk, including Native American, African American, Latino, or Asian groups.
  • Low physical activity levels. Sedentary lifestyles increase weight and other factors that contribute to Type II diabetes.
  • High blood pressure.
  • Low HDL cholesterol and high triglycerides.


Parsing Pre-diabetes

It used to be called “borderline,” but health care providers have shifted to calling it “pre-diabetes.” Palmer says the call is made when you have higher than normal blood sugar, but not quite high enough to cause the havoc in the body that can be classified as diabetic. That may mean you’re unaware it’s even happening. (Full-blown Type II diabetes symptoms include excessive thirst, urination, blurry vision, and fatigue, among other things.)

The good news is that it is possible to reverse pre-diabetes and lower blood sugar back down into the normal range. Even better, it also comes off your medical chart.

Weight Loss for Diabetes

The evidence is highly conclusive that losing weight matters. In 2001, the government launched the Diabetes Prevention Plan Trial and put thousands of people on a food plan to see if it made a difference.

“It was so conclusive they stopped the study early,” Palmer says. “If subjects lost weight, their blood sugar went down.” And it didn’t have to be 80 to 100 pounds, either. “If the subjects lost just 5 to 7 percent of their body weight, they decreased their risk of diabetes by 58 percent. That’s really significant.”

Even so, the prospect of losing weight can seem insurmountable. Palmer says it’s important to start small. “For every 2.2 pounds you lose, you decrease the risk of diabetes by 11 percent. A little bit of weight loss makes a big difference.”

Exercise for Diabetes

The Diabetes Prevention Plan Trial had another conclusion: Exercise made a difference, too. Why? Insulin works better when you are moving.

Time to clear off the treadmill that turned into a clothes hanger years back. “Build on success so you don’t feel overwhelmed,” Palmer says. “Start with just five minutes at a time and work your way up.”

The American Diabetes Association recommends 150 minutes of exercise per week. Cross-training is ideal, with 40 of those minutes used for strength training, divided into at least two days

That doesn’t mean you need a gym membership, though.

“Do something, as long as you like it and are moving,” Palmer advises. “People usually start with cardio more easily than strength training. But just get a couple of weights and during commercials, do some arm movements. Or get some resistance bands. Walk while talking on the phone. Park further from the store, avoid car dents and get exercise. Walk around the grocery store an extra couple of times. Use your Fitbit or pedometer to see if you can get to 10,000 steps a day, which is the gold standard.”

But remember, she says, “Just making progress is better than anything.”

Diet for Diabetes Prevention and Management

Look at carb intake to total caloric intake. All starches and sugars have to be accounted for, from milk to fruit to the granulated stuff. Eat a wide variety of foods to get all the necessary vitamins, minerals, fiber, and fat you need.

Don’t skip meals. So many of us get up in the morning and run out the door without breakfast. Then we eat a light lunch on the fly and eat from dinnertime until we hit the hay. But to avoid diabetes, and to manage it well, you have to make sure you don’t get overly hungry, and spread meals and snacks out over the day.

Delete sweetened drinks. If you’re drinking sugar-sweetened soda, lemonade, or other drinks, that needs to change. “You have to take them out of your diet,” Palmer says.

Look at fat intake. Fat is calorie dense. Many people cut back on carbs, but then substitute it with a ton of nuts, which are low-carb, but high calorie. Stick to recommended portion sizes or you may get frustrated with slow progress.



Beef up fiber intake. Taking in more undigestibles is key. “Fiber releases in your stomach slowly. Think of it this way, if you drink a half a cup of apple juice or eat an apple, which one will keep you full longer,” Palmer points out. “If you don’t have 20-35 grams of fiber a day, you will be hungry.” Whole grains and non-starchy vegetables, such as broccoli are a good place to turn.

Make changes you can live with. “It would be great if people lost their sweet tooth with their diagnoses, but that doesn’t happen,” Palmer says. “No food is off limits—you just have to cut back and make healthier substitutions where you can.” Sometimes making substitutions helps—switch brownies to graham crackers, choose granola bars with peanut butter and chocolate instead of cake. Buying individually portioned snacks can help keep you mindful of your intake.

“Fruit is great to satisfy your sweet tooth with fiber,” Palmer says. And if your tastes run to the savory—say you love pizza—eat salad with your pizza. Cut it in half and freeze half. Eat the salad first. Get full, but still enjoy your favorite food.

Stop Diabetes Step by Step

“People have to learn habit changes they can live with the rest of their lives,” Palmer acknowledges. “And that usually involves baby steps.

“No one is perfect,” Palmer continues. “Just try to make good choices and learn from that.”

Keep in mind the bigger picture: You could feel better, everyday. Palmer says people often confuse symptoms of diabetes with just being busy or getting older. “The fatigue comes because there is sugar in blood, but it doesn’t get into the cells. It’s like having a full tank of gas, but the gas doesn’t get into the engine—so the car’s not going anywhere.”

It can take up to 12 years from the start of diabetic conditions to a diagnosis, she adds. And the scarier complications—nerve damage, organ damage, amputation—can be slowed or stopped with proper blood-sugar control.

“Complications are preventable,” she says. Make sure you’re following good preventive care, watch your diet and exercise, and get some of your life and energy back.

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