A Mass General expert offers those with prediabetes and diabetes some strategies to help delay and possibly prevent further advancement of the disease.

There are an estimated 86 million Americans who have prediabetes, which means they are at risk of joining the 29 million Americans who already have type 2 diabetes. But research led by Massachusetts General Hospital has shown that moderate weight loss will help both those with prediabetes and diabetes to delay and possibly prevent further advancement of the disease. It’s as simple as your mother told you: eat healthier and exercise regularly.

Linda Delahanty, MS, RDN, LDN, is chief dietitian at Mass General’s Diabetes Center and director of Nutrition and Behavioral Research at the hospital’s Diabetes Research Center. She is a nationally recognized authority on nutrition and lifestyle interventions for the treatment of diabetes and obesity and has been awarded the 2015 Outstanding Diabetes Educator of the Year Award by the American Diabetes Association.
Linda Delahanty, MS, RDN, LDN

These five tips will help everyone lead a healthier life, but are particularly important for those with prediabetes and diabetes. I’ve adapted them from the book “Beating Diabetes,” which I co-authored with David Nathan, MD, director of the MGH Diabetes Center and the Clinical Research Center.

Weight and Prevention

• Lose at least five to ten pounds to start. A landmark research trial led at Mass General called the Diabetes Prevention Program showed that losing a modest 5 to 7 percent of your initial weight could delay or even prevent diabetes. Reducing the calories you eat to lose weight is the most powerful lifestyle change that you can make to lower your blood glucose (sugar) levels to normal levels. Weight loss is also recommended to help control type 2 diabetes once you have it. High levels of blood glucose over many years damages nerves and blood vessels and can lead to serious complications like heart disease and stroke, blindness, kidney failure and limb amputation.

Fresh fruit has fiber, is more filling than juice and is more slowly digested and absorbed.

• Reduce or eliminate sweetened or naturally sweetened beverages. These include regular soda, fruit punch and natural fruit juices. Carbohydrates in liquid form are more rapidly absorbed than carbohydrates in a solid form (solids usually contain fiber that slows down the digestion of sugars) and can cause your blood glucose to rise to high levels. Try sugar-free diet soda instead. Eat fresh fruit instead of fruit juice as much as possible. Fresh fruit has fiber, is more filling than juice and is more slowly digested and absorbed.

• Try several small meals at regularly time intervals rather than infrequent large meals. It is better to space your meals and snacks throughout the day than to skip meals and eat one or two large meals.

The Benefits of Fiber

• Include more fiber in your food choices. Fiber has several beneficial effects. It satisfies hunger, blunts the rise in blood sugar after eating and lowers cholesterol levels. Choose fresh fruits instead of juice, whole grain breads and cereals instead of refined grains, and increased amounts of fresh or frozen vegetables. Legumes—a class of vegetables that includes beans, peas and lentils—are helpful too.

When you exercise, you help the insulin that your pancreas produces to work more effectively.

• Increase your activity level. Gradually work toward a goal of at least 30 minutes of activity (equivalent to a brisk walk) five to six times per week. This level of activity can often lower your blood glucose level by 50 or more points. When you exercise, you help the insulin that your pancreas produces to work more effectively. Every 10 minute bout of activity helps.

Linda Delahanty, MS, RDN, LDN, is chief dietitian at Mass General’s Diabetes Center and director of Nutrition and Behavioral Research at the hospital’s Diabetes Research Center. She is a nationally recognized authority on nutrition and lifestyle interventions for the treatment of diabetes and obesity and has been awarded the 2015 Outstanding Diabetes Educator of the Year Award by the American Diabetes Association.