The causes of type 1 diabetes are under investigation, and researchers are working to learn how to prevent the disease. While the causes of type 2 diabetes are not well understood, recent research has demonstrated that it often can be prevented or delayed through lifestyle changes in at risk persons.42 This section focuses on the prevention of type 2 diabetes. The “Treatment” section within this document addresses the prevention of medical complications caused by diabetes.
The prevalence of diagnosed type 2 diabetes increased sixfold in the latter half of the past century.43 Obesity and physical inactivity have played a major role in this dramatic increase in rates of type 2 diabetes.44 For example, until recently type 2 diabetes was not frequently seen in school-aged children and adolescents. Now the prevalence of type 2 diabetes for persons 20 and under appears to be rising considerably, and this rise can be attributed to increases in physical inactivity and excess weight gain.45 More than one-third of young people in grades 9-12 do not regularly engage in vigorous activity (Figure 8).46
Vigorous activity is defined as sustained activity that results in a significant increase in heart and breathing rate.47
The Diabetes Prevention Program (DPP)—a major clinical trial involving 3,234 people with impaired glucose tolerance, a condition that often precedes diabetes—demonstrated that some people at high risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 percent to 7 percent of their body weight and getting 30 minutes or more of physical activity at least 5 days per week.48 In this study, the development of type 2 diabetes was reduced by 58 percent over a three-year period. This benefit was seen in participants of all ages and racial and ethnic backgrounds. The very encouraging results of this trial show that it is possible to prevent or delay type 2 diabetes in high-risk persons.
It is not easy for many people to lose weight and increase their physical activity. However, it is imperative to build upon the results of the DPP and encourage people to take the necessary steps to prevent type 2 diabetes. This not only will help many Americans live healthier, more productive lives, but it also has the potential to save billions of dollars in health care costs associated with hospitalizations for diabetes and its complications. Friends, families, schools, health care providers, work sites and communities all can contribute in important ways to support healthier lifestyles.
Figure 8. Vigorous physical activity in adolescents by grade level, 2001
SOURCE: Kann L, et al. (2000). Youth Risk Behavior Surveillance Survey – US 1999, in CDC Surveillance Survey. MMWR, 49(SS-5), 1-96.
42 Diabetes Prevention Program Research Group, op.cit.
43 Centers for Disease Control and Prevention (CDC). (2001). Diabetes: A serious public health problem. Atlanta, GA: Department of Health and Human Services.
44 CDC, op.cit., Promising practices in Chronic Disease.
46 Kann L, et al. (2000). Youth Risk Behavior Surveillance Survey – US 1999, in CDC surveillance survey. MMWR, 49(SS-5), 1-96.
47 Centers for Disease Control and Prevention (CDC). Physical Activity Terms. Available at: http://www.cdc.gov/nccdphp/dnpa/physical/terms/index.htm#Vigorous. Accessed September 15, 2004.
48 Diabetes Prevention Program Research Group, op.cit.