One of the best health strategies you can adopt is prevention.

In other words, to gain understanding and take action in making wise choices so as to help prevent an illness or disease before it happens. One example is Type 2 diabetes.

While your genetics are hardwired, there are steps you can take to reduce your risk for Type 2 diabetes.

The good news is that Type 2 diabetes is largely preventable. It is estimated that 90 percent of cases of Type 2 diabetes could be avoided by being aware of lifestyle risk factors and taking the necessary steps to modify them.

This includes keeping your weight under control, exercising more, eating a healthy diet, managing stress and not smoking.

Tragically, Type 2 diabetes is a growing epidemic in the United States. More than one-third of Americans have a blood glucose level above the normal range; and it is estimated about 6 million don’t know they have the disease. This disease, once called adult-onset diabetes, is now beginning to show up in teens and children.

The problems behind the numbers are even more alarming. It’s the seventh leading cause of death in the U.S., directly causing thousands of deaths each year while contributing to thousands more.

Diabetes is the leading cause of blindness and kidney failure among adults. It causes mild to severe nerve damage that, coupled with diabetes-related circulation problems, can lead to the loss of a leg or foot (amputation). It also significantly increases the risk of heart disease.

You may be familiar with the risk factors, including a lack of physical activity, being overweight, having high cholesterol and high blood pressure or having a family history of diabetes, heart disease or stroke.

Are you also aware that psychological factors may also play a role in the development of type 2 diabetes?

Living with depression may make the risk higher, and a new study just released suggests work-related stress may also increase the likelihood of developing the condition, at least for women. And overall, both mentally-tiring work and Type 2 diabetes are an increasingly prevalent phenomena.

What is diabetes?

A metabolic disorder where the body is unable to produce or appropriately respond to insulin. Metabolism is defined as chemical processes that occur in living organisms to maintain life.

Insulin is a hormone, produced by our pancreas. It functions as a key that allows sugar/glucose to enter our cells from the bloodstream and be broken down to provide energy.

It also signals our liver, muscle, and fat tissues to take up sugar and convert it to glycogen which can be broken down and utilized as fuel when glucose levels in the bloodstream drop. Thus, storing it for future use. As a result, insulin’s role is to keep our blood sugar levels normal — not too high, not too low.

Diabetics are unable to properly access glucose from the bloodstream. As a result, they experience elevated blood glucose levels. Over time, this can lead to a number of long-term complications.

What are the different types?

Although they have the same name, there are two very different types: Type 1 or insulin-dependent diabetes, and Type 2 or noninsulin dependent diabetes, which comprises the vast majority (90 percent) of all cases.

Type 1 diabetes: The pancreas does not produce insulin, likely from autoimmune destruction of insulin-producing cells. It is usually diagnosed in children and young adults.

Type 2 diabetes: Our cells do not properly respond to insulin — known as insulin resistance — or the pancreas cannot make enough insulin. It can result from genetics, as well as poor diet, physical inactivity and being overweight. When it comes to Type 2 diabetes — the most common form of diabetes — lifestyle changes not only can prevent, but in some cases, reverse it.

Gestational diabetes: A temporary form of diabetes that occurs during pregnancy because the mother cannot produce adequate amounts of insulin or her cells become insulin-resistant. It generally resolves after delivery but may mean an increased risk of developing diabetes down the road.

What is prediabetes?

There are an estimated 86 million adults with prediabetes, characterized by insulin resistance and elevated blood sugar levels.

Prediabetes is when blood sugar levels are elevated compared to normal, however they are not quite high enough to meet the criteria for a diabetes diagnosis.

People with prediabetes generally don’t have any symptoms. Thus, it is important to have regular checkups with a primary care physician and discuss risk factors. And, with early diagnosis, it can often be reversed. You may be able to return to a healthy blood sugar level and prevent the onset of Type 2 diabetes and the resultant ill-effects of high blood sugar levels.

Symptoms of diabetes: Insufficient fuel and elevated blood glucose levels can result in three major symptoms: polyphagia, polydipsia and polyuria. Polyphagia means increased hunger and appetite. When glucose cannot enter our cells and be utilized as fuel, alarms sound off that we are hungry and need to eat. Polydipsia is the term for increased thirst and fluid intake and is linked to our body’s attempt to excrete sugar in our blood via urine, resulting in polyuria, or frequent urination.

Complications: Chronically elevated blood sugars in our blood vessels causes inflammation and a myriad of molecular issues, that result in damage to them. This manifests in serious complications including: vision problems and blindness, stroke, heart disease, kidney disease and failure, limb amputations, and impaired wound healing and immune system function.

Unfortunately, they are more common than we may think. Diabetic retinopathy is the leading cause of blindness in American adults — affecting more than 4.1 million people. According to the Centers for Disease Control and Prevention (CDC), in 2014 there were 108,000 adults that required a lower-extremity amputation (toes, feet) and more than 52,000 whose diabetes caused them to develop kidney failure.

Lifestyle changes to make

Proven and effective steps include:

Maintain a healthy weight: According to the Harvard School of Public Health, increased weight is the single most important cause of Type 2 diabetes — elevating risk by seven times. Science shows excess fat promotes insulin resistance by our cells as well as signals our liver to inappropriately increase glucose production. The combination results in elevated blood sugars. The good news is when pre-diabetics or diabetics lose just 5 percent to 10 percent of their body weight, their blood sugar levels improve profoundly. In one study, pre-diabetics who did, lowered their risk of developing diabetes by 58 percent.

Physical activity: It is a major component of prevention as well as blood glucose level control. When we are active and moving, our cells become more sensitive to insulin and, too, are better able to remove glucose from the bloodstream using a mechanism totally separate from insulin. And although recommendations vary on how much physical activity is ideal, aiming for at least 30 minutes of moderate-intensity aerobic activity 5 or more days of the week is a great start.

Sedentary activities: Sitting at work, a classroom, browsing the internet, using social media or watching television can result in insulin resistance. Interrupt prolonged sitting time by standing up and stretching, swinging your arms, taking a short walk or going up a flight of stairs.

Increase fiber consumption: Research shows diabetics who consume 50 grams of fiber a day are able to control their blood sugars better than those who ate far less. Fiber can “soak” up sugar in the intestines preventing it from being absorbed and raising blood sugar levels. It is abundant in fruit, veggies, nuts, whole grains and legumes.

Quit or don’t start smoking: Nicotine, found in tobacco products and e-cigarettes, promotes insulin resistance. This can increase your risk of developing pre-diabetes or Type 2 diabetes, or making your diabetes worse.

Manage Stress: Chronic stress, depression and mental tiredness have been identified as risk factors for diabetes among women. Figure out where your stress is coming from and consider what you can control — and work on that. Excellent stress busters include yoga, relaxation time, talking with trusted friends, journaling, etc. Get the support you need.

See your doctor for regular check-ups. It is always a good idea to regularly check your blood glucose, blood pressure and blood cholesterol levels.

Type 2 diabetes is a serious and potentially deadly medical condition. The good news is that making lifestyle changes can be an effective foundation for diabetes prevention and managing the disease.

Dr. Nina Radcliff, of Galloway Township, is a physician anesthesiologist, television medical contributor and textbook author. Email questions for Dr. Nina to with “Dr. Nina” in the subject line. This article is for general information only and should not be used for the diagnosis or treatment of medical conditions and cannot substitute for the advice from your medical professional.

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