Preventing type 2 diabetes (Part 1)

Preventing type 2 diabetes (Part 1)

Today, diabetes affects 17 million Americans. In 2002, the direct and indirect costs of the disease totaled $132 billion, or “one out of every ten healthcare dollars spent in the United States,” says the American Diabetes Association (ADA). Yet the healthcare burden and personal costs related to diabetes can largely be prevented through lifestyle modification.


A study published in the New England Journal of Medicine in 2001 showed that more than 90% of type 2 diabetes is preventable and relates to unhealthy habits and behaviors (Hu et al, 2001). The scientists found that overweight or obesity was by far the most important predictor of the disease. Of the 17 million individuals living with diabetes in the U.S., 16 million have the type 2 disease. A further 16 million adults ages 40–74 have prediabetes, says the National Diabetes Education Program (NDEP), a federally sponsored public/private initiative.


With prediabetes, an individual’s blood sugar levels are higher than normal, but not high enough for a diabetes diagnosis. Doctors commonly refer to this condition as impaired glucose tolerance or impaired fasting glucose. Research supported by the U.S. Department of Health and Human Services (HHS) shows that most individuals with prediabetes will likely develop type 2 diabetes within 10 years unless they make some changes to their lifestyle.


In 2002, a panel of experts convened by HHS and ADA stated that intervention in prediabetes is critical for three reasons:

  • First, simply having blood glucose levels in the prediabetes range puts a person at a 50% greater likelihood of having a heart attack or stroke;
  • Second, research shows that the development of type 2 diabetes can be delayed or prevented through modest lifestyle improvements; and
  • Third, for many people, modest lifestyle improvements can ‘turn back the clock’ and return elevated blood glucose levels to the normal range.


The panel analyzed several major studies that evaluated strategies to prevent type 2 diabetes. These studies included the 1998–2001 Diabetes Prevention Program, a clinical trial of more than 3,000 people, which was sponsored by the National Institutes of Health. This multi-site program found that diet and exercise resulting in a weight loss of 5–7% lowered the incidence of type 2 diabetes in study participants by 58%. According to NDEP, this intervention was particularly successful with adults ages 60 and older, reducing their development of diabetes by 71%. Participants in the program lost weight by cutting fat and calories in their diet and by exercising— mostly walking—at least 30 minutes a day, 5 days a week.


NDEP has launched a national awareness campaign called “Small Steps. Big Rewards. Prevent Type 2 Diabetes,” which aims to reach people with prediabetes. Based on the Diabetes Prevention Program, the campaign’s GAME PLAN program (Goals, Accountability, Monitoring and Effectiveness: Prevention through a Lifestyle of Activity and Nutrition) provides tools to help people make lifestyle changes. Visit NDEP’s website at or call 800-438-5383 for details or educational materials. (Check out the GAME PLAN Toolkit for Health Care Providers for information on how to talk to clients about the program, plus copier-ready client handouts.)


NDEP also partners with organizations concerned about diabetes and the health status of their constituents. To learn more, check out the NDEP fact sheet at Or join NDEP’s partnership network by filling out the online form at



  • American Diabetes Association. “Direct and Indirect Costs of Diabetes in the United States.”, accessed July 9, 2003
  • American Diabetes Association and U.S. Department of Health and Human Services. Press release: “HHS, ADA warn Americans of ‘pre-diabetes,’ encourage people to take healthy steps to reduce risks: updated statistics show 17 million with diabetes, 16 million more with pre-diabetes.” March 27, 2002., accessed July 10, 2003
  • Hogan, P; Dall, T; Nikolov, P. 2003. “American Diabetes Association: Economic Costs of Diabetes in the U.S. in 2002.” Diabetes Care 2003;26:917–932
  • Hu, F.B.: et al. 2001. “Diet, Lifestyle, and the Risk ofType 2 Diabetes Mellitus in Women.” New England Journal of Medicine 2001;345:790–797
  • National Diabetes Education Program. “HHS/NDEP Diabetes Prevention Campaign.”, accessed July 9, 2003
  • National Diabetes Education Program. “NDEP Fact Sheet.”, accessed July 9, 2003


This article is provided courtesy of the International Council on Active Aging