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Can diabetes really be prevented with diet, exercise and a normal BMI - despite family history?
wisdomfromyou
Posts: 198 Member
My mother is diabetic and my father is borderline (pre-diabetic).
Both became quite sedentary after they retired from their comparatively active jobs (agronomists, walking up and down green-house alleys a good part of the day).
My mother acquired diabetes a few years after that. My father just plain sits on the couch and watches the news a good part of the day. They both live overseas (not in the US).
My mom was almost obese when she was diagnosed and she was a major emotional eater due to some problems related to my brother - but she lost weight ever since. My father is overweight too.
What are my chances of NEVER getting diabetes if, unlike them:
1. I will work to keep my BMI at a normal level.
2. I exercise daily and make sure to get in at least 10,000 steps a day (not just the hour of intense exercise).
3. I stay on top of diet and do low-carb, avoid sugar, take blood sugar lowering supplements, whatever.
Last year I had a BMI of 24.8 but I have put on some weight over the past few months due to work-related stress. I am on my way back down to 24.9 which would make me "normal".
My fasting blood sugar varies from upper 80's to mid 90's on a home testing device (Relion) which, in my experience, shows higher values than doctor's lab.
I have 13 lbs to lose to be back to a normal BMI - and I am 43.
I am so terrified of getting this illness given my family history.
Please someone tell me I can avoid it altogether if I BEHAVE long term - per diabetes guidelines.
Thank you all.
Both became quite sedentary after they retired from their comparatively active jobs (agronomists, walking up and down green-house alleys a good part of the day).
My mother acquired diabetes a few years after that. My father just plain sits on the couch and watches the news a good part of the day. They both live overseas (not in the US).
My mom was almost obese when she was diagnosed and she was a major emotional eater due to some problems related to my brother - but she lost weight ever since. My father is overweight too.
What are my chances of NEVER getting diabetes if, unlike them:
1. I will work to keep my BMI at a normal level.
2. I exercise daily and make sure to get in at least 10,000 steps a day (not just the hour of intense exercise).
3. I stay on top of diet and do low-carb, avoid sugar, take blood sugar lowering supplements, whatever.
Last year I had a BMI of 24.8 but I have put on some weight over the past few months due to work-related stress. I am on my way back down to 24.9 which would make me "normal".
My fasting blood sugar varies from upper 80's to mid 90's on a home testing device (Relion) which, in my experience, shows higher values than doctor's lab.
I have 13 lbs to lose to be back to a normal BMI - and I am 43.
I am so terrified of getting this illness given my family history.
Please someone tell me I can avoid it altogether if I BEHAVE long term - per diabetes guidelines.
Thank you all.
2
Replies
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Type two diabetes is largely due to lifestyle. YES you can avoid it by staying thin and active, keep watching your blood sugar and be reasonable with your diet.
No idea what your actual odds are, or whether that is even possible to calculate. Talk to your doctor. But yes it's avoidable. No diabetes at all among the old people in my family or that of my fiance or the ex, except for the one guy who is obese. That's just lifestyle, they are active. Some thin, some average, some sort of padded, no diabetes.11 -
While there is a hereditary component, type II diabetes is largely a matter of lifestyle.6
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Only when it comes to type 1. - Genetics will win regardless of any lifestyle management with that one.
As @robininfl pointed out, it's largely lifestyle-dependent, something that's strongly passed down from our parents
by learned-by-exampled type thing. I think if you are genetically predisposed to have Type 2, then you could avoid it, or stave it off for much longer by lifestyle. That is, maintaining healthy body weight, saying lean and with regular exercise can keep your body insulin-sensitive.3 -
Also, low-carb isn't the focus; it should be regular exercise and healthy body fat % (lack of abdominal obesity is the ultimate goal).10
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You can't 100% guarantee you won't get it, but you can reduce your chances in a major way. Very few thinner people are diagnosed with type 2 diabetes. It is a matter of keeping your weight down and not eating an excess of sugar and carbs.
It is possible you could still draw the really short straw, but eating well and staying fit is like the difference between playing Russian Roulette with 1 bullet in the revolver or 5.4 -
Hey there,
Disclaimer: I am not a medical professional. I am an MPH who studies health statistics, and who has lots of personal family experience with diabetes.
I imagine you are talking, in both cases, about Type 2 diabetes. Type 2 makes up about 90-95% of diabetes cases in the world. (Type 1 used to be typically referred to as "child onset" before more and more kids started getting Type 2).
First of all, I want to tell you that there is absolutely no way to properly, without fail, "predict" your personal, individual, health outcome in life. Probabilities (just like prognoses) are just educated estimates...they compare the metrics known about YOU to those known about the GENERAL POPULATION, and make a rough estimate based on the disease rate that people LIKE YOU suffer from. I could tell you that you have a 20% chance of getting Type 2 diabetes, or I could tell you that you have a 95% chance of getting diabetes, and you could STILL end up with it, or without it. You have absolutely no idea on which side of that statistic you will fall into.
Second, you have to understand that 22%-33% of the ENTIRE adult population older than 65 (of the US at least, and it is similar in other countries) has Type 2 diabetes [http://care.diabetesjournals.org/content/35/12/2650]. These rates have only increased with increasingly obese population, HOWEVER, one can be slim, active, eat "perfectly," and still get Type 2 diabetes at this age. Some of it may be related to genetic (familial) predisposition. Since both your parents have it, yet both seem to also be obese/sedentary/bad-eaters, then you are not sure which one. It could be that your family has it solely because of their behaviors. It could ALSO be that their behaviors "interact" with genetic pre-determination for diabetes, which would be a double whammy. Either way, you have no clue.
Third, Type 2 diabetes is a symptom. The disease itself is high blood sugar. Things that lead to high blood sugar and therefore to Type 2 diabetes are: fatty liver, stress, genetics, inflammation, auto-immunity. Studies also suggest that just having a "low BMI" is not actually the most important. You want to be metabolically healthy, which means when you DO have fat, have the RIGHT KINDS. Work out your core. Balance your foods.
TL;DR: My non-medically-trained advice? You can't calculate your personal chances with any kind of guarantee. Eating well and staying active is always a good thing. Diabetes "prevention" shouldn't be your only goal...there is also delaying onset in the first place, and delaying the complications (eye disease, blindness, limb loss, kidney failure, etc) if you do get it. Eating well and exercising is quite likely to do this, if not 'prevent' it all together. It will very likely increase the number of quality life years you have on this crazy planet. There are many cardiovascular and other diseases (cancer, stroke, etc) in addition to diabetes that you can prevent by eating well and exercising and, oddly enough, not smoking.
TL;DR the TL;DR - eat well. exercise. don't stress too much. don't smoke cigarettes. stress is horrible for your physical health. take care of your parents.
Here are some more resources:
https://www.niddk.nih.gov/health-information/health-topics/Diabetes/type-2-diabetes-taking-steps-lower-your-risk-diabetes/Pages/index.aspx
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I'm type 2. I avoid grain, including added sugar, and oils.2
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Most of the "type II" people ate themselves into diabetes. That can be avoided, of course. That doesn't mean tha everyone can avoid being diabetic. Not that we know of, anyway.2
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Your risk will be lowered immensely, but if diabetes is genetic in your family, there will always be a risk versus those who don't have a history of it in their families.
A.C.E. Certified Personal and Group Fitness Trainer
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Been in fitness for 30 years and have studied kinesiology and nutrition
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Drop the whites, sugar..flour...do enjoy healthy fats like olive oil, avocado. My risk level via family history (like yours) is strong, my choice is to eat LcHf--i've never had an elevated blood sugar even once.
Rice quickly elevates blood sugar, my choice is not to eat rice, even the so called healthier brown breads and grains i avoid. Instead i do enjoy a vast array of all colors of vegetables; red peppers, yellow peppers, brussel sprouts, spinach, really all the leafy greens along with moderate protein.
Good Luck and yes, drop the extra pounds in the manner you choose.4 -
You may have a genetic predisposition. You MAY delay onset with lifestyle changes. Ever since I was diagnosed pre-diabetic l have looked at it as a lifetime condition. In remission right now from significant weight loss.
I still eat like a diabetic. Lots of veggies with my meals, portioned protein, enough protein at my meals.2 -
Yes and no. Thin people who exercise and eat right can develop diabetes 2. You're still improving your chances of not getting it by exercising, eating right, and maintaining a healthy body composition.5
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Every single person in my family who is a descendant of my maternal grandfather who is my age or older has diabetes - diagnosed in the 5th or 6th decade of life. Period. Some of us are/were overweight or obese - others are (and have always been) skinny as rails. Most of us were and are physically active.
Personally, I was obese at diagnosis - but generally physically active (I ride my bike 150 miles over 2 days every summer without significant effort). I am currently normal weight. My blood glucose has been in the normal ranges for the vast majority of the time since 3 days after diagnosis, controlled by limiting my carb intake (I had my blood glucose in the normal range before I lost a single pound). I lost around 50 lbs, without any change at all in insulin resistance. It changed only when I went on an extremely calorie restricted diet that mimics the post-bariatric surgery diet (both of which has been shown in small tests to reverse diabetes). I currently (via the gold-standard oral glucose tolerance test) test as pre-diabetic.
That said, when I consume more than 20 carbs in a 3 hour period, it is clear that my insulin resistance has not changed significantly, despite a weight loss of (now) 65 lbs. I didn't really expect it to - since it is clear from my family history that our diabetes is not significantly linked to lifestyle (weight or exercise).
It is highly likely there are different varieties of Type 2 diabetes. Some are weight/activity dependent - others aren't. I happen to be blessed with one that is only loosely (if at all) linked to weight.
I would encourage you to limit your carb intake if you are serious about trying to avoid diabetes. Ignore the ADA guidelines (which push at least 150 carbs, often more, a day). Once I am done playing with cancer (I had to put eating at a calorie deficit on a hold while undergoing cancer treatment), I will return to the extremely calorie restricted diet for up to 8 weeks in an attempt to nudge my metabolism back to non-diabetic. If I can alter my insulin resistance enough to get back to "normal," rather than diabetic, going forward I would limit my carbs to fewer than 100 a day.
Bottom line - all carbs ultimately turn into glucose. excess glucose is stored as glycogen for future use in the liver. The less you have stored in your liver, the healthier your glucose processing metabolism is, and the less likely you are to be heading toward diabetes.13 -
Thank you, all.
Your answers helped - and without a doubt, I know that the changes in lifestyle compared to my 30's (when I was trying to build a career, raising small children and stressing like a maniac, including emotional eating) - can never happen again.
Since I turned 40, 3 years ago - I have been doing much better, with some lapses here and there.
To address some of the questions/comments above:
- My family history of diabetes (yes, it is Type 2) is limited to my parents (mainly my mom, clear diabetic, and my dad - pre-diabetic/borderline). Nobody else in our family has ever been diagnosed with it.
All of my grandparents lived in their very late 80's or 90's and grandfather on father's side to 99. They were all active because they had to be living under communism. No cars, walking everywhere, only basic, 100% natural/organic food available, no fun snackies, extremely little processed food etc.
My parents, however, became sedentary after retirement and when the market was invaded by processed food, post-socialism, they went to town.
My mom ate a lot emotionally, until she reached about 250-270 lbs at 5'3" height.
Given this background, I hope that perhaps I can dodge it with lifestyle, having caught better awareness times.
- My other medical tests are very nice, including cholesterol and tryglicerides which my doctor gushes over every time. Of course, she never said anything bad about blood sugar either - with 87 and 84 fasting glucose on the most recent annual physicals (lab results) and an A1C of 5.4 (meh!).
- Granted, I was lighter last year and now I am kind of scared about the numbers that will come out in August when I have my yearly physical again - with about 15 lbs extra.Drop the whites, sugar..flour...do enjoy healthy fats like olive oil, avocado. My risk level via family history (like yours) is strong, my choice is to eat LcHf--i've never had an elevated blood sugar even once.
Rice quickly elevates blood sugar, my choice is not to eat rice, even the so called healthier brown breads and grains i avoid. Instead i do enjoy a vast array of all colors of vegetables; red peppers, yellow peppers, brussel sprouts, spinach, really all the leafy greens along with moderate protein.
Good Luck and yes, drop the extra pounds in the manner you choose.
What is LcHf, Linia?
I already try to do everything you mentioned. Well...in my good, "aware", "good control" periods. I did have relapses into "whatever food, little exercise" over the past few years though.
So I have not been perfect all the time - but generally, I DO aim to avoid white, processed carbs.
I myself have never had an officially elevated blood sugar at the lab, but my home Relion (which apparently overestimates values) has shown , has been knows to show some values into 100's, one or two times.
On average, hwoever, I show upper 80's-mid 90's on my home testers. At the doctor's lab, I come out in the mid 80's. This year (August) I am bracing myself because I weigh at least 10 lbs more than last year when I had my physical. :-(I would encourage you to limit your carb intake if you are serious about trying to avoid diabetes. Ignore the ADA guidelines (which push at least 150 carbs, often more, a day). Once I am done playing with cancer (I had to put eating at a calorie deficit on a hold while undergoing cancer treatment), I will return to the extremely calorie restricted diet for up to 8 weeks in an attempt to nudge my metabolism back to non-diabetic. If I can alter my insulin resistance enough to get back to "normal," rather than diabetic, going forward I would limit my carbs to fewer than 100 a day.
If you drastically limit carbs, even good ones such as those in beans, fruit, some veggies, etc...I suppose then you eat a lot of protein?
I try to focus on veggies and greens (including a daily green smoothie), nuts and some clean sources of meat (grass fed beef, free-range chicken, organic rarely due to expense, and fish).
I do have about once slice of whole grain bread a day. Sometimes very few no-salt, organic chips just so I can dip into guacamole, which otherwise makes me sick.
I do try to limit the carbs as much as I can ...but I don't think I can ban them altogether.
Regarding non-diagnosed people eating like a diabetic, I understand the general consensus is that everyone should really eat like a diabetic anyway.
The question is...if those of us with family history, predisposition, blood sugar creeping into 90's...do so - will we be able to prevent with diet, exercise and monitoring?
Exercise doesn't come naturally to me....or with those proverbial serotonins/highs/whatever. I am darn exhausted all the time and my muscles hurt.
I make serious efforts to do it - not because I am very heavy but simply because I am naturally low energy and I like to sit and think/read, rather than move around and do. :-)
I even once had some kind of test which came out very low and that apparently indicates a genetic and rare tendency towards low energy or something like that. Dr. said nothing of it but that was quite intriguing to me after I read more about it.
So knowing that all this exercise effort might still not work to prevent the illness - can be very disheartening.
I just hope those estimations that say people can DRAMATICALLY lower the risk with diet, exercise and normal BMI are true. I understand risk cannot be guaranteed to be zero...but still.
As for cancer, I don't have it in my family, but the word itself sends shivers down my spine.
Then again, I suffer from major health-related anxiety (formerly known as hypochondria :-)).
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Higher than normal blood sugar (not high enough for a diagnosis of diabetes) runs in my family, and I have it to some extent even though I'm only 22. While it hasn't been 100% confirmed that there is no autoimmune component to my family history, one thing I can say is that weight and activity level are mostly irrelevant in my family history. So it appears as though carb intake is more of a factor in my case.
I do think that it would be prudent to keep an eye on your carb intake, which it sounds like you are already doing.0 -
ForecasterJason wrote: »Higher than normal blood sugar (not high enough for a diagnosis of diabetes) runs in my family, and I have it to some extent even though I'm only 22. While it hasn't been 100% confirmed that there is no autoimmune component to my family history, one thing I can say is that weight and activity level are mostly irrelevant in my family history. So it appears as though carb intake is more of a factor in my case.
I do think that it would be prudent to keep an eye on your carb intake, which it sounds like you are already doing.
Thank you, Jason . Definitely keeping a tight eye on the carbs.
Do you find weights help?
I wanted to add that I just came back from the gym where I did some slightly more intensive than normal weight lifting, as well as some brisk walking to and from the gym - and after this, I tested my blood sugar on Relion.
I was floored to see it at 76.
It is amazing what weight lifting can do for blood sugar. I had noticed such episodes before after weight lifting - my blood sugar goes down significantly (in the low 80's...and now mid 70's).
I could have watched that number on the Relion screen forever! :-)
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LCHF is Low Carb High Fat. Generally, the "High Fat" is superfluous as "Low Carb" is enough of a code word to identify adherents.0
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Type 1 diabetes requires both the HLA genes (on chromosome 6) AND an auto-immune trigger. Obesity makes no difference.
Type 2 diabetes (this is probably what you are talking about, and I suggest changing the name of type 1 diabetes to avoid confusion when people say "diabetes") is often discussed as being "genetic," but there hasn't been a gene identified for most cases... instead, there are sometimes genes identified that relate to obesity due to various indirect causes, and obesity often leads to metabolic disorders, including type 2 diabetes.
The exception that doesn't matter in your case, but is an interesting study: In a very few type 2 cases (you are more than twice as likely to have both the genes and the auto-immune trigger for type 1 than you are to have the type 2 genes I'm about to discuss), type 2 is genetic. But it isn't exactly the same disease as most type 2's experience. The way it works is more like type 1 than type 2, though the symptoms look like type 2, the actual cause is different than most. Specifically, most type 2's don't use insulin efficiently (because we are fat, to be less technical). That isn't genetic. Often people will say "I don't make enough insulin" and I've even heard of dr.'s using this explanation, though that isn't quite right. In fact, they don't make enough insulin only because they don't use it properly. If your car should get 25 mpg but there is something wrong with the engine and it is only getting 10 mpg, would you say that you didn't buy enough gas or that your car is not using gas efficiently? Technically both are correct, but you did buy enough gas for what it should have used. In almost all type 2's, the pancreas makes enough insulin and is just not using it efficiently. In a very small group of type 2's, the pancreas really does not make enough insulin... and those type 2's can legitimately blame bad genes.6 -
There was literally a study about perhaps it being more to do with gut flora? That said, maybe its high sugar foods that are causing the environment for this, that said, its always good to not be squish!
I eat low GI/Keto, and I feel much healthier for it
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So Midwesterner,
How would I know what type of Type2 is likely in my family hisory ?
With both of my parents, I strongly suspect just lifestyle factors - because there was no trace of diabetes in the family before them.
When diagnosed, my mom had become obese and was eating emotionally (a lot) without any exercise other than some trips to the market. Her mother and sisters were never anywhere close to diabetes.
She also had a terrible doctor who only mentioned the word diabetes when she found her blood sugar in the 300's. She had found it well ino the diabetic range before but all she told my mom at that time was to "watch the bread" - no diagnosis. A year later, with values in the 300's the dr. Panicked and only then she told my mom she had diabetes. In the US, she would have had the living lights sued out of her, but in my home country, the suing thing doesn't work.
My dad comes from great genes, everyone in his family lives close to 100 (father 99, mother 90, aunts 95+). He is 71 now and even with a largely sedentary lifestyle and eating whatever he wants (including sweets and animal fat), he is still only "prediabetic". He also smoked for decades but quit about 10 years ago. I have a feeling that if both had had better lifestyles earlier, they would not have developed type 2 and pre-diabetes, respectively.
So I keep hoping its a type 2 I can avoid, now that we all know better.
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