Am I at risk for type 2 diabetes?

Taking Steps to Lower Your Risk 

of Getting Diabetes

National Diabetes Information 

Clearinghouse

Am I at risk for type 2 diabetes? 

Taking Steps to Lower Your Risk of 

Getting Diabetes 

Contents

What is type 2 diabetes? ................................................... 1 

Can type 2 diabetes be delayed or prevented? ............... 3 

Other Types of Diabetes ................................................... 7 

What are the signs and symptoms of 

type 2 diabetes? ................................................................. 9 

Should I be tested for diabetes and prediabetes? ........ 10 

What does having prediabetes mean? ........................... 11 

What factors increase my risk for 

type 2 diabetes? ............................................................... 11 

Does sleep matter?........................................................... 13 

How can I reduce my risk for type 2 diabetes?.............. 14 

Making Changes to Lower My Risk .............................. 16 

Eating, Diet, and Nutrition ............................................. 20 

Measure Your Waist........................................................ 21 

Body Mass Index (BMI) .................................................. 24 

Hope through Research ................................................. 30 

For More Information .................................................... 31 

Acknowledgments ............................................................ 32 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is type 2 diabetes? 

Type 2 diabetes, formerly called adult-onset diabetes, is 

the most common type of diabetes. About 95 percent of 

people with diabetes have type 2. People can develop 

type 2 diabetes at any age, even during childhood. 

However, this type of diabetes develops most often 

in middle-aged and older people. People who are 

overweight and inactive are also more likely to develop 

type 2 diabetes. 

In type 2 and other types of diabetes, you have too 

much glucose, also called sugar, in your blood. People 

with diabetes have problems converting food to energy. 

After a meal, food is broken down into glucose, which 

is carried by your blood to cells throughout your body. 

With the help of the hormone insulin, cells absorb 

glucose from your blood and use it for energy. Insulin 

is made in the pancreas, an organ located behind the 

stomach. 

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Liver 

Pancreas 

Insulin is made in the pancreas. 

Type 2 diabetes usually begins with insulin resistance, a 

condition linked to excess weight in which your body’s 

cells do not use insulin properly. As a result, your body 

needs more insulin to help glucose enter cells. At first, 

your pancreas keeps up with the added demand by 

producing more insulin. But in time, your pancreas loses 

its ability to produce enough insulin, and blood glucose 

levels rise. 

Over time, high blood glucose damages nerves and 

blood vessels, leading to problems such as heart disease, 

stroke, kidney disease, blindness, dental disease, and 

amputations. Other problems of diabetes may include 

increased risk of getting other diseases, loss of mobility 

with aging, depression, and pregnancy problems. 

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Treatment includes taking diabetes medicines, making 

wise food choices, being physically active on a regular 

basis, controlling blood pressure and cholesterol, and for 

some, taking aspirin daily. 

Can type 2 diabetes be delayed or 

prevented?

Yes. The results of the Diabetes Prevention Program 

(DPP) proved that weight loss through moderate diet 

changes and physical activity can delay or prevent type 2 

diabetes. The DPP was a federally funded study of 3,234 

people at high risk for diabetes. This study showed that a 

5- to 7-percent weight loss, which for a 200-pound person 

would be 10 to 14 pounds, slowed development of type 2 

diabetes. 

People at High Risk for Diabetes 

DPP study participants were overweight and had higher 

than normal levels of blood glucose, a condition called 

prediabetes. Many had family members with type 2 

diabetes. Prediabetes, obesity, and a family history 

of diabetes are strong risk factors for type 2 diabetes. 

About half of the DPP participants were from minority 

groups with high rates of diabetes, including African 

Americans, Alaska Natives, American Indians, Asian 

Americans, Hispanics/Latinos, and Pacific Islander 

Americans. 

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DPP participants also included others at high risk for 

developing type 2 diabetes, such as women with a history 

of gestational diabetes and people age 60 and older. 

Approaches to Preventing Diabetes 

The DPP tested three approaches to preventing diabetes: 

l	 Making lifestyle changes. People in the lifestyle 

change group exercised, usually by walking 5 days a 

week for about 30 minutes a day, and lowered their 

intake of fat and calories. 

l	 Taking the diabetes medicine metformin. Those 

who took metformin also received information about 

physical activity and diet. 

l	 Receiving education about diabetes. The third group 

only received information about physical activity and 

diet and took a placebo—a pill without medicine in 

it. 

People in the lifestyle change group showed the best 

outcomes. But people who took metformin also 

benefited. The results showed that by losing an average 

of 15 pounds in the first year of the study, people in the 

lifestyle change group reduced their risk of developing 

type 2 diabetes by 58 percent over 3 years. Lifestyle 

change was even more effective in those age 60 and 

older. People in this group reduced their risk by 

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71 percent. But people in the metformin group also 

benefited, reducing their risk by 31 percent. More 

information about the DPP, funded under National 

Institutes of Health (NIH) clinical trial number 

NCT00004992, is available at www.bsc.gwu.edu/dpp. 

Lasting Results 

The Diabetes Prevention Program Outcomes Study 

(DPPOS) has shown that the benefits of weight loss and 

metformin last for at least 10 years. The DPPOS has 

continued to follow most DPP participants since the DPP 

ended in 2001. The DPPOS showed that 10 years after 

enrolling in the DPP, 

l	 people in the lifestyle change group reduced their 

risk for developing diabetes by 34 percent 

l	 those in the lifestyle change group age 60 or older 

had even greater benefit, reducing their risk of 

developing diabetes by 49 percent 

l	 participants in the lifestyle change group also had 

fewer heart and blood vessel disease risk factors, 

including lower blood pressure and triglyceride 

levels, even though they took fewer medicines to 

control their heart disease risk 

l	 the metformin group reduced the risk of developing 

diabetes by 18 percent 

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Even though controlling your weight with lifestyle 

changes is challenging, it produces long-term health 

rewards by lowering your risk for type 2 diabetes, 

lowering your blood glucose levels, and reducing other 

heart disease risk factors. More information about 

the DPPOS, funded under NIH clinical trial number 

NCT00038727, can be found at www.bsc.gwu.edu/dpp. 

People in the lifestyle change 

group exercised, usually by 

walking 5 days a week for about 

30 minutes a day. 

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Other Types of Diabetes 

In addition to type 2, the other main types of 

diabetes are type 1 diabetes and gestational 

diabetes. 

Type 1 Diabetes 

Type 1 diabetes, formerly called juvenile diabetes, 

is usually first diagnosed in children, teenagers, and 

young adults. In this type of diabetes, your pancreas 

can no longer make insulin because your body’s 

immune system has attacked and destroyed the cells 

that make it. Treatment for type 1 diabetes includes 

taking insulin shots or using an insulin pump, 

making wise food choices, being physically active 

on a regular basis, controlling blood pressure and 

cholesterol, and, for some, taking aspirin daily. 

Gestational Diabetes 

Gestational diabetes is a type of diabetes that 

develops only during pregnancy. Hormones 

produced by your placenta and other pregnancyrelated factors contribute to insulin resistance, which 

occurs in all women during late pregnancy. Insulin 

resistance increases the amount of insulin needed to 

control blood glucose levels. If your pancreas can’t 

produce enough insulin, gestational diabetes occurs. 

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As with type 2 diabetes, excess weight is linked to 

gestational diabetes. Overweight or obese women 

are at particularly high risk for gestational diabetes 

because they start pregnancy with a higher need 

for insulin due to insulin resistance. Excessive 

weight gain during pregnancy may also increase 

risk. Gestational diabetes occurs more often in 

some ethnic groups and among women with a family 

history of diabetes. 

Although gestational diabetes usually goes away 

after the baby is born, a woman who has had 

gestational diabetes is more likely to develop type 2 

diabetes later in life. Babies born to mothers who 

had gestational diabetes are also more likely to 

develop obesity and type 2 diabetes as they grow up. 

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What are the signs and symptoms of 

type 2 diabetes? 

The signs and symptoms of type 2 diabetes can be so mild 

that you might not even notice them. Nearly 7 million 

people in the United States have type 2 diabetes and 

don’t know they have the disease. Many have no signs 

or symptoms. Some people have symptoms but do not 

suspect diabetes. 

Symptoms include 

l increased thirst 

l increased hunger 

l fatigue 

l increased urination, especially at night 

l unexplained weight loss 

l blurred vision 

l numbness or tingling in the feet or hands

l sores that do not heal 

Many people do not find out they have the disease until 

they have diabetes problems, such as blurred vision 

or heart trouble. If you find out early that you have 

diabetes, you can get treatment to prevent damage to 

your body. 

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Should I be tested for diabetes and 

prediabetes? 

Anyone 45 years of age or older should consider getting 

tested for diabetes and prediabetes. If you are 45 or 

older and overweight—see the body mass index (BMI) 

chart on pages 24 and 25—getting tested is strongly 

recommended. If you are younger than 45, overweight, 

and have one or more other risk factors, you should 

consider getting tested. Ask your doctor for an A1C test, 

a fasting blood glucose test, or an oral glucose tolerance 

test. 

Your doctor will tell you if you have normal blood 

glucose, diabetes, or prediabetes. If you are told you 

have prediabetes, take steps to prevent type 2 diabetes. 

And ask your doctor if you should be tested again in 

1 year.

Prediabetes Caution: Take steps to prevent type 2 diabetes now. 

Diabetes 

Normal 

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What does having prediabetes mean? 

Having prediabetes means your blood glucose is higher 

than normal but not high enough to be diagnosed as 

diabetes. In 2009, at least 78 million American adults 

were estimated to have prediabetes. Having prediabetes 

also means you are at risk for getting type 2 diabetes 

and heart disease. However, you can reduce your risk of 

getting diabetes and even return blood glucose levels to 

normal by losing a little weight through healthy eating 

and being more physically active. 

What factors increase my risk for type 2 

diabetes?

To find out your risk for type 2 diabetes, check each item 

that applies to you. 

q I am age 45 or older. 

q I am overweight or obese. 

q I have a parent, brother, or sister with diabetes. 

q My family background is African American, Alaska 

Native, American Indian, Asian American, Hispanic/ 

Latino, or Pacific Islander American. 

q I have had gestational diabetes. 

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q I gave birth to at least one baby weighing more than 

9 pounds. 

q My blood pressure is 140/90 or higher, or I have 

been told that I have high blood pressure. 

q My cholesterol levels are higher than normal. My 

HDL, or good, cholesterol is below 35, or my 

triglyceride level is above 250. 

q I am fairly inactive. 

q I have polycystic ovary syndrome, also called PCOS. 

q On previous testing, I had prediabetes—an A1C 

level of 5.7 to 6.4 percent, impaired fasting glucose 

(IFG), or impaired glucose tolerance (IGT). 

q I have other clinical conditions associated with 

insulin resistance, such as a condition called 

acanthosis nigricans, characterized by a dark, velvety 

rash around my neck or armpits. 

q I have a history of cardiovascular disease. 

The more items you checked, the higher your risk. 

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Does sleep matter? 

Yes. Studies show that untreated sleep problems, 

especially sleep apnea, can increase the risk of 

type 2 diabetes. Sleep apnea is a common disorder 

in which you have pauses in breathing or shallow 

breaths while you sleep. Most people who have 

sleep apnea don’t know they have it and it often 

goes undiagnosed. Night shift workers who have 

problems with sleepiness may also be at increased 

risk for obesity and type 2 diabetes. 

If you think you might have sleep problems, ask 

your doctor for help. More information about sleep 

problems is available from the National Heart Lung 

and Blood Institute at www.nhlbi.nih.gov/health/ 

public/sleep. 

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How can I reduce my risk for type 2 

diabetes?

You can do a lot to reduce your risk of getting type 2 

diabetes. Being more physically active, reducing fat 

and calorie intake, and losing a little weight can help 

you lower your chances of developing type 2 diabetes. 

Taking the diabetes medicine metformin can also 

reduce risk, particularly in younger and heavier people 

with prediabetes and women who have had gestational 

diabetes. Lowering blood pressure and cholesterol levels 

also helps you stay healthy. 

If you are overweight, then take these steps: 

l	 Reach and maintain a reasonable body weight (see 

page 20). Even a 10 or 15 pound weight loss makes a 

big difference. 

l	 Make wise food choices most of the time (see 

page 27). 

l	 Be physically active every day (see page 17). 

If you are fairly inactive, then take this step: 

l	 Be physically active every day (see page 17). 

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If your blood pressure is too high, then take these steps: 

l	 Reach and maintain a reasonable body weight (see 

page 20). 

l	 Make wise food choices most of the time (see 

page 27). 

l	 Reduce your sodium and alcohol intake (see 

page 28). 

l	 Be physically active every day (see page 17). 

l	 Talk with your doctor about whether you need 

medicine to control your blood pressure (see 

page 20). 

If your cholesterol or triglyceride levels are too high, 

then take these steps: 

l	 Make wise food choices most of the time (see 

page 27). 

l	 Be physically active every day (see page 17). 

l	 Talk with your doctor about whether you need 

medicine to control your cholesterol levels (see 

page 20). 

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Making Changes to Lower My Risk 

Making big changes in your life is hard, especially if you 

are faced with more than one change. You can make it 

easier by taking these steps: 

l	 Make a plan to change behavior. 

l	 Decide exactly what you will do and give yourself a 

time frame. 

l	 Plan what you need to get ready. 

l	 Track your goals and activity on a food and activity 

tracker, available at www.ndep.nih.gov/media/ 

gp_foodacttracker.pdf 

l	 Think about what might prevent you from reaching 

your goals. 

Your doctor, a dietitian, or a counselor can 

help you make a plan. 

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l	 Find family and friends who will support and 

encourage you. 

l	 Decide how you will reward yourself—a shopping 

trip, movie tickets, an afternoon in the park—when 

you do what you have planned. 

Your doctor, a dietitian, or a counselor can help you 

make a plan. 

Be Physically Active Every Day 

Regular physical activity tackles several risk factors at 

once. Activity helps you lose weight; keeps your blood 

glucose, blood pressure, and cholesterol under control; 

and helps your body use insulin. People in the DPP 

who were physically active for 30 minutes a day, 5 days a 

week, reduced their risk of type 2 diabetes. Many chose 

brisk walking as their physical activity. 

If you are not fairly active, you should start slowly. First, 

talk with your doctor about what kinds of physical activity 

are safe for you. Make a plan to increase your activity 

level toward the goal of being active at least 30 minutes a 

day most days of the week. You can increase your level 

of physical activity in two main ways: 

1. Start an exercise program. 

2. Increase your daily activity. 

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Start an exercise program. Pick exercises that suit you. 

Find a friend to walk with you or join an exercise class 

that will help you keep going. 

l	 Do aerobic activities, which use your large muscles to 

make your heart beat faster. The large muscles are 

those of the upper and lower arms; upper and lower 

legs; and those that control head, shoulder, and hip 

movements. 

l	 Do activities to strengthen muscles and bone, such as 

lifting weights or sit-ups, two to three times a week. 

Find help—such as a video or a class—to learn how 

to do these exercises properly. 

Do activities to strengthen muscles 

and bone, such as lifting weights or 

sit-ups, two to three times a week. 

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Increase your daily activity. Choose activities you enjoy. 

You can work extra activity into your daily routine by 

doing the following: 

l	 Increase daily activity by decreasing time spent 

watching TV or at the computer. Set up a reminder 

on your computer to take an activity break. 

l	 Take the stairs rather than an elevator or escalator. 

l	 Park at the far end of the parking lot and walk. 

l	 Get off the bus a few stops early and walk the rest of 

the way. 

l	 Walk or bicycle whenever you can. 

Choose activities you enjoy. 

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Take Your Prescribed Medicines 

Some people need medicine to help control their blood 

pressure or cholesterol levels. If you do, take your 

medicines as directed. Ask your doctor if you should 

take metformin to prevent type 2 diabetes. Metformin 

is a medicine that makes insulin work better and can 

reduce the risk of type 2 diabetes. 

Eating, Diet, and Nutrition 

Your eating, diet, and nutrition choices play an 

important role in preventing or delaying diabetes. 

Follow the suggestions below to reach and maintain a 

reasonable weight and make wise food choices most of 

the time. Remember that it can take time to change 

your habits and be patient with yourself. You can also 

get help from a dietitian or join a weight-loss program to 

support you while you reach your goals. 

Reach and Maintain a Reasonable Body Weight 

Your weight affects your health in many ways. Being 

overweight can keep your body from making and using 

insulin properly. Excess body weight can also cause high 

blood pressure. Every pound you lose lowers your risk of 

getting diabetes. 

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In addition to weight, the location of excess fat on 

the body can be important. A waist measurement of 

40 inches or more for men and 35 inches or more for 

women is linked to insulin resistance and increases a 

person’s risk for type 2 diabetes. This is true even if your 

BMI falls within the normal range. 

Measure Your Waist 

To measure your waist, 

l place a tape measure around your bare 

abdomen just above your hip bone 

l make sure the tape is snug but isn’t digging into 

your skin and is parallel to the floor 

l relax, exhale, and measure 

Source: www.cdc.gov 

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Find Your BMI 

The BMI is a measure of body weight relative to height. 

The BMI can help you find out whether you are normal 

weight, overweight, or obese. Use the table on pages 24 

and 25 to find your BMI. 

l	 Find your height in the left-hand column. 

l	 Move across in the same row to the number closest 

to your weight. 

l	 The number at the top of that column is your BMI. 

Check the word above your BMI to see whether you 

are normal weight, overweight, or obese. 

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The BMI has certain limitations. The BMI may 

overestimate body fat in athletes and others who have 

a muscular build and underestimate body fat in older 

adults and others who have lost muscle. 

The BMI for children and teens must be determined 

based on age, height, weight, and sex. The Centers 

for Disease Control and Prevention (CDC) has 

information about BMI in children and teens, including 

a BMI calculator, at www.cdc.gov/nccdphp/dnpa/bmi. 

The CDC website also has a BMI calculator for 

adults. A BMI calculator from the NIH is available at 

www.nhlbisupport.com/bmi. 

The NIH also has a free smartphone app for calculating 

BMI. You can search “My BMI Calculator” on your 

phone to find the app. The app also provides links to 

information about steps you can take to bring your BMI 

into a healthy range. 

23 
 Body Mass Index (BMI)

24 25

Normal	 Overweight	 Obese	 Extreme Obesity 

BMI 19	 20	 21	 22	 23	 24	 25	 26	 27	 28	 29	 30	 31	 32	 33	 34	 35	 36	 37	 38	 39	 40	 41	 42	 43	 44	 45	 46	 47	 48	 49	 50	 51	 52	 53	 54 

Height	 

(inches) 

Body Weight	 

(pounds) 

58	 

59	 

60	 

61	 

62	 

63	 

64	 

65	 

66	 

67	 

68	 

69	 

70	 

71	 

72	 

73	 

74	 

75	 

76	 

91	 96	 100	 105	 110	 115	 119	 124	 129	 134	 138	 143	 148	 153	 158	 162	 167	 172	 177	 181	 186	 191	 196	 201	 205	 210	 215	 220	 224	 229	 234	 239	 244	 248	 253	 258 

94	 99	 104	 109	 114	 119	 124	 128	 133	 138	 143	 148	 153	 158	 163	 168	 173	 178	 183	 188	 193	 198	 203	 208	 212	 217	 222	 227	 232	 237	 242	 247	 252	 257	 262	 267 

97	 102	 107	 112	 118	 123	 128	 133	 138	 143	 148	 153	 158	 163	 168	 174	 179	 184	 189	 194	 199	 204	 209	 215	 220	 225	 230	 235	 240	 245	 250	 255	 261	 266	 271	 276 

100	 106	 111	 116	 122	 127	 132	 137	 143	 148	 153	 158	 164	 169	 174	 180	 185	 190	 195	 201	 206	 211	 217	 222	 227	 232	 238	 243	 248	 254	 259	 264	 269	 275	 280	 285 

104	 109	 115	 120	 126	 131	 136	 142	 147	 153	 158	 164	 169	 175	 180	 186	 191	 196	 202	 207	 213	 218	 224	 229	 235	 240	 246	 251	 256	 262	 267	 273	 278	 284	 289	 295 

107	 113	 118	 124	 130	 135	 141	 146	 152	 158	 163	 169	 175	 180	 186	 191	 197	 203	 208	 214	 220	 225	 231	 237	 242	 248	 254	 259	 265	 270	 278	 282	 287	 293	 299	 304 

110	 116	 122	 128	 134	 140	 145	 151	 157	 163	 169	 174	 180	 186	 192	 197	 204	 209	 215	 221	 227	 232	 238	 244	 250	 256	 262	 267	 273	 279	 285	 291	 296	 302	 308	 314 

114	 120	 126	 132	 138	 144	 150	 156	 162	 168	 174	 180	 186	 192	 198	 204	 210	 216	 222	 228	 234	 240	 246	 252	 258	 264	 270	 276	 282	 288	 294	 300	 306	 312	 318	 324 

118	 124	 130	 136	 142	 148	 155	 161	 167	 173	 179	 186	 192	 198	 204	 210	 216	 223	 229	 235	 241	 247	 253	 260	 266	 272	 278	 284	 291	 297	 303	 309	 315	 322	 328	 334 

121	 127	 134	 140	 146	 153	 159	 166	 172	 178	 185	 191	 198	 204	 211	 217	 223	 230	 236	 242	 249	 255	 261	 268	 274	 280	 287	 293	 299	 306	 312	 319	 325	 331	 338	 344 

125	 131	 138	 144	 151	 158	 164	 171	 177	 184	 190	 197	 203	 210	 216	 223	 230	 236	 243	 249	 256	 262	 269	 276	 282	 289	 295	 302	 308	 315	 322	 328	 335	 341	 348	 354 

128	 135	 142	 149	 155	 162	 169	 176	 182	 189	 196	 203	 209	 216	 223	 230	 236	 243	 250	 257	 263	 270	 277	 284	 291	 297	 304	 311	 318	 324	 331	 338	 345	 351	 358	 365 

132	 139	 146	 153	 160	 167	 174	 181	 188	 195	 202	 209	 216	 222	 229	 236	 243	 250	 257	 264	 271	 278	 285	 292	 299	 306	 313	 320	 327	 334	 341	 348	 355	 362	 369	 376 

136	 143	 150	 157	 165	 172	 179	 186	 193	 200	 208	 215	 222	 229	 236	 243	 250	 257	 265	 272	 279	 286	 293	 301	 308	 315	 322	 329	 338	 343	 351	 358	 365	 372	 379	 386 

140	 147	 154	 162	 169	 177	 184	 191	 199	 206	 213	 221	 228	 235	 242	 250	 258	 265	 272	 279	 287	 294	 302	 309	 316	 324	 331	 338	 346	 353	 361	 368	 375	 383	 390	 397 

144	 151	 159	 166	 174	 182	 189	 197	 204	 212	 219	 227	 235	 242	 250	 257	 265	 272	 280	 288	 295	 302	 310	 318	 325	 333	 340	 348	 355	 363	 371	 378	 386	 393	 401	 408 

148	 155	 163	 171	 179	 186	 194	 202	 210	 218	 225	 233	 241	 249	 256	 264	 272	 280	 287	 295	 303	 311	 319	 326	 334	 342	 350	 358	 365	 373	 381	 389	 396	 404	 412	 420 

152	 160	 168	 176	 184	 192	 200	 208	 216	 224	 232	 240	 248	 256	 264	 272	 279	 287	 295	 303	 311	 319	 327	 335	 343	 351	 359	 367	 375	 383	 391	 399	 407	 415	 423	 431 

156	 164	 172	 180	 189	 197	 205	 213	 221	 230	 238	 246	 254	 263	 271	 279	 287	 295	 304	 312	 320	 328	 336	 344	 353	 361	 369	 377	 385	 394	 402	 410	 418	 426	 435	 443 

Source: 		Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and 

Obesity in Adults: The Evidence Report. 		National Institutes of Health, 1998. 
 

 

 

 

 

 

 

 

 

 

 

 

If you are overweight or obese, choose sensible ways to 

get in shape: 

l	 Avoid crash diets. Instead, eat less of the foods you 

usually have. Limit the amount of fat you eat. 

l	 Increase your physical activity. Aim for at least 

30 minutes of physical activity most days of the week. 

l	 Set a reasonable weight-loss goal, such as losing 

1 pound a week. Aim for a long-term goal of losing 

5 to 7 percent of your total body weight. To estimate 

this amount in pounds, find the weight closest to 

yours on the chart below. Follow the row across to 

see how many pounds you need to lose. 

Your weight 

in pounds 

5 percent loss 

in pounds 

7 percent loss 

in pounds 

150 8 11 

175 9 12 

200 10 14 

225 11 16 

250 13 18 

275 14 19 

300 15 21 

325 16 23 

350 18 25 

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To find your exact weight loss goal, multiply .05 by your 

weight in pounds to find your 5 percent goal; multiply 

.07 by your weight to find your 7 percent goal. 

Make Wise Food Choices Most of the Time 

What you eat has a big effect on your health. By making 

wise food choices, you can help control your body weight, 

blood glucose, blood pressure, and cholesterol. 

l	 Take a look at the serving sizes of the foods you eat. 

Reduce serving sizes of main courses, meat, desserts, 

and other foods high in fat. Increase the amount 

of fruits and vegetables you eat at every meal. Try 

using a small plate. For more help with choosing 

serving sizes, see the United States Department of 

Agriculture’s website at www.choosemyplate.gov. 

Reduce foods high in fat and 

increase the amount of fruits and 

vegetables you eat at every meal. 

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l	 Limit your fat intake to about 25 percent of your 

total calories. For example, if your food choices add 

up to about 2,000 calories a day, try to eat no more 

than 56 grams of fat. Your doctor or a dietitian can 

help you figure out how much fat to have. You can 

also check food labels for fat content. 

l	 Limit your sodium intake to less than 

2,300 milligrams—about 1 teaspoon of salt—each 

day. 

l	 Talk with your doctor about whether you may drink 

alcoholic beverages. If you choose to drink alcoholic 

beverages, limit your intake to one drink for women 

or two drinks for men per day. 

l	 You may also wish to reduce the number of calories 

you have each day. People in the DPP lifestyle 

change group lowered their daily calorie total by 

an average of about 450 calories. Your doctor or 

dietitian can help you with a healthy eating plan that 

emphasizes weight loss. 

l	 Keep a food and physical activity log. Write down 

what you eat and how much physical activity you are 

getting. People who keep track are more successful 

in losing weight. 

l	 When you meet your goal, reward yourself with a 

nonfood item or activity, such as watching a movie. 

28 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dietary Supplements 

Vitamin D studies show a link between people’s ability 

to maintain healthy blood glucose levels and having 

enough vitamin D in their blood. However, studies to 

determine the proper vitamin D levels for people with 

diabetes and for preventing diabetes are ongoing; no 

special recommendations have been made about vitamin 

D levels or supplements for people with diabetes. 

Currently, the Institute of Medicine (IOM), the agency 

that recommends supplementation levels based on 

current science, provides the following guidelines for 

daily vitamin D intake: 

l	 People ages 1 to 70 years may require 

600 International Units (IUs)

l	 People age 71 and older may require as much as 

800 IUs

The IOM also recommended that no more than 

4,000 IUs of vitamin D be taken per day. 

To help ensure coordinated and safe care, you should 

discuss your use of complementary and alternative 

medicine practices, including your use of dietary 

supplements, with your doctor. 

More information about using dietary supplements 

to help with diabetes is available from the National 

Diabetes Information Clearinghouse at www.diabetes. 

niddk.nih.gov/dm/pubs/alternativetherapies/index.aspx. 

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Hope through Research 

The National Institute of Diabetes and Digestive and 

Kidney Diseases (NIDDK) conducts and supports research 

related to the causes, treatment, and prevention of diabetes. 

For example, clinical trials include The Avoiding Diabetes 

Thru Action Plan Targeting Pilot Randomized Control 

Trial (ADAPT). This trial is an innovative study that uses 

technology to affect lifestyle behavior change. This study is 

funded under NIH clinical trial number NCT01473654. 

We now know that many people can delay or prevent type 2 

diabetes through weight loss, regular physical activity, and 

lowering their intake of fat and calories. Researchers are 

working hard to understand the genetic and environmental 

factors that contribute to a person’s tendency to develop 

obesity, diabetes, and prediabetes. As researchers learn 

more about the molecular events that lead to diabetes, 

they will develop ways to prevent and cure different stages 

of this disease. Already, the DPP has shown that even in 

participants at higher genetic risk for type 2 diabetes, losing 

weight through lifestyle change lowered the risk of diabetes. 

DPP researchers continue to monitor DPP participants 

through the DPPOS to learn more about the study’s longterm effects. 

Participants in clinical trials can play a more active 

role in their own health care, gain access to new 

research treatments before they are widely available, 

and help others by contributing to medical research. 

For more information about current studies, visit 

www.ClinicalTrials.gov. 

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For More Information 

More information about insulin resistance, the DPP, and 

how to lower your risk for type 2 diabetes is available in 

the following publications: 

l Insulin Resistance and Prediabetes 

l Diabetes Prevention Program (DPP) 

These publications are available at www.diabetes.niddk. 

nih.gov or by calling 1–800–860–8747. 

As part of its Small Steps. Big Rewards. Prevent type 2 

Diabetes campaign, the National Diabetes Education 

Program (NDEP) offers several booklets about 

preventing type 2 diabetes, including information about 

setting goals, tracking progress, implementing a walking 

program, and finding additional resources. These 

materials are available at www.ndep.nih.gov or by calling 

the NDEP at 1–888–693–NDEP (1–888–693–6337). 

American Diabetes Association 

1701 North Beauregard Street 

Alexandria, VA 22311 

Phone: 1–800–DIABETES (1–800–342–2383) 

Fax: 703–549–6995 

Email: AskADA@diabetes.org 

Internet: www.diabetes.org 

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Acknowledgments 

Publications produced by the Clearinghouse are carefully 

reviewed by both NIDDK scientists and outside experts. 

This publication was originally reviewed by David G. 

Marrero, Ph.D., Indiana University School of Medicine, 

Diabetes Research and Training Center, and Michael 

L. Parchman, M.D., M.P.H., associate professor, 

Department of Family and Community Medicine, 

University of Texas Health Science Center. 

National Diabetes Education Program 

1 Diabetes Way 

Bethesda, MD 20814–9692 

Phone: 1–888–693–NDEP (1–888–693–6337) 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndep@mail.nih.gov 

Internet: www.ndep.nih.gov 

www.yourdiabetesinfo.org 

The National Diabetes Education Program is a federally 

funded program sponsored by the U.S. Department 

of Health and Human Services’ National Institutes 

of Health and the Centers for Disease Control and 

Prevention and includes over 200 partners at the federal, 

state, and local levels, working together to reduce the 

morbidity and mortality associated with diabetes. 

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National Diabetes Information 

Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162 

Fax: 703–738–4929

Email: ndic@info.niddk.nih.gov

Internet: www.diabetes.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC) is a service 

of the National Institute of Diabetes and Digestive and Kidney Diseases 

(NIDDK). The NIDDK is part of the National Institutes of Health of the 

U.S. Department of Health and Human Services. Established in 1978, the 

Clearinghouse provides information about diabetes to people with diabetes 

and to their families, health care professionals, and the public. The NDIC 

answers inquiries, develops and distributes publications, and works closely 

with professional and patient organizations and Government agencies to 

coordinate resources about diabetes. 

This publication is not copyrighted. The Clearinghouse encourages 

users of this publication to duplicate and distribute as many copies as 

desired. 

This publication is available at www.diabetes.niddk.nih.gov.

This publication may contain information about medications. When 

prepared, this publication included the most current information available. 

For updates or for questions about any medications, contact the U.S. Food 

and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463– 

6332) or visit www.fda.gov. Consult your health care provider for more 

information. 
NIH Publication No. 12–4805

June 2012

The NIDDK prints on recycled paper with bio-based ink.