Summary evaluation and suggestions for diabetes prevention

As of 2024, domestic evidence-based medicine data shows that more than 80% of type 2 diabetes can be delayed or even avoided through effective intervention. There is no absolutely unified standard for the core logic of prevention. The benefits of individualized lifestyle adjustments are much higher than any health products or special effects programs. The consensus on intervention among different academic schools far outweighs the differences.

I have worked in the chronic disease management position at a community health service center for four years. I have followed up on 217 families at high risk of diabetes. I have seen too many people who have taken detours, and I have also seen many ordinary people who control their blood sugar steadily. In fact, there is no completely unified intervention standard for diabetes prevention in the academic community: the traditional guidelines of endocrinology departments tend to "control total caloric intake + 150 minutes of moderate-intensity exercise per week + blood sugar screening at least once a year". The core is to maintain energy balance steadily; many researchers in the field of sports medicine believe that They pay more attention to the role of muscle mass. I believe that as long as the skeletal muscle mass is up to standard and the insulin sensitivity is sufficient, even eating high-sugar foods occasionally will not be too risky. I met a fitness coach last year. Both of his parents are diabetic. He also likes to drink iced Coke, but his body fat rate remains at about 15% all year round for 3 consecutive years. The annual glycated hemoglobin is around 5.2%, which is completely within the normal range. There is also a debate between low-carb and low-fat schools in the nutrition world. The former advocates reducing the daily carbohydrate energy supply ratio to less than 40%, while the latter recommends controlling fat intake and eating more whole grains. The two aunts I followed up tried two plans respectively, and both of them were successful. Within half a year, the fasting blood sugar dropped from 6.2mmol/L to about 5.5mmol/L. The only difference was that the aunt who took the low-carbohydrate route was often constipated during that time, while the aunt who took the low-fat route always felt hungry. In the end, both of them adjusted their plans and found a comfortable balance point before sticking to it for a long time.

When many people hear that they need to prevent diabetes, their first reaction is to "quit sugar." Last time, there was a 52-year-old Uncle Zhang. After he was found to have impaired fasting blood sugar, he threw away all the honey and cakes at home, drank sugar-free Coke every day, and ate braised pork every meal. Little do they know that the fat in braised pork and the sugar substitute in sugar-free Coke can also affect blood sugar metabolism, as well as those health products that are said to "lower blood sugar", such as bitter melon and mulberry leaf tea. I have seen too many people spend a lot of money to buy them. After half a year of eating, their blood sugar did not drop, but their stomachs were damaged. Currently, no health products have been proven to be a substitute for lifestyle intervention in preventing diabetes. This is a definite conclusion. Some people also say that diabetes is a "genetic disease" that parents cannot escape. In fact, it is not true. Heredity only gives you a "susceptibility buff". As long as you don't stay up late every day, eat high-fat and high-sugar meals, and are too lazy to go downstairs, you will most likely not get the disease.

To be honest, I have seen so many cases, and intervention programs that can be sustained for a long time are effective. If you don't like to exercise, there is really no need to force yourself to run 5 kilometers every day. Even if you walk 2,000 more steps a day, stand up and stretch for two minutes after sitting for a long time, the long-term benefits will be considerable. You don't need to count calories every time you eat. Remember a simple principle: eat vegetables first, then meat, and lastly staple food. The rate of blood sugar rise will be much slower. If you really like sweets, you don't have to give up completely. If you drink a cup of milk tea in the afternoon, eat half a bowl of rice less for dinner, and walk for 10 minutes more after meals, it's totally fine. Oh, by the way, high-risk groups should pay more attention, such as those whose parents have diabetes, have a BMI over 24, and usually sit for a long time. Don’t just check fasting blood sugar. It is best to check glycated hemoglobin once every six months. It can reflect your average blood sugar level in the past three months, which is more accurate than pricking your finger occasionally.

In fact, after having been managing chronic diseases for so long, my biggest feeling is that diabetes prevention has never been an ascetic life. There is no need to put a lot of shackles on yourself. You don’t have to completely give up your favorite milk tea and hot pot. As long as you grasp the appropriateness and integrate small changes into your daily life, it is enough. Most of those programs that require you to completely quit all "happy foods" are difficult to stick to, and instead tend to lead to greater blood sugar fluctuations due to rebound. Of course, if you have suffered from polydipsia, polyuria, and sudden weight loss, don’t blindly browse popular science on the Internet. Go directly to the hospital to see an endocrinologist, which is more reliable than anything else.