December 01, 2009
By Edward C. Geehr, M.D., LifeScript Chief Medical Officer
Jumping on your bike or going for a jog can do more than just burn calories and boost energy levels. And cutting back on fast food and saying "Yes!" to coffee is more than just a dietary choice. This strange mix of variables can also help you fend off the most common form of diabetes...
Walking has been shown to be effective in preventing the onset of diabetes in middle-aged women. In an article published in the Journal of the American Medical Association, the rate that diabetes normally develops at was cut in half in those who walk regularly. Even when taking into account the differences in body mass index, walking still reduced the incidence of diabetes. And the more often women walked and the more vigorous their pace, the greater the benefit.
While exercise alone has been shown to be effective for delaying the development of diabetes in middle-aged women, the combination of modest weight loss and exercise has been shown to be the most effective strategy for all groups.
The Diabetes Prevention Program (DPP), a 27-center clinical trial, examined the effect of lifestyle changes compared with glucose-lowering drugs. Diet and exercise were nearly twice as effective as drug therapy. Those who exercised just 30 minutes per day five times per week and lost an average of 7% of their body weight reduced their risk of developing diabetes by 58%. Those taking metformin, a glucose-lowering drug, reduced their risk by 31%.
In the DPP, taking the drug metformin cut risk by 31%. Two other studies, each using a different class of glucose-lowering agent -- troglitazone (not available in the U.S.) and acarbose -- also showed reductions in the rate of diabetes. Even after patients stopped taking troglitazone for several months, the preventive effects continued, suggesting the drug may help avoid, not just delay, diabetes.
A more recent study, DREAM (diabetes reduction assessment with ramipril and rosiglitazone medication), found that rosiglitazone (Avandia) appeared to cut the risk of developing diabetes or -- or dying of it -- by more than half. In many participants, the drug also helped the body return to normal blood-sugar function. In 2006, however, the FDA required Avandia to include a label warning about the possibility of an increased risk of heart attacks and heart-related chest pain, particularly in patients with pre-existing heart disease.
Several studies have shown that drinking coffee helps lower the chance of developing type 2 diabetes. In fact, both current and former coffee drinkers who did not have diabetes had a 60% lower chance of getting type 2 diabetes. One of the studies found that both caffeinated and decaffeinated coffee lowered the risk, which suggests that it may be an ingredient other than caffeine that is doing the trick.
Researchers at Brigham and Women's Hospital in Boston found that a combined daily intake of more than 1,200 milligrams of calcium and 800 units of vitamin D was linked with a one-third lower risk for developing type 2 diabetes. Further studies are needed to confirm the finding, but the supplements are nonetheless worth taking: They may also ward off osteoporosis.
To avoid becoming one of the growing number of Americans who have type 2 diabetes, lose a modest amount of weight, exercise 30 minutes per day, take supplemental calcium and vitamin D (unless your doctor advises against it), and drink coffee. Also, ask your doctor about glucose-lowering medications.
For more from Dr. Geehr on how to prevent diabetes: LifeScript
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