According to Diabetes UK, 4.4m people live with diabetes in the UK. The true figure is likely even higher as the organisation predicts 1.2m more could have undiagnosed Type 2 diabetes but don't know it.
The World Health Organisation explains that the condition is a chronic metabolic disease that means sufferers have high levels of blood sugar or blood glucose. Over time and if left unmanaged, it can cause serious issues to essential organs like the heart, eyes, nerves and kidneys.
There are two types of diabetes: the first is 1, a rare type with about 8 per cent of sufferers having this condition. Type 2 is the most common version of diabetes (90 per cent have this kind) and can be reversible for a small percentage through exercise and making healthier diet choices.
Most of us know the healthier food choices we should be making but busy lifestyles mean that we’re often reaching for something quick and convenient. If you’re managing diabetes, this can be a reckless gamble with your health, so it warrants extra consideration.
Award-winning author and chef Theo Michaels is working with SmarterNaturally, a UK company that has created a unique super-strain of broccoli (called ‘GRextra’) with patented health-boosting properties. In turn, this has been made into a 'SuperSoup' (a portion of which is the same as eating 1kg of raw broccoli) aimed at supporting diabetic diets, as well as those with high cholesterol.
We spoke to him about making the best diabetes-friendly snack options.
What should diabetics think about when choosing a snack?
Snacks high in fibre and protein are great for making you feel full for longer which helps to avoid over-eating.
Diabetic-friendly products are always worth looking out for such as Smarter Naturally soup which is specifically designed for diabetics. Equally, avoid snacks that are high in simple carbohydrates and sugar; these will spike your blood sugar and inevitably lead to a sugar crash, then a craving for more sugar – a vicious cycle to avoid.
Are snack options the same for Type 1 and Type 2?
Whether you are Type 1 or Type 2 the considerations for snacks tend to be the same; for Type 1 the caveat is having a sugary snack or sweet tucked away in case blood sugar levels drop dramatically.
But in general, aim for snacks that are dense in useful nutrients such as vitamins, minerals, proteins, and healthy fats. Avoid anything sugary.
What's off-limits?
Even with diabetes, you can still enjoy sweet things – but be sensible. My dad, who has Type 2, still enjoys his desserts but is conscious of watching his sugar levels and will eat less carbs at dinner if he knows there is a pudding he likes later! Rather than eating a whole slice of dessert, he’ll just have a slither.
To play it safe, avoid sugary sweets or anything highly processed (sweet or savoury) as they can be very high in sugar and saturated fats. Ice creams can vary a lot so pay attention to the ingredients list first; avoiding any that are very high in sugar.
Equally crisps with simple carbohydrates can spike blood sugar levels. Salted popcorn is a great alternative.
Can diabetics snack on chocolate?
Yes! Good quality dark chocolate is delicious, rich and only takes a few small bites to leave your sweet tooth satisfied. It usually has lower sugar content and comes packed with antioxidants.
Milk chocolate on the other hand has a much higher sugar content and should be avoided. There is an argument that white chocolate shouldn’t be classified as chocolate altogether and is very high in sugar.
What's an easy homemade snack idea for diabetics?
I’d be outed by the Greek community if I didn’t mention Greek yoghurt (low in sugar, great for gut health) topped with nuts or seeds and a small drizzle of honey or blend a few berries together for a homemade fruity sauce.
Power balls are great and incredibly versatile; a simple process of mixing peanut butter, a little honey, rolled oats, nuts, seeds and rolled into balls and stored in the fridge. The combinations are endless; dried fruits, dark chocolate shavings, dates, and more.
Smarter Naturally soup is also versatile. By adding a variety of toppings or checking out their delicious range of meals made using the soup.
Finally, good old-fashioned boiled eggs; packed with protein, healthy fats and incredibly easy!
Is it better to choose sweet or savoury snacks?
You can get diabetic-friendly sweet snacks but in general, I lean towards savoury being a safer bet. Read the ingredients list as things will vary in sugar, fat and other content.
What shop-bought snacks are best for those with diabetes?
Snack bars can be a great choice – just check they are low in sugar, contain lots of fibre and if possible, include protein. Talking of snack bars, SmarterNaturally is about to launch super-broccoli bars which are specifically designed as diabetic friendly and contain ingredients which actively work to lower blood sugar levels and support diabetic health.
Feeling overwhelmed after receiving a type 2 diabetes diagnosis is quite common, but it's also important to keep in mind that, with the correct care, the illness is completely manageable. Even though the path ahead may need adjustments to your daily schedule, a healthier and more balanced lifestyle in the future is certain. For those who are unaware, type 2 diabetes is a chronic illness in which the body either produces insufficient amounts of insulin or grows resistant to it–which results in elevated blood sugar.
In an exclusive interaction with the editorial team of Onlymyhealth, Dr Shrey Kumar Srivastav, Senior Consultant and Physician at Sharda Hospital, Noida, sheds light on six things to keep in mind if you were recently diagnosed with Type-2 diabetes.
1. Learn About The Disease
Understanding type 2 diabetes is your first step toward effective management. Consult reliable resources, such as your healthcare provider, diabetes educators, and trusted medical websites, to familiarise yourself with the basics. The next up would be to understand your body and how it reacts to this disease.
2. Consume A Balanced Diet
Eating habits would also be used to manage your diabetes. Dr Srivastav suggested to eat whole food-based diets that will consist of fruits, vegetables, lean proteins, whole grains, and healthy fats. If you observe the portion control and count carbohydrates, it will help in blood sugar stabilisation. Make sure to consult a dietician for advice on personalised meal planning so that you consume a well-balanced diet.
3. Be Active
Regular physical activity is the hallmark of diabetes control. Exercise would help your body use insulin well, reduce high blood sugar, and maintain weight. "Aim for at least 150 minutes of moderate-intensity activity each week, such as walking, swimming, or cycling," Dr Srivastav highlighted. In case you're not an active person, and you never made time for some form of exercise before, that's okay, begin with baby steps and incorporate your level and preferences into what you do for your fitness.
4. Manage Your Blood Glucose
Make checking your blood sugar a habit. It will help track how your body responds to all these different foods, activities, and medications, providing valuable information for the management of the condition.
5. Maintain Mental Well-Being
Type-2 diabetes or any chronic disease has an impact on one's emotional psyche. Anxiety, frustration, or sadness are common responses to living with this diagnosis. These emotions have to be confronted by a therapist or counsellor specialising in chronic illness. Other mindfulness practices that you can involve yourself in are meditation and deep breathing, according to experts that reduce stress and improve one's outlook on life.
6. Prevention For Type-2 Diabetes
A studyclaims that type 2 diabetes may lead to various complications such as heart disease, nerve damage, and other problems with the kidney. However, it can be reduced if one takes proper precautions. Dr Srivastav mentioned that it is always good to have healthy blood pressure, cholesterol levels, and weight. Besides that, regular screening and preventive care will capture most of the problems before it's too late and keep a person at an optimum health level.
Bottom line
Remember that a diagnosis of type 2 diabetes doesn't mark the end at the finish line, but rather is a starting point on the way to a more healthy and thoughtful lifestyle. When you make sure that you have the right tools, support, and attitude in place, you can take charge of your health once again and really live well.
Learn about fear of hypoglycaemia in people with diabetes and what you can do to help.
Fear of hypoglycaemia is common in people with diabetes. Linda Gonder-Frederick, PhD, associate professor of psychiatry and neurobehavioral sciences at the University of Virginia School of Medicine, discusses how fear of hypoglycaemia can affect people with diabetes as well as their caregivers and what health care professionals can do to support these patients.
Q: What is fear of hypoglycaemia?
A: Fear of hypoglycaemia is the anxiety that people with diabetes and their loved ones can experience about low blood glucose levels, also called hypoglycaemia.
Hypoglycaemia can vary in severity. Typically, a blood glucose level below 70 milligrams per decilitre (mg/dL) is considered hypoglycaemia. A blood glucose reading at that level is a signal to the person with diabetes that they may need to consume some sort of fast-acting carbohydrate, such as fruit juice or something similar, to bring blood glucose levels back up. An episode like this would be considered a mild episode of hypoglycaemia.
However, when blood glucose levels drop below 54 mg/dL, people may begin to experience short- and long-term negative effects, such as mental confusion and an increased risk of developing heart problems. Some people also develop hypoglycaemia unawareness, also called impaired awareness of hypoglycaemia, which is when they are no longer able to feel the symptoms of low blood glucose levels. How often and how severely people experience hypoglycaemia varies greatly from person to person.
Hypoglycaemic episodes are physically unpleasant for most people. People can experience waves of nausea, dizziness, and trembling. These episodes can be scary, too. For example, imagine if someone is driving or caring for a young child, and then suddenly, they can’t think clearly or move their body well. Hypoglycaemia can even become so severe that people are no longer able to give themselves treatment. People can be afraid of experiencing these episodes, especially if they’ve had a severe episode before. Caregivers of someone with diabetes can also be afraid that the person they’re caring for may experience severe episodes of hypoglycaemia.
Q: Is fear of hypoglycaemia common in people with diabetes? How can fear of hypoglycaemia affect caregivers or family members?
A: Fear of hypoglycaemia is common. A healthy level of fear—also called adaptive fear—about hypoglycaemia is necessary. People with adaptive fear are aware that hypoglycaemia could happen, how damaging it can be, and how to treat it if it happens. However, the level of fear can be unhealthy if it grows to a point that provokes extreme anxiety.
Caregivers may have an even greater fear of hypoglycaemia than the person with diabetes. This is especially true for parents and other caregivers of children who have diabetes. Having low blood glucose levels during sleep, or nocturnal hypoglycaemia, is common. Parents and other caregivers often feel they must get up several times during the night to check their child’s blood glucose level. Diabetes technology, such as continuous glucose monitors (CGMs), may be helpful for many families with children who have diabetes. Caregivers may be able to have an alarm in their room that will go off if the child’s blood glucose level gets too low.
Q: Are there certain behaviours or signs that may indicate fear of hypoglycaemia? What should health care professionals look for when talking with their patients?
A: Some people who are extremely fearful may try to avoid low blood glucose by keeping their blood glucose levels in a higher range. Often, these people have had a traumatic or socially embarrassing experience with hypoglycaemia that affects how they manage their diabetes.
Another thing that health care professionals can look for is how people with diabetes treat an episode of hypoglycaemia. Sometimes, people with fear of hypoglycaemia will overtreat low blood glucose. They may eat or drink too many carbohydrates and then have high blood glucose levels, which can be hard to bring back down.
Q: What questions can health care professionals ask their patients to see if they may experience fear of hypoglycaemia? Are there any tools or questionnaires that can help?
A: I think health care professionals should always ask patients with diabetes if they’ve had any episodes of hypoglycaemia. Unfortunately, some people may not want to admit that they’ve had an episode, especially if it was severe. Many people are fearful of having some sort of negative consequence from admitting that they’ve had a severe episode, such as losing their ability to drive.
Health care professionals should not only ask about whether an episode of hypoglycaemia has occurred, but also what the impact was. What were the circumstances, and what happened? Were there other people around? Did it happen during an important social occasion? Were they alone with no food available? Several social and environmental factors can affect how traumatic the episode was, and asking these questions can help give a full picture of the incident.
From a clinical perspective, it might be helpful to do a quick assessment before giving people a longer questionnaire. I think health care professionals should ask something like, “If I asked you how worried you are about hypoglycaemia on a zero- to five-point scale, with zero being not worried at all and five being extremely worried, what would you say?” Then, if someone answers with a four or five, perhaps it’s time to do a longer questionnaire.
The tool health care professionals most commonly use to assess fear of hypoglycaemia is the Hypoglycaemia Fear SurveyExternal link (PDF, 372 KB) . This tool is available in more than 60 languages, and health care professionals all over the world have used it.
Q: What can health care professionals do to help support people with fear of hypoglycaemia?
A: Most of the time, fear of hypoglycaemia is tied to actual hypoglycaemia, so it’s important to address hypoglycaemia first. The health care team should review the person’s insulin regimen, how often they’re checking their blood glucose levels, and whether they could benefit from a continuous glucose monitoring system or other medical intervention.
Some people who are afraid of hypoglycaemia may also benefit from some form of anxiety-reduction therapy. Several different interventions—such as cognitive behavioural therapy, stress relaxation training, or mindfulness training—can help people lower their overall levels of anxiety. Certain versions of diabetes-specific interventions—such as blood glucose awareness training—have also been shown to reduce fear of hyperglycaemia.
Q: What are we learning, or hoping to learn, from research about fear of hypoglycaemia?
A: People who have hypoglycaemia unawareness and are no longer able to feel the symptoms of low blood glucose levels are at the highest risk of having a severe episode. Several studies are looking into possible interventions for people with hypoglycaemia unawareness, such as diabetes technologies and patient education programs. The sooner a person with diabetes knows their blood glucose is low, the sooner they can do something about it, and the less likely they are to experience a severe episode.
Linda Gonder-Frederick, PhD, is an associate professor of psychiatry and neurobehavioral sciences at the University of Virginia School of Medicine. Her research focuses on diabetes-related behavioural and psychological issues.
When it’s cold, there may be more to managing diabetes than you expect
How cold weather can affect diabetes
Cold weather can slow blood flow around the body, which can increase the risk of heart attacks and stroke. Living with diabetes increases your risk of these complications therefore it is important to stay warm and know how to manage your blood sugar levels during cold weather.
If you are living with diabetes complications, for example heart disease or nerve pain (neuropathy), cold weather can make this worse for some people. Cold weather can raise blood pressure and if it’s too high, it puts extra strain on the body. It affects how the blood flows around the body and circulation to your hands and feet can slow down, which could make neuropathy more painful in these areas.
NHS advice is to heat your home to at least 18°C in the rooms that you regularly use and to keep bedroom windows closed at night. This is particularly important if you have a health condition like diabetes. Here's the NHS guide to staying well this winter.
Keeping warm by heating your home will help, but we know it’s not as simple as that with the cost of living. (UK: You might be entitled to grants or benefits to help make your home more energy efficient – the Citizen's Advice website is a good place to start and you can choose the advice based on where you live in the UK.)
“My tip would be to wear warm clothing before you felt cold. Not waiting until you were already feeling chilly. I often layer my socks which I find helps. A thin pair next to my skin and a thicker pair over the top. And try thermal vests and leggings.”
If you usually check your own blood sugar levels, keep a closer eye on them during the winter months. Monitoring them more regularly can help with managing your diabetes.
You might find the cold makes it more difficult to draw a drop of blood for finger-prick testing, so try warming up your fingers using hand warmers, holding a warm cup of tea or wearing gloves just before you check. However if you have peripheral neuropathy in your hands or fingers with any changes in sensation it can be difficult to feel how hot things are. So don't hold a hot cup to warm your hands and if you use handwarmers check that they are suitable for you to use.
Check your feet
Living with diabetes means you are at greater risk of developing serious foot problems. Although you may need to layer up, remember to still take your shoes and socks off each day to check your feet thoroughly for any sign of a foot problem.
If you have neuropathy in your feet, be extra careful if you use a hot water bottle, electric blanket or heater to keep warm. If using a hot water bottle fill with hot water not boiling water and ensure it has a cover. Always remove the hot water bottle from your bed before getting in. If using an electric blanket always turn it off before getting into bed and make sure you have checked the manufacturer’s recommendations before use. This is because if you’ve lost sensation in your feet you may not notice when they are getting too hot and starting to burn.
If you take insulin to treat your diabetes, keep a close eye on how you store it. Insulin can freeze if it is left out in extreme cold so keep your insulin that is in use at room temperature, for more information on how to store insulin, visit our what is insulin page.
Blood sugar testing equipment and insulin pump handsets can also be affected by the cold so keep these at room temperature or if you are outside keep them in an inside pocket.
Get your flu jab and Covid booster
It’s really important people with diabetes get their free NHS flu jab and Covid booster, to protect themselves from getting ill. This is because winter is when viruses circulate most and people living with diabetes are at a higher risk of complications associated with flu and Covid.
Getting both vaccines is the best way to protect yourself from getting flu and Covid. The NHS have more information on vaccinations and staying well this winter on their website.
If you do get unwell you may find it more difficult to manage your blood sugars and keep them within range. Make sure you contact your healthcare team for advice and follow your sick day rules.
The cold winter months and shorter daylight hours can affect us mentally, as well as physically. It can make us feel low, lethargic and even depressed. And this year, more people may be finding it tougher than usual, with the cost of living crisis adding extra stress. When you have diabetes, these emotions can impact on your blood sugar levels too.
Whatever you’re feeling, you’re not alone. Talking to other people about how you’re feeling isn’t always easy, but it can help. This could be your healthcare team, a family member, or even a stranger on our online support forum.
We know that many people living with diabetes or caring for a loved one with diabetes have been struggling with the cost of living, including energy bills. In May 2023 we published research in our report The Hidden Cost showing the impact that this can have on managing diabetes.
That’s why we want Ofgem to make sure that people with diabetes have guaranteed protection against energy disconnection and to permanently stop forced pre-payment meter installation. We also support the Guarantee Our Essentials campaign calling for Universal Credit to be enough to cover the cost of essentials like energy bills, so that more people can have the warm home that they need to stay well.
If you need further support with the cost-of-living crisis, you can visit our cost of living support page for advice and resources.
Eat well
We’ve got a whole host of recipes to keep you toasty and healthy through the colder months. Check out our budget-friendly meal plan for the week, filled with warming stews and soups.
You might be surprised to hear that alcohol can make your blood vessels dilate and cause you to lose more heat from your body. So drinking alcohol isn't a quick fix to warm you up, it will have the opposite effect and make you colder.
Stay active
Winter can mean you’re not as active if you’re inside a bit more, which can affect your blood sugars and you may find they are above your target range.
Being active has so many benefits, but it can be particularly helpful in the winter months. Exercise can keep you warm, boost your mood, and help with blood flow around the body – not to mention help you manage your blood sugars.
Try to get out in the natural sunlight – a lunchtime walk can help, or if you're spending more time inside there are lots of ways to keep moving. Try climbing the stairs a few times, dancing in the ad breaks while you’re watching TV, or vacuuming the house.
“Movement is just as important as wrapping up! Going out for a brisk walk is good, but it's just as good to do some sort of exercise in your home. Even just getting up and walking around even a little bit every hour will make you feel warmer than sitting still for hours on end, as well as being better for your health in general.” - A tip from one of our online forum members.
Nearly 40 percent of U.S. adults—and 50 percent of those over 65—have prediabetes. Eight out of 10 don’t know it. On the upside, the toolbox for preventing or reversing prediabetes is expanding. Here’s what to know.
1. Prediabetes isn’t pre-disease.
Haemoglobin A1c, a long-term measure of blood sugar, is the easiest way to test for diabetes.
“Don’t let the ‘pre’ fool you,” says the Centers for Disease Control and Prevention. “Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.”
The good news: If you have prediabetes, losing excess weight and boosting exercise can help keep type 2 diabetes at bay. That was one takeaway from the Diabetes Prevention Program (DPP), a trial involving 3,234 people with prediabetes.
“The lifestyle intervention reduced the risk of type 2 diabetes by 58 percent,” says Dana Dabelea, professor of epidemiology and paediatrics at the University of Colorado.
And keeping your blood sugar under control may protect your blood vessels even if you never get diabetes.
“After the trial ended, everyone in the DPP was offered the lifestyle intervention,” explains Dabelea.
Over the next 15 years, the participants who kept a lid on their blood sugar did better.
“People who did not develop diabetes had nearly a 30 percent lower prevalence of damage in small blood vessels compared to those who developed diabetes,” notes Dabelea. That damage occurs mostly in the eyes, nerves, and kidneys.
And even among people who stayed in the prediabetes range, the lower their haemoglobin A1c, the lower their risk of damage to tiny blood vessels in the eyes.
“The higher the A1c, the higher the risk, even before you get to diabetes,” says Dabelea.
How does insulin resistance lead to prediabetes and type 2 diabetes?
designua - stock.adobe.com.
Insulin acts as a key that allows blood sugar (glucose) to enter the body’s cells, where it is either burned for fuel or stored. But in some people, the key can’t open the lock. To compensate for that “insulin resistance,” the pancreas pumps out more and more insulin, but it’s not enough to keep blood sugar from creeping up to “prediabetes” levels. After years of straining to keep up, the pancreas starts to fail and blood sugar reaches the “diabetes” range.
(That’s type 2 diabetes. In type 1 diabetes, the body’s immune system destroys the pancreas’s ability to make insulin. Type 1 accounts for about 5 percent of diabetes.)
Scroll down to see if you’re at risk for type 2 diabetes.
2. Cut the crappy carbs.
“A stunning 40 percent of what we eat is added sugars and refined carbs,” says Christopher Gardner, professor of medicine at the Stanford University School of Medicine.
“Most people don’t do a good job of getting rid of those crappy carbs.”
Many diets—from Mediterranean to keto to Paleo—do get that job done, he points out.
“Looking across all the popular diets, you see no added sugar, no refined grain, lots of vegetables, and whole—rather than ultra-processed—foods,” says Gardner.
In a recent trial, he randomly assigned 33 people with prediabetes or type 2 diabetes to eat a keto (very-low-carb) or Mediterranean diet for 12 weeks each. Both diets were low in added sugars and refined grains and rich in non-starchy vegetables.
A key difference: People could eat fruits, beans, and whole, unprocessed grains on the Mediterranean diet, but not on the keto diet.
The main results: “Haemoglobin A1c fell on both diets,” says Gardner.
“LDL—so-called bad cholesterol—was worse for keto, but triglycerides were better.” And people lost about 15 pounds on each diet.
“If it’s a wash, why get rid of the beans, fruits, and grains?” asks Gardner. “They provide far more variety, so the Mediterranean diet is more appealing and easier to stick with.”
3. Think twice about a continuous glucose monitor.
Lingo and Stelo offer continuous glucose monitors at a lower cost than most other websites. But don’t expect them to help you lose weight.
“Meet your metabolism.” “See how your body responds to food in real time,” says Signos.com.
Levels, Lingo, Nutrisense, Signos, Stelo. They’re just some of the websites that sell continuous glucose monitors (CGMs). Since early 2024, when the FDA cleared the first device that didn’t need a prescription, the market for CGMs has exploded.
They’re not cheap. Most charge roughly $200 to $500 per month, depending on whether you sign up for 1, 3, 6, or 12 months.
The CGMs are all made by one of two companies: Abbott or Dexcom. And CGMs sold directly by those companies are cheaper. Abbott’s Hellolingo.com offers a 2-week CGM for just $49, and Dexcom’s Stelo.com sells a 1-month subscription for $89.
For people with type 1—and some with type 2—diabetes, a CGM that sends alerts for low blood sugar can replace frequent finger sticks to test blood sugar levels. Is a CGM worth the cost for everyone else? Here’s what to keep in mind:
Are CGMs accurate?
CGMs measure glucose levels in the space between cells just under your skin. The devices can detect the wide swings in blood sugar that occur in people with diabetes. But for smaller swings, their results may be less reliable.
“We often found different glucose responses to the same meals when people without diabetes simultaneously wore two different CGMs,” says Kevin Hall of the National Institute of Diabetes and Digestive and Kidney Diseases.
And you can’t jump to conclusions about foods based on one CGM reading, adds Hall.
“Our CGM responses to a meal on one day didn’t reliably predict the CGM response of the same person to the same meal on another day.”
Will CGMs help you lose weight?
“As glucose rises, so does insulin,” explains Lingo. “And when insulin is chronically elevated, it can impair the body’s ability to burn fat for energy. That’s why having steady glucose levels can help with losing and maintaining weight.”
But there’s no good evidence that lower—or “steady”—glucose levels cause people to lose weight.
“When we put people on a low-carbohydrate diet, they had much lower glucose levels on CGMs after meals than when they ate a high-carbohydrate diet,” says Hall. “But they didn’t lose more body fat on the low-carbohydrate diet.”
Likewise, CGM results didn’t track with weight loss in Gardner’s study.
“When people were on the Keto diet, the CGM data showed lower average blood sugar levels than when they were on the Mediterranean diet, but we saw no difference in overall weight loss,” he points out.
It’s not as though the calories in protein and fat don’t count. Ditto for the calories in fructose, even though it raises blood sugar far less than glucose.
“The CGM is a shiny new toy, and it has led some people to do whatever they can to blunt a normal glucose response, as if any kind of spike is unhealthy,” notes Gardner.
“But a spike doesn’t mean you’re going to gain weight. If you eat some carbs, it’s normal for your glucose to go up. Your body secretes insulin, and you put the glucose away.”
Don’t be alarmed by high glucose readings.
When researchers had 1,175 people aged roughly 50 to 70 wear a CGM for a week, those without diabetes or prediabetes spent three hours a day with their blood sugar above what many experts—and many CGMs—consider a healthy range (70 to 140 milligrams per decilitre).
(People with prediabetes spent 5½ hours—and those with diabetes averaged 13¾ hours—above that range.)
“Don’t panic,” says Nicole Spartano, assistant professor of medicine at the Boston University Chobanian & Avedisian School of Medicine, who led the study.
“We don’t yet know what CGM levels are of concern for people without diabetes or prediabetes.”
A CGM might get you moving.
“You can take a bite out of a glucose spike by doing 15 minutes of exercise 30 minutes after your meal,” says Spartano, citing a study on older people with prediabetes and obesity.
“Seeing that change on a CGM might increase your physical activity. But that may only last a few weeks, as we see with wearables like a Fitbit.”
4. Exercise can reverse prediabetes.
An hour a day of moderate-intensity exercise may reverse prediabetes.
Kay Abrahams - stock.adobe.com.
Exercise can curb your risk of type 2 diabetes. Researchers are trying to figure out how...and which kind of exercise is best.
“We wanted to tease out whether high- and moderate-intensity exercise had similar benefits,” says Steven Malin, director of the Applied Metabolism & Physiology Laboratory at Rutgers University.
His team randomly assigned 31 sedentary older adults with prediabetes and obesity to one of two groups that did an hour of cycling every day for two weeks.
“Both groups burned the same 350 calories at each workout,” explains Malin. “But the continuous moderate-intensity exercise group cycled at about 70 percent of their maximum heart rate for an hour, while the high-intensity interval group alternated between 3 minutes at 90 percent of their maximum and 3 minutes at 50 percent for an hour.”
The results: “About 40 percent of both groups reversed their prediabetes,” says Malin. “That was pretty impressive for a two-week trial.”
(Of course, their prediabetes could have returned after the trial, especially if they stopped the exercise.)
What did the exercise change? When both groups took a glucose tolerance test—that is, when they drank a hefty dose of glucose—their blood sugar levels didn’t rise as much as it did when they entered the study. And their muscle cells were less insulin-resistant than when the study started.
What’s more, exercise revved up the insulin-secreting cells in the pancreas. “Beta-cell function improved similarly in the two groups,” notes Malin.
His bottom line: “Get out there and move. An hour a day should help your body produce insulin and help manage your blood glucose levels. It can be high-intensity interval exercise, but walking or biking is okay, too.”
5. Obesity meds work...and more are coming.
In a recent trial on people with prediabetes and obesity, 81 percent of semaglutide takers—but only 14 percent of placebo takers—no longer had prediabetes after one year.
(The trial was funded by Novo Nordisk, which sells semaglutide as Ozempic for diabetes and Wegovy for obesity.)
Remarkable? Yes. Surprising? No, since the drug is approved to treat not just obesity but—given its ability to lower blood sugar—type 2 diabetes.
(The same goes for tirzepatide, which is sold as Mounjaro for diabetes and Zepbound for obesity.)
How do the drugs reverse prediabetes?
“They’re improving insulin secretion from the beta-cells,” explained Ania Jastreboff, associate professor of medicine at the Yale School of Medicine, in Yale’s recent “Health & Veritas” podcast.
And “if you lose weight, you’re improving insulin sensitivity,” she added, “because you’re offloading the work that the beta-cell has to do.”
(Jastreboff has led several clinical trials on tirzepatide and retatrutide funded by Eli Lilly and has served on the Scientific Advisory Boards for Eli Lilly, Novo Nordisk, Pfizer, Amgen, and several other companies.)
How do the drugs trigger weight loss?
Semaglutide (sold as Ozempic for diabetes) is a long-acting version of the GLP-1 hormone secreted by the gut. Here are some of its effects (seen in industry-sponsored trials). Some effects are partly due to weight loss.
Oleksandr Pokusai - stock.adobe.com.
Semaglutide is a long-acting version of a hormone released by the intestine—GLP-1 (glucagon-like peptide-1)—that slows gastric emptying and makes you feel full. Tirzepatide leads to even more weight loss because it’s a long-acting version of GLP-1 plus GIP (glucose-dependent insulinotropic polypeptide), which has similar effects.
But “this is just the tip of the iceberg,” Jastreboff noted. Among the dozens of meds in the pipeline:
Survodutide. Long-acting GLP-1 plus glucagon, a hormone that curbs food intake.
CagriSema. A long-acting version of GLP-1 plus amylin, a hormone that slows stomach emptying.
The drugs are “all based on these hormones that are stimulated when we eat,” explained Jastreboff.
Also in the works: drugs to curb the loss of muscle and lean tissue that occurs whether you lose weight with drugs, surgery, or diet.
Drugs that extend the life of GLP-1 “have been around for over 20 years,” Jastreboff noted. But when it comes to the newer drugs’ safety, “we have to do our due diligence.” Stay tuned.
The bottom line
The best way to dodge pre-diabetes or type 2 diabetes is to lose (or not gain) extra pounds. Cutting carbs—especially white flour, added sugars, and juices—may help lower blood sugar even if you don’t lose weight.
Replace unhealthy carbs with unsaturated fats like olive or canola oil, nuts, and fish. Fill half your plate with nonstarchy vegetables.
Aim for 30 to 60 minutes of brisk walking or other aerobic exercise daily.
If you have obesity, ask your physician about Ozempic-like medications. (So far, the drugs have been approved for treating type 2 diabetes but not prediabetes.)
