Prevention strategies

1The Effectiveness of Type 2 Diabetes Prevention Strategies
Adrian Moreno
Nova Southeastern University
College of Health Care Sciences
Master of Health Science Program
MHS 5501- Epidemiology and Biostatistics
Dr. Carla Theresa Altomare
July 23, 2023
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The Effectiveness of Type 2 Diabetes Prevention Strategies
Type 2 diabetes mellitus (T2DM) stands as one of the most prevalent chronic metabolic
disorders affecting millions of individuals worldwide. According to the World Health
Organization, the number of persons living with T2DM rose from 108 million in 1980 to over
420 million in 2014 (WHO, 2023). In the U.S. more than 37 million (approximately 1 in 10 or
11.3% of the entire population) have diabetes and T2DM accounts for about 95% (CDC, 2023).
Persons of ages between 18 and 44, 45 and 64, and above age 65 account for averagely 4.9%,
17.5%, and 26.8%, respectively. Men had higher prevalence rates at 14% than women at 12%
(The U.S. Department of Health and Human Services, 2020). As the prevalence of T2DM
continues to surge at an alarming rate, it has become a major public health concern with
significant socio-economic implications. For this reason, there has been an increasing focus on
the implementation of prevention strategies to combat the rising cases of T2DM. Nonetheless,
fewer studies have delved into the effectiveness of various prevention strategies employed in
curbing the development and progression of the disease, which will be the primary focus of this
study.
T2DM Prevention Strategies
Studies have proven the effectiveness of diet in preventing or reversing T2DM. A healthy
diet seeks to control an individual’s weight. Excessive weight (excess visceral fat) has been the
leading precursor of T2DM. It causes insulin resistance due to higher levels of fatty acids and
cytokines, dysregulates adipokines resulting in increased levels of harmful ones like leptin, and
causes beta-cell dysfunction causing T2DM. As such, “dietary calorie restriction dosedependently improves body composition by progressively decreasing total body fat, intraabdominal fat (known as visceral adipose tissue) and intrahepatic lipid content” (Magkos et al.,
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2020, p.2). Once weight is reduced, the body restores first-phase insulin secretion, which is a
critical part of reversing T2DM. Physical workouts have also been a critical segment in reversing
T2DM.
Progressive aerobic and resistance exercises are instrumental in reducing T2DM.
According to Magkos et al., (2020), physical activity, prescribed alone or in various
combinations, reduces body fat, improves blood lipid profile and pressure, and optimizes glucose
homeostasis mechanisms, such as insulin sensitivity in persons with T2DM. Sigal et al., (2006,
p.1433) support these findings by citing randomized control trials which found that physical
activity lessens the “risk of progression from impaired glucose tolerance (IGT) to type 2 diabetes
by 58%.” While Sigal et al., (2006) opine that effective weight loss should involve physical
workout and proper nutrition, one can still attain considerable fat loss if they only participate in
high-volume aerobic exercise (700kcal per day – 1hour/day of moderate intensity exercise)
minus controlled caloric intake. As a result, one would realize improved insulin resistance. The
other aspect of controlling diabetes is avoiding tobacco.
Tobacco, which contains nicotine and many harmful chemicals, primarily affects the
respiratory and cardiovascular systems. It is a major risk factor for various health conditions,
including heart disease, stroke, and lung cancer. Notably, tobacco smoking “potentiates insulin
resistance and worsens glycemic control in patients with DM.” Typically, insulin secretion was
twice as impaired in smokers as individuals who have never smoked” (Kayar et al., 2018, p.377).
What this shows is smokers with T2DM should avoid smoking if they must reverse the illness.
The Effectiveness of the Prevention Strategies
T2DM occurs progressively due to the complex interplay between insulin resistance and
beta cell dysfunction. Magkos et al., (2020) found that diet influences glucose-insulin
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homeostasis thereby impacting sugar levels. Therefore, Toi et al., (2020) opine that select dietary
inputs have been proven to reduce body fat thus beneficial to insulin sensitivity and levels of
blood sugar. Toi et al., (2020) further affirm that low calorie and low carbohydrate diet (2530kcal/kg or carbohydrate