Are there any medications I can take to help prevent diabetes?

Yes, there are a number of medications that will help to reduce the likelihood of a person developing type 2 diabetes, but not type 1 diabetes. These are shown in Table 2. None are labeled by the Food and Drug Administration for this indication. Our use of them is mainly confined to choosing a drug that will tend to slow progression to type 2 diabetes when the drug is needed for another condition. For example, when a patient at risk for diabetes needs treatment for high blood pressure, one would consider using a drug that has been shown to slow progression to diabetes in those at high risk, as opposed to one that might actually accelerate it. Early use of drugs that are approved to treat type 2 diabetes in people at high risk of development of type 2 diabetes (mainly those with prediabetes — for definition see Question 9) has also been shown to prevent or delay the onset of the disease. Examples of this use are also shown in Table 2. Whether this represents prevention of diabetes or pretreatment of diabetes is not conclusively known. To be considered true prevention, the drug needs to modify the course and progression of the underlying factors leading to the disease and not merely lower the blood sugar. This means the rate at which those at risk progress to diabetes should be reduced in a sustained manner. It should be emphasized that one must be very cautious in advocating the use of oral antidiabetic drugs in this manner. The FDA and other authoritative bodies have not evaluated the ratio of risk to benefit sufficiently to recommend their use in prediabetes.

Table 2 Medications That May Help to Prevent Diabetes

Medication

Approved Use

Ramipril

Blood pressure

Losarían

Blood pressure

Carvedilol

Blood pressure

Metformin

Type 2 diabetes

Acarbose

Type 2 diabetes

Hydroxychoroquine

Rheumatoid arthritis, malaria

Vitamin D

Vitamin supplementation

Aspirin

Pain and inflammation

Is there a particular type of diet that will reduce my chance of type 2 diabetes?

The most important aspect of any diet to prevent type 2 diabetes is its calorie (i.e., energy) content. If calorie intake exceeds calorie usage, then the excess calories will, in the absence of other modifying factors, be directed toward the body's energy storage compartment, which is, of course, the fat tissue. Therefore, a diet that matches calorie consumption with output is the key to prevention of overweight and obesity and therefore diabetes. If one is already overweight, then the diet should provide fewer calories than are required, so that energy will be drawn from the body fat stores and gradual weight loss will occur. Even modest weight loss can be very beneficial. The benefits can be shown very early, almost as soon as calorie intake drops below that required to maintain body weight and before significant weight loss actually occurs. The consumption side of this balance is, of course, food intake. The output side that we can control is exercise. Neither can operate successfully to regulate weight independent of the other. Very calorie- dense foods, such as those with a high fat content (e.g., cheese, ice cream, fried foods, and processed meats) are common components of diets that lead to weight gain, obesity, and ultimately diabetes. Although sugar itself does not cause diabetes, foods with a high content of refined sugar, such as sodas and candies, are also more likely to be associated with weight gain and diabetes than those with natural sugars. Natural sugars tend to be associated with fiber, which delays and limits their absorption. Thus, portion for portion, more sugar is consumed in foods high in refined sugar. The question of whether a specific diet composition can prevent diabetes, independent of its actual energy content, is not entirely known. Studies have shown that diets high in grain and fiber tend to be associated with a lower frequency of diabetes in the population. This may be related to the more gradual breakdown and absorption of the components of the meal, especially the carbohydrates, as discussed previously.

The most important aspect of any diet to prevent type 2 diabetes is its calorie (i.e., energy) content.

Fiber

The structural part of plants and plant products that consists of carbohydrates that are wholly or partially indigestible.

Carbohydrates

Substances composed of long chains of oxygen, hydrogen, and carbon molecules. Carbohydrates in food (for example, sugar and starch) provide energy for the body and, if present in excess, are stored as fat.

Since, in all parts of the world, the explosive rise in diabetes is clearly linked to weight gain (with some population groups being more susceptible than others) rather than to a specific type of diet, the dietary focus should remain on eating a healthy diet that provides the recommended amounts of important nutrients, in quantities necessary to maintain a healthy weight (see Question 11) and prevent undesirable weight gain.

For more information, visit diabetes.org/ nutrition-and-recipes/nutrition/foodpyramid.jsp.

 
< Prev   CONTENTS   Next >