This answer is yes: the vast majority of prediabetes and type 2 diabetes can be prevented through diet and lifestyle changes, and this has been proven by 20 years of medical research. Researchers from the DPP took people at risk for type 2 diabetes and gave them a week diet and lifestyle intervention, a medication metformin , or a placebo a fake pill , to see if anything could lower their risk for developing diabetes.

The very comprehensive diet and lifestyle intervention had the goal of changing participants' daily habits, and included: 16 classes teaching basic nutrition and behavioral strategies for weight loss and physical activity; lifestyle coaches with frequent contact with participants; supervised physical activity sessions; and good clinical support for reinforcing an individualized plan.

Perhaps not surprisingly, the diet and lifestyle intervention was incredibly effective. Men, women, and all racial and ethnic groups had similar results and almost half of participants represented racial and ethnic minorities.

You may think you learned enough in the first 6 months and can skip the second half of the program. Making lifestyle changes is an ongoing process. Staying in the program for the full year is essential to help you stick to new habits and avoid slipping back into old habits.

And if you have not reached your goals in the first half of the program, your lifestyle coach and other group members can help you succeed. These sessions will review key ideas such as tracking your food and physical activity, setting goals, staying motivated, and overcoming barriers.

The lifestyle coach and small group will continue to support you. You may learn some new information, too. Check out a list of all the topics covered in the program [PDFKB].

All CDC-recognized lifestyle change programs follow a CDC-approved curriculum and discuss the same topics over the year. The cost of participating in a CDC-recognized lifestyle change program varies, depending on location, organization offering it, and type of program in person or online.

To learn about the cost of a specific program, Find a Program that works for you and ask the organization offering it about the cost. It may even be free! In addition, some employers and insurance carriers cover the cost of these programs.

Check with your employer or insurance carrier to see if they cover the cost of attending one of these programs. You can choose either an in-person, online, distance learning, or combination lifestyle change program. Find a program location near you.

CDC-recognized lifestyle change in-person programs are offered in a variety of places throughout the community, including health care clinics, community-based organizations, and worksites.

Hands-on demonstrations will help with learning, and the coach will provide handouts with useful information and practice activities. They all follow a CDC-approved curriculum and are held to the same standards as in-person programs. However, although DSME and DSMS can also be provided via phone calls and telehealth, these remote versions may not always be reimbursed.

For many individuals with diabetes, the most challenging part of the treatment plan is determining what to eat and following a food plan.

There is not a one-size-fits-all eating pattern for individuals with diabetes. Nutrition therapy has an integral role in overall diabetes management, and each person with diabetes should be actively engaged in education, self-management, and treatment planning with his or her health care team, including the collaborative development of an individualized eating plan 36 , All individuals with diabetes should receive individualized medical nutrition therapy MNT , preferably provided by a registered dietitian who is knowledgeable and skilled in providing diabetes-specific MNT.

MNT delivered by a registered dietitian is associated with A1C decreases of 0. It is important that each member of the health care team be knowledgeable about nutrition therapy principles for people with all types of diabetes and be supportive of their implementation.

Emphasis should be on healthful eating patterns containing nutrient-dense, high-quality foods with less focus on specific nutrients. The Mediterranean 45 , Dietary Approaches to Stop Hypertension DASH 46 , 47 , and plant-based diets 48 are all examples of healthful eating patterns.

See Table 4. To promote and support healthful eating patterns, emphasizing a variety of nutrient-dense foods in appropriate portion sizes, in order to improve overall health and specifically to:. To address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful foods, willingness and ability to make behavioral changes, and barriers to change.

To provide an individual with diabetes the practical tools for developing healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods.

Body weight management is important for overweight and obese people with type 1 and type 2 diabetes. Lifestyle intervention programs should be intensive and have frequent follow-up to achieve significant reductions in excess body weight and improve clinical indicators. Sustaining weight loss can be challenging The diets used in intensive lifestyle management for weight loss may differ in the types of foods they restrict e.

high-carbohydrate foods , but their emphasis should be on nutrient-dense foods, such as whole grains, vegetables, fruits, legumes, low-fat dairy, lean meats, nuts, and seeds, as well as on achieving the desired energy deficit 55 — Studies examining the ideal amount of carbohydrate intake for people with diabetes are inconclusive, although monitoring carbohydrate intake and considering the blood glucose response to dietary carbohydrate are key for improving postprandial glucose control 59 , The literature concerning glycemic index and glycemic load in individuals with diabetes is complex, though in some studies lowering the glycemic load of consumed carbohydrates has demonstrated A1C reductions of —0.

A systematic review 61 found that whole-grain consumption was not associated with improvements in glycemic control in type 2 diabetes.

One study did find a potential benefit of whole-grain intake in reducing mortality and cardiovascular disease CVD among individuals with type 2 diabetes As for all Americans, individuals with diabetes should be encouraged to replace refined carbohydrates and added sugars with whole grains, legumes, vegetables, and fruits.

Individuals with type 1 or type 2 diabetes taking insulin at mealtimes should be offered intensive education on the need to couple insulin administration with carbohydrate intake. For people whose meal schedules or carbohydrate consumption is variable, regular counseling to help them understand the complex relationship between carbohydrate intake and insulin needs is important.

In addition, education regarding the carbohydrate-counting approach to meal planning can assist them with effectively modifying insulin dosing from meal to meal and improving glycemic control 39 , 59 , 65 — Individuals who consume meals containing more protein and fat than usual may also need to make mealtime insulin dose adjustments to compensate for delayed postprandial glycemic excursions 68 , For individuals on a fixed daily insulin schedule, meal planning should emphasize a relatively fixed carbohydrate consumption pattern with respect to both time and amount By contrast, a simpler diabetes meal planning approach emphasizing portion control and healthful food choices may be better suited for some elderly individuals, those with cognitive dysfunction, and those for whom there are concerns over health literacy and numeracy 37 — 39 , 41 , 59 , The modified plate method which uses measuring cups to assist with portion measurement may be an effective alternative to carbohydrate counting for some patients in improving glycemia There is no evidence that adjusting the daily level of protein ingestion typically 1—1.

Therefore, protein intake goals should be individualized based on current eating patterns. Reducing the amount of dietary protein below the recommended daily allowance is not recommended because it does not alter glycemic measures, cardiovascular risk measures, or the rate at which glomerular filtration rate declines 71 , In individuals with type 2 diabetes, ingested protein may enhance the insulin response to dietary carbohydrates Therefore, carbohydrate sources high in protein should not be used to treat or prevent hypoglycemia.

The ideal amount of dietary fat for individuals with diabetes is controversial. The type of fats consumed is more important than total amount of fat when looking at metabolic goals and CVD risk 64 , 75 — Multiple randomized controlled trials including patients with type 2 diabetes have reported that a Mediterranean-style eating pattern 75 , 79 — 82 , rich in monounsaturated fats, can improve both glycemic control and blood lipids.

However, supplements do not seem to have the same effects. A systematic review concluded that dietary supplements with ω-3 fatty acids did not improve glycemic control in individuals with type 2 diabetes Randomized controlled trials also do not support recommending ω-3 supplements for primary or secondary prevention of CVD 83 — People with diabetes should be advised to follow the guidelines for the general population for the recommended intakes of saturated fat, dietary cholesterol, and trans fat In general, trans fats should be avoided.

Lowering sodium intake i. However, other studies 89 , 90 have recommended caution for universal sodium restriction to 1, mg in people with diabetes.

Sodium intake recommendations should take into account palatability, availability, affordability, and the difficulty of achieving low-sodium recommendations in a nutritionally adequate diet There continues to be no clear evidence of benefit from herbal or nonherbal i.

Metformin is associated with vitamin B12 deficiency, with a recent report from the Diabetes Prevention Program Outcomes Study DPPOS suggesting that periodic testing of vitamin B12 levels should be considered in metformin-treated patients, particularly in those with anemia or peripheral neuropathy Routine supplementation with antioxidants, such as vitamins E and C and carotene, is not advised because of lack of evidence of efficacy and concern related to long-term safety.

In addition, there is insufficient evidence to support the routine use of herbals and micronutrients, such as cinnamon 93 and vitamin D 94 , to improve glycemic control in people with diabetes 37 , Moderate alcohol consumption does not have major detrimental effects on long-term blood glucose control in people with diabetes.

Risks associated with alcohol consumption include hypoglycemia particularly for those using insulin or insulin secretagogue therapies , weight gain, and hyperglycemia for those consuming excessive amounts 37 , For people who are accustomed to sugar-sweetened products, nonnutritive sweeteners have the potential to reduce overall calorie and carbohydrate intake and may be preferred to sugar when consumed in moderation.

All adults, and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior. B Prolonged sitting should be interrupted every 30 min for blood glucose benefits, particularly in adults with type 2 diabetes.

Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance.

Physical activity is a general term that includes all movement that increases energy use and is an important part of the diabetes management plan. Exercise is a more specific form of physical activity that is structured and designed to improve physical fitness.

Both physical activity and exercise are important. Exercise has been shown to improve blood glucose control, reduce cardiovascular risk factors, contribute to weight loss, and improve well-being. Physical activity is as important for those with type 1 diabetes as it is for the general population, but its specific role in the prevention of diabetes complications and the management of blood glucose is not as clear as it is for those with type 2 diabetes.

There are also considerable data for the health benefits e. of regular exercise for those with type 1 diabetes Higher levels of exercise intensity are associated with greater improvements in A1C and in fitness Other benefits include slowing the decline in mobility among overweight patients with diabetes All children, including children with diabetes or prediabetes, should be encouraged to engage in at least 60 min of physical activity each day.

Children should engage in at least 60 min of moderate-to-vigorous aerobic activity every day with muscle- and bone-strengthening activities at least 3 days per week In general, youth with type 1 diabetes benefit from being physically active, and an active lifestyle should be recommended to all.

The U. The guidelines suggest that adults over age 65 years and those with disabilities follow the adult guidelines if possible or, if not possible, be as physically active as they are able.

Recent evidence supports that all individuals, including those with diabetes, should be encouraged to reduce the amount of time spent being sedentary e.

Avoiding extended sedentary periods may help prevent type 2 diabetes for those at risk and may also aid in glycemic control for those with diabetes.

Clinical trials have provided strong evidence for the A1C-lowering value of resistance training in older adults with type 2 diabetes and for an additive benefit of combined aerobic and resistance exercise in adults with type 2 diabetes If not contraindicated, patients with type 2 diabetes should be encouraged to do at least two weekly sessions of resistance exercise exercise with free weights or weight machines , with each session consisting of at least one set group of consecutive repetitive exercise motions of five or more different resistance exercises involving the large muscle groups For type 1 diabetes, although exercise in general is associated with improvement in disease status, care needs to be taken in titrating exercise with respect to glycemic management.

Each individual with type 1 diabetes has a variable glycemic response to exercise. This variability should be taken into consideration when recommending the type and duration of exercise for a given individual Women with preexisting diabetes, particularly type 2 diabetes, and those at risk for or presenting with gestational diabetes mellitus should be advised to engage in regular moderate physical activity prior to and during their pregnancies as tolerated However, providers should perform a careful history, assess cardiovascular risk factors, and be aware of the atypical presentation of coronary artery disease in patients with diabetes.

Certainly, high-risk patients should be encouraged to start with short periods of low-intensity exercise and slowly increase the intensity and duration.

Providers should assess patients for conditions that might contraindicate certain types of exercise or predispose to injury, such as uncontrolled hypertension, untreated proliferative retinopathy, autonomic neuropathy, peripheral neuropathy, and a history of foot ulcers or Charcot foot.

Those with complications may require a more thorough evaluation Hypoglycemia is less common in patients with diabetes who are not treated with insulin or insulin secretagogues, and no routine preventive measures for hypoglycemia are usually advised in these cases.

In some patients, hypoglycemia after exercise may occur and last for several hours due to increased insulin sensitivity. Intense activities may actually raise blood glucose levels instead of lowering them, especially if pre-exercise glucose levels are elevated If proliferative diabetic retinopathy or severe nonproliferative diabetic retinopathy is present, then vigorous-intensity aerobic or resistance exercise may be contraindicated because of the risk of triggering vitreous hemorrhage or retinal detachment Consultation with an ophthalmologist prior to engaging in an intense exercise regimen may be appropriate.

Decreased pain sensation and a higher pain threshold in the extremities result in an increased risk of skin breakdown, infection, and Charcot joint destruction with some forms of exercise.

Therefore, a thorough assessment should be done to ensure that neuropathy does not alter kinesthetic or proprioceptive sensation during physical activity, particularly in those with more severe neuropathy.

Studies have shown that moderate-intensity walking may not lead to an increased risk of foot ulcers or reulceration in those with peripheral neuropathy who use proper footwear All individuals with peripheral neuropathy should wear proper footwear and examine their feet daily to detect lesions early.

Anyone with a foot injury or open sore should be restricted to non—weight-bearing activities. Autonomic neuropathy can increase the risk of exercise-induced injury or adverse events through decreased cardiac responsiveness to exercise, postural hypotension, impaired thermoregulation, impaired night vision due to impaired papillary reaction, and greater susceptibility to hypoglycemia Cardiovascular autonomic neuropathy is also an independent risk factor for cardiovascular death and silent myocardial ischemia Therefore, individuals with diabetic autonomic neuropathy should undergo cardiac investigation before beginning physical activity more intense than that to which they are accustomed.

Physical activity can acutely increase urinary albumin excretion. However, there is no evidence that vigorous-intensity exercise increases the rate of progression of diabetic kidney disease, and there appears to be no need for specific exercise restrictions for people with diabetic kidney disease Advise all patients not to use cigarettes and other tobacco products A or e-cigarettes.

Include smoking cessation counseling and other forms of treatment as a routine component of diabetes care. Results from epidemiological, case-control, and cohort studies provide convincing evidence to support the causal link between cigarette smoking and health risks Recent data show tobacco use is higher among adults with chronic conditions Other studies of individuals with diabetes consistently demonstrate that smokers and people exposed to secondhand smoke have a heightened risk of CVD, premature death, and microvascular complications.

Smoking may have a role in the development of type 2 diabetes One study in smokers with newly diagnosed type 2 diabetes found that smoking cessation was associated with amelioration of metabolic parameters and reduced blood pressure and albuminuria at 1 year The routine and thorough assessment of tobacco use is essential to prevent smoking or encourage cessation.

Numerous large randomized clinical trials have demonstrated the efficacy and cost-effectiveness of brief counseling in smoking cessation, including the use of telephone quit lines, in reducing tobacco use. For the patient motivated to quit, the addition of pharmacological therapy to counseling is more effective than either treatment alone.

Special considerations should include assessment of level of nicotine dependence, which is associated with difficulty in quitting and relapse Although some patients may gain weight in the period shortly after smoking cessation, recent research has demonstrated that this weight gain does not diminish the substantial CVD benefit realized from smoking cessation Nonsmokers should be advised not to use e-cigarettes.

There are no rigorous studies that have demonstrated that e-cigarettes are a healthier alternative to smoking or that e-cigarettes can facilitate smoking cessation. More extensive research of their short- and long-term effects is needed to determine their safety and their cardiopulmonary effects in comparison with smoking and standard approaches to smoking cessation — Psychosocial care should be integrated with a collaborative, patient-centered approach and provided to all people with diabetes, with the goals of optimizing health outcomes and health-related quality of life.

Psychosocial screening and follow-up may include, but are not limited to, attitudes about the illness, expectations for medical management and outcomes, affect or mood, general and diabetes-related quality of life, available resources financial, social, and emotional , and psychiatric history.

Providers should consider assessment for symptoms of diabetes distress, depression, anxiety, disordered eating, and cognitive capacities using patient-appropriate standardized and validated tools at the initial visit, at periodic intervals, and when there is a change in disease, treatment, or life circumstance.

Including caregivers and family members in this assessment is recommended.

Diabetes prevention impact toolkit shows employers how much can diabetes prevention programs can save. Breadcrumb Home Support for Your Health Journey Lifestyle Change Programs. It could cut your risk of developing type 2 diabetes in half. Find a Program.

You are not alone. Through year-long sessions and with the support of a group, lifestyle coaches trained to use a CDC-approved curriculum help you stay motivated to: Make small changes to the way you eat without giving up the foods you love Increase your physical activity levels to 30 minutes a few days a week Manage your stress The program follows a research-based curriculum that starts with weekly group meetings for the first six months, followed by upkeep sessions to keep you on track to meet your goals.

Hear from providers and participants Participants and health care professionals share their first-hand experience with the program. View Testimonials. Here are just a few ways small changes can make your life better: You will feel healthier and have a better quality of life You will learn how to deal with stress You will be able to stay independent, healthy and active as you age If you have children or grandchildren, you will be able to keep up with them.

Ready to get started? Lifestyle Change Program If you are high risk or find out you have prediabetes, find a CDC-recognized lifestyle change program near you.

Diabetes Education Program If you find out you have diabetes, find a diabetes education program. Employers: Prevention for Life Work Employers know the importance of maintaining a healthy workforce to not only reduce their staff related expenses, but also increase satisfaction and productivity.

Find a program in your area To find a program in your area, review the CDC registry. These should be a small part of your diet. You can limit saturated fats by eating low-fat dairy products and lean chicken and pork. Many fad diets — such as the glycemic index, paleo or keto diets — may help you lose weight.

There is little research, however, about the long-term benefits of these diets or their benefit in preventing diabetes. Your dietary goal should be to lose weight and then maintain a healthier weight moving forward.

Healthy dietary decisions, therefore, need to include a strategy that you can maintain as a lifelong habit. Making healthy decisions that reflect some of your own preferences for food and traditions may be beneficial for you over time. One simple strategy to help you make good food choices and eat appropriate portions sizes is to divide up your plate.

These three divisions on your plate promote healthy eating:. The American Diabetes Association recommends routine screening with diagnostic tests for type 2 diabetes for all adults age 45 or older and for the following groups:.

Share your concerns about diabetes prevention with your doctor. He or she will appreciate your efforts to prevent diabetes and may offer additional suggestions based on your medical history or other factors.

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Request Appointment. Diabetes prevention: 5 tips for taking control. Products and services. Diabetes prevention: 5 tips for taking control Changing your lifestyle could be a big step toward diabetes prevention — and it's never too late to start. By Mayo Clinic Staff.

Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Robertson RP.

Prevention of type 2 diabetes mellitus. Accessed April 12, American Diabetes Association. Prevention or delay of type 2 diabetes: Standards of Medical Care in Diabetes — Diabetes Care. Diabetes mellitus.

Merck Manual Professional Version. Accessed April 14, Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes — Your game plan to prevent type 2 diabetes. National Institute of Diabetes and Digestive and Kidney Diseases.

Accessed April 8, Melmed S, et al. Therapeutics of type 2 diabetes mellitus. Williams Textbook of Endocrinology. Elsevier; Interactive Nutrition Facts label: Dietary fiber.

Food and Drug Administration. Accessed April 16, Department of Health and Human Services and U. Department of Agriculture. Interactive Nutrition Facts label: Monounsaturated and polyunsaturated fats. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes — Products and Services Assortment of Health Products from Mayo Clinic Store A Book: The Essential Diabetes Book.

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