Diabetes is a chronic disease that affects millions of people
worldwide. Uncontrolled cases can cause blindness, kidney
failure, heart disease and other serious conditions.
Before diabetes is diagnosed, there is a period where blood
sugar levels are high but not high enough to be diagnosed as
diabetes. This is known as prediabetes.
It’s estimated that up to 70% of people with prediabetes go on
to develop type 2 diabetes. Fortunately, progressing from
prediabetes to diabetes isn’t inevitable (1).
Although there are certain factors you can’t change — such as
your genes, age or past behaviors — there are many actions you
can take to reduce the risk of diabetes.
Here are 13 ways to avoid getting diabetes.
1. Cut Sugar and Refined Carbs From Your Diet
Your body rapidly breaks these foods down into small sugar
molecules, which are absorbed into your bloodstream.
The resulting rise in blood sugar stimulates your pancreas to
insulin, a hormone that helps sugar get out of the
bloodstream and into your body’s cells.
In people with prediabetes, the body’s cells are resistant to
insulin’s action, so sugar remains high in the blood. To
compensate, the pancreas produces more insulin, attempting to
bring blood sugar down to a healthy level.
Over time, this can lead to progressively higher blood sugar
and insulin levels, until the condition eventually turns into
type 2 diabetes.
Many studies have shown a link between the frequent consumption
of sugar or refined carbs and the risk of diabetes. What’s
more, replacing them with foods that have less of an effect on
blood sugar may help reduce your risk (2, 3, 4, 5, 6).
A detailed analysis of 37 studies found that people with the
highest intakes of fast-digesting carbs were 40% more likely to
develop diabetes than those with the lowest intakes (7).
Summary: Eating foods high in refined carbs
and sugar increases blood sugar and insulin levels, which may
lead to diabetes over time. Avoiding these foods may help
reduce your risk.
2. Work Out Regularly
physical activity on a regular basis may help prevent
Exercise increases the insulin sensitivity of your cells. So
when you exercise, less insulin is required to keep your blood
sugar levels under control.
One study in people with prediabetes found that
moderate-intensity exercise increased insulin sensitivity by
51% and high-intensity exercise increased it by 85%. However,
this effect only occurred on workout days (8).
Many types of physical activity have been shown to reduce
insulin resistance and blood sugar in overweight, obese and
prediabetic adults. These include aerobic exercise,
high-intensity interval training and strength training
(9, 10, 11, 12, 13, 14).
Working out more frequently seems to lead to improvements in
insulin response and function. One study in people at risk of
diabetes found that burning more than 2,000 calories
weekly via exercise was required to achieve these benefits
Therefore, it’s best to choose physical activity that you
enjoy, can engage in regularly and feel you can stick with
Summary: Performing physical activity on a
regular basis can increase insulin secretion and sensitivity,
which may help prevent the progression from prediabetes to
3. Drink Water as Your Primary Beverage
is by far the most natural beverage you can drink.
What’s more, sticking with water most of the time helps you
avoid beverages that are high in sugar, preservatives and other
Sugary beverages like soda and punch have been linked to an
increased risk of both type 2 diabetes and latent autoimmune diabetes of adults
LADA is a form of type 1 diabetes that occurs in people over 18
years of age. Unlike the acute symptoms seen with type 1
diabetes in childhood, LADA develops slowly, requiring more
treatment as the disease progresses (15).
One large observational study looked at the diabetes risk of
Those who consumed more than two servings of sugar-sweetened
beverages per day had a 99% increased risk of developing LADA
and a 20% increased risk of developing type 2 diabetes
One 24-week study showed that overweight adults who replaced
diet sodas with water while following a weight loss program
experienced a decrease in insulin resistance and lower
fasting blood sugar and insulin levels (19).
Summary: Drinking water instead of other
beverages may help control blood sugar and insulin levels,
thereby reducing the risk of diabetes.
4. Lose Weight If You’re Overweight or Obese
Although not everyone who develops type 2 diabetes is
overweight or obese, the majority are.
What’s more, those with prediabetes tend to carry excess weight
in their midsection and around abdominal organs like the liver.
This is known as visceral fat.
One study of more than 1,000 people with prediabetes found that
for every kilogram (2.2 lbs) of weight participants lost, their
risk of diabetes reduced by 16%, up to a maximum reduction of
There are many healthy options for losing weight, including
low-carb, Mediterranean, paleo and vegetarian diets.
However, choosing a way of eating you can stick with long-term
is key to helping you maintain the
One study found that obese people whose blood sugar and insulin
levels decreased after losing weight experienced elevations in
these values after gaining back all or a portion of the weight
they lost (26).
Summary: Carrying excess weight,
particularly in the abdominal area, increases the likelihood
of developing diabetes. Losing weight may significantly
reduce the risk of diabetes.
5. Quit Smoking
Smoking has been shown to cause or contribute to many serious
health conditions, including heart disease, emphysema and
cancers of the lung, breast, prostate and digestive tract
In an analysis of several studies totaling over one million
people, smoking was found to increase the risk of diabetes by
44% in average smokers and 61% in people who smoked more than
20 cigarettes daily (30).
One study followed the risk of diabetes in middle-aged male
smokers after they quit. After five years their risk had
reduced by 13%, and after 20 years they had the same risk as
people who had never smoked (31).
Researchers stated that even though many of the men gained
weight after quitting, after several smoke-free years, their
risk of diabetes was lower than if they’d continued smoking.
Summary: Smoking is strongly linked to the
risk of diabetes, especially in heavy smokers. Quitting has
been shown to reduce this risk over time.
6. Follow a Very-Low-Carb Diet
Following a ketogenic
or very-low-carb diet can help you avoid diabetes.
Although there are a number of ways of eating that promote
weight loss, very-low-carb diets have strong evidence behind
In a 12-week study, prediabetic individuals consumed either a
low-fat or low-carb diet. Blood sugar dropped by 12% and
insulin dropped by 50% in the low-carb group.
In the low-fat group, meanwhile, blood sugar dropped by only 1%
and insulin dropped by 19%. Thus, the low-carb diet had better
results on both counts (35).
If you minimize your carb intake, your blood sugar levels won’t
rise very much after you eat. Therefore, your body needs less
insulin to maintain your blood sugar within healthy levels.
What’s more, very-low-carb or ketogenic diets may also reduce
fasting blood sugar.
In a study of obese men with prediabetes who followed a
ketogenic diet, average fasting blood sugar decreased from 118
to 92 mg/dl, which is within the normal range. Participants
also lost weight and improved several other health markers
For more info, check out this Guide
to Healthy Low-Carb Eating With Diabetes.
Summary: Following a ketogenic or
very-low-carb diet can help keep blood sugar and insulin
levels under control, which may protect against diabetes.
7. Watch Portion Sizes
Whether or not you decide to follow a low-carb diet, it’s
important to avoid large portions of food to reduce the risk of
diabetes, especially if you are overweight.
Eating too much food at one time has been shown to cause higher
blood sugar and insulin levels in people at risk of diabetes
On the other hand, decreasing portion sizes may help prevent
this type of response.
A two-year study in prediabetic men found that those who
reduced food portion sizes and practiced other healthful
nutrition behaviors had a 46% lower risk of developing diabetes
than the men who made no lifestyle changes (38).
Another study looking at weight loss methods in people with
prediabetes reported that the group practicing portion control
lowered their blood sugar and insulin levels significantly
after 12 weeks (39).
Summary: Avoiding large portion sizes can
help reduce insulin and blood sugar levels and decrease the
risk of diabetes.
8. Avoid Sedentary Behaviors
It’s important to avoid being sedentary if you want to prevent
If you get no or very little physical activity, and you sit
during most of your day, then you lead a sedentary lifestyle.
A large analysis of 47 studies found that people who spent the
highest amount of time per day engaged in sedentary behavior
had a 91% increased risk of developing diabetes (41).
Changing sedentary behavior can be as simple as
standing up from your desk and walking around for a few
minutes every hour.
Unfortunately, it can be hard to reverse firmly entrenched
One study gave young adults at risk of diabetes a 12-month
program designed to change sedentary behavior. Sadly, after the
program ended, the researchers found that participants hadn’t
reduced how much time they sat (42).
Set realistic and achievable goals, such as standing while
talking on the phone or taking the stairs instead of the
elevator. Committing to these easy, concrete actions may be the
best way to reverse sedentary tendencies.
Summary: Avoiding sedentary behaviors like
excessive sitting has been shown to reduce your risk of
9. Eat a High-Fiber Diet
of fiber is beneficial for gut health and weight
Fiber can be divided into two
broad categories: soluble and insoluble. Soluble fiber
absorbs water, whereas insoluble fiber does not.
In the digestive tract, soluble fiber and water form a gel that
slows down the rate at which food is absorbed. This leads to a
more gradual rise in blood sugar levels (47).
Most unprocessed plant foods contain fiber, although some have
more than others. Check out this list of 22
high-fiber foods for many excellent sources of fiber.
Summary: Consuming a good fiber source at
each meal can help prevent spikes in blood sugar and insulin
levels, which may help reduce your risk of developing
10. Optimize Vitamin D Levels
D is important for blood sugar control.
Most health organizations recommend maintaining a vitamin D
blood level of at least 30 ng/ml (75 nmol/l).
One study found that people with the highest blood levels of
vitamin D were 43% less likely to develop type 2 diabetes than
those with the lowest blood levels (49).
Another observational study looked at Finnish children who
received supplements containing adequate levels of vitamin D.
Children who took the vitamin D supplements had a 78% lower
risk of developing type 1 diabetes than children who received
less than the recommended amount of vitamin D (50).
Controlled studies have shown that when people who are
deficient take vitamin D supplements, the function of their
insulin-producing cells improves, their blood sugar levels
normalize and their risk of diabetes reduces significantly
Good food sources of vitamin D include fatty fish and cod liver
oil. In addition, sun exposure can increase vitamin D levels in
However, for many people, supplementing with 2,000–4,000 IU of
vitamin D daily may be necessary to achieve and maintain
Summary: Consuming foods high in vitamin D
or taking supplements can help optimize vitamin D blood
levels, which can reduce your risk of diabetes.
11. Minimize Your Intake of Processed Foods
One clear step you can take to improve your health is to
minimize your consumption of
They’re linked to all sorts of health problems, including heart
disease, obesity and diabetes.
This may be partly due to the protective effects of whole foods
like nuts, vegetables, fruits and other plant foods.
One study found that poor-quality diets that were high in
processed foods increased the risk of diabetes by 30%. However,
including nutritious whole foods helped reduce this risk
Summary: Minimizing processed foods and
focusing on whole foods with protective effects on health may
help decrease the risk of diabetes.
12. Drink Coffee or Tea
Although water should be your primary beverage, research
suggests that including
coffee or tea in your diet may help you avoid diabetes.
Studies have reported that drinking coffee on a daily basis
reduced the risk of type 2 diabetes by 8–54%, with the
greatest effect generally seen in people with the highest
consumption (56, 57, 58, 59, 60, 61).
Another review of several studies that included caffeinated tea
and coffee found similar results, with the largest risk
reduction in women and overweight men (62).
Coffee and tea have antioxidants known as polyphenols that may
help protect against diabetes (63).
In addition, green
tea contains a unique antioxidant compound called epigallocatechin gallate (EGCG) that has
been shown to reduce blood sugar release from the liver and
increase insulin sensitivity (64, 65).
Summary: Drinking coffee or tea may help
reduce blood sugar levels, increase insulin sensitivity and
reduce the risk of diabetes.
13. Consider Taking These Natural Herbs
There are a
few herbs that may help increase insulin sensitivity and
reduce the likelihood of diabetes progression.
Curcumin is a component of the bright gold spice turmeric,
which is one of the main ingredients in curries.
It has strong anti-inflammatory properties and has been used in
India for centuries as part of Ayurvedic medicine.
In a controlled nine-month study of 240 prediabetic adults,
among the group who took 750 mg of curcumin daily, no one
developed diabetes. However, 16.4% of the control group did
In addition, the curcumin group experienced an increase in
insulin sensitivity and improved functioning of
insulin-producing cells in the pancreas.
Berberine is found in several herbs and has been used in
traditional Chinese medicine for thousands of years.
Studies have shown that it fights inflammation and lowers
cholesterol and other heart disease markers (70).
In fact, a large analysis of 14 studies found that berberine is
as effective at lowering blood sugar levels as metformin, one
of the oldest and most widely used diabetes medications
Because berberine works by increasing insulin sensitivity and
reducing the release of sugar by the liver, it might
theoretically help people with prediabetes avoid diabetes.
However, at this point there are no studies that have looked at
In addition, since its effects on blood sugar are so strong, it
should not be used in conjunction with other diabetes
medications unless authorized by a doctor.
Summary: The herbs curcumin and berberine
increase insulin sensitivity, reduce blood sugar levels and
may help prevent diabetes.
The Bottom Line
You have control over many of the factors that influence
Rather than viewing prediabetes as a stepping stone to
diabetes, it may be helpful to see it as a motivator for making
changes that can help reduce your risk.
Eating the right foods and adopting other lifestyle behaviors
that promote healthy blood sugar and insulin levels will give
you the best chance at avoiding diabetes.