The diagnosis surprised me. After a routine physical exam, my doctor informed me that I’m prediabetic. How could I have higher-than-normal levels of glucose in my blood? I run, and I eat sensibly. I’ve always been slim. And yet I’m on the brink of getting a disease that’s assumed to affect only the overweight.
It’s not a poor assumption. Type 2 diabetes occurs when insulin—a hormone that controls the glucose levels in the blood—fails to deliver the glucose (which you get from food) to your organs; as a result, it rises to toxic levels and remains there unless the condition is treated with a special diet, exercise, and in some cases medication. (Type 1 diabetes, in contrast, is genetic and unpreventable, occurring because the body makes little or no insulin.) Scientists have thought that the excess pounds themselves somehow directly cause insulin resistance. After all, 85 percent of those who suffer from type 2 diabetes are overweight.
But that still leaves 15 percent—about 3 million Americans—with the disease despite having a healthy weight. It turns out that what’s on the scale alone doesn’t determine who gets type 2. In talking to experts, I discovered a range of health issues that may be throwing the body’s glucose levels off-balance. But by simply improving the following conditions, you (and I) can stave off the disease—and feel a whole lot better, too.
Lack of sleep
Mounting evidence suggests that insufficient sleep disrupts our ability to regulate blood sugar. A study presented at the Endocrine Society’s annual meeting this year shows that a sleep deficit of a mere 30 minutes on weeknights can lead to insulin resistance in as little as six months.
Rx: “Sleep’s a big deal,” says George King, M.D., chief scientific officer at the Joslin Diabetes Center, in Boston. To shift your body back to balance, he says, “aim for at least six and a half to seven hours.”
“Whether mental or physical, stress can cause blood-sugar levels to rise,” says Maggie Powers, Ph.D., president-elect of health care and education at the American Diabetes Association. When scientists at the German Research Center for Environmental Health followed more than 5,300 workers without diabetes for a median of 13 years, nearly 300 were diagnosed with type 2 by the end of the study. It turns out that those who reported a high-pressure work environment were 45 percent likelier to develop the disease.
Rx: If work or your personal life makes you feel anxious, zero in on the source and try to change it, or find other ways to counterbalance it, whether by exercising, meditating, or engaging in a hobby.
Too many highly processed carbs
“Years of a poor-quality diet, in addition to genetic factors, can place a person at a higher risk of diabetes even if he’s not obese,” says Joel Fuhrman, M.D., author of The End of Diabetes (HarperOne, 2013). Overindulging in highly processed, high-glycemic carbohydrates, such as soda and white bread, can cause marked upticks in blood-sugar and insulin levels. According to a 2013 Diabetologia study, habitually drinking just one 12-ounce sugar-sweetened beverage a day can up the risk of diabetes by 22 percent. And that’s not just because of the subjects’ weight; researchers noted that the correlation held true even after accounting for body-weight status, suggesting that other factors, like the spike in blood sugar, may be at play.
Rx: Replace soda with water and unsweetened tea and coffee—and you may see glucose levels go down. In addition, swapping out refined carbohydrates for whole grains can lower one’s risk of diabetes by 36 percent, the Nurses’ Health Studies (among the nation’s largest, longest-running clinical trials on women’s health) found.
The gut’s microbiota (the bacterial flora in the digestive tract) may hold clues as to why some people develop diabetes. When Cornell University researchers administered a probiotic supplement to diabetic rats, the rats’ blood-glucose levels decreased by 30 percent, according to a Diabetes study published earlier this year.
Rx: You can enhance your microbiota and decrease your diabetes risk by eating the right foods: “Raw vegetables, onions, beans, and berries promote the growth of beneficial gut bacteria—the kinds that help slow glucose absorption,” says Fuhrman. You may also be able to improve blood-glucose levels by limiting artificial sweeteners. A 2014 paper published in Nature suggests that noncaloric artificial sweeteners (NAS) may alter gut microbiota, which in turn has an effect on your ability to process glucose. According to researchers at the Weizmann Institute of Science, in Rehovot, Israel, when healthy volunteers who normally didn’t consume NAS or NAS-containing foods were fed artificial sweeteners (the equivalent of 10 to 12 coffee-shop packets) over the course of a week, many developed elevated blood-sugar levels; some even exhibited levels considered prediabetic.
Too little muscle
Some slim people have more body fat than they do muscle. As a result, they suffer from metabolic issues similar to those found in much heavier people.
Rx: The latest research corroborates that fat (not just weight) needs to be taken into account when considering a patient’s risk for diabetes. According to a 2012 study published in JAMA Internal Medicine, 30 minutes of weight training five days a week can cut diabetes risk by 34 percent. And other research has shown that strength training helps to improve insulin function.
All this convincing evidence has compelled me to change my ways. After tweaking my diet and workout routine and getting more sleep (a welcome fix!), I’m feeling healthier already.