Introduction to Diabetes Prevention

Content written and reviewed by Sara Benjamin-Neelon, PhD, RD, MPH, JD, Director of the Lerner Center for Public Health Promotion at the Johns Hopkins Bloomberg School of Public Health; and Meghan Ames, MSPH, RD, Community Program Manager, the Lerner Center for Public Health Promotion at the Johns Hopkins Bloomberg School of Public Health.

Diabetes and prediabetes

An estimated 1 in 3 US adults have prediabetes, and of these 88 million people, over 80% aren’t aware of their condition.[1] People with prediabetes are at increased risk for developing type 2 diabetes, heart disease, and stroke. Emerging research also suggests that people with diabetes may be more at-risk for severe COVID-19 symptoms if infected.

The good news is that by integrating a few small healthy behaviors into their daily routine, people at-risk or with prediabetes can dramatically reduce their likelihood of developing type 2 diabetes or other major health complications.


What is type 2 diabetes?

Type 2 diabetes impacts the body’s metabolism of sugar. In a healthy person, insulin aids in the absorption of sugar from foods, so it can be used by the body for energy. In people with type 2 diabetes, however, the body doesn’t produce enough insulin or respond to insulin properly. As a result, sugars build up in the blood stream. High blood sugar can cause many health complications, including blindness or other serious eye problems, kidney disease, nerve damage, and other health issues.[2]

Type 2 diabetes is diagnosed by elevated blood sugar levels. The hemoglobin A1C blood test indicates average blood sugar levels over the past three months. People with an A1C above 6.5% are diagnosed with type 2 diabetes, and those with an A1C between 5.7% – 6.4% are diagnosed with prediabetes. People with prediabetes have a 50% chance of developing type 2 diabetes within 5 to 10 years.[3] Because some complications develop without symptoms, it’s important to have your doctor screen you for prediabetes regularly.

How do I prevent type 2 diabetes?

Two major risk factors that dramatically increase the risk of diabetes are being overweight and being inactive. By adopting a healthy lifestyle, people can reduce the impact of complications from diabetes and decrease the chance that prediabetes turns into diabetes. The Diabetes Prevention Program or DPP help people with prediabetes maintain a healthy weight through regular physical activity, healthy food choices, and behavioral support. Participating in this program can reduce your risk of diabetes by over 50%.[4]

Get active. Experts recommend at least 150 minutes per week of moderate physical activity.[5] That’s 30 minutes, five days per week of exercise that gets your heart rate elevated. This doesn’t have to mean joining a gym or running a marathon. Moderate physical activity can be fast walking or dancing. There are many small ways to start moving more, including find an exercise buddy and spending time outside. Physical activity helps manage blood sugar (especially if your body is not responding to insulin properly). It will also help you maintain a healthy weight, sleep better, and feel healthier.[6]

Eat healthy. Following a healthy diet is key to maintaining a healthy weight, managing your blood sugar, and preventing complications from diabetes. In general, people with diabetes or prediabetes need to be mindful of the types and amounts of carbohydrates they eat, as these foods can impact their blood sugar levels. A healthy diet is high in fruits, vegetables, and whole grains, and low in processed foods, fat, sugar, or salt. Plant-based diets may also help in the prevention or treatment of diabetes.[7] Meal planning, label reading, and home food prepping are great strategies to improving your food choices. Change your environment to make healthier foods the easy choice.

Manage stress. Behavior change is hard, but there are some simple strategies that can make adopting a healthy lifestyle easier. Reduce stress and improve your sleep through exercise, meditation, and mindfulness. Deep breathing and belly breathing are two techniques to help deal with stress. Try to think positive – surround yourself with positive people, find humor, be kind to yourself, and identify areas that need to change. See a mental health professional if you are feeling worried, anxious, or overwhelmed most of the time and these feelings are interfering with your normal life.

Refresh on Mondays. Small steps are key. Using Monday as a weekly cue to commit or recommit to healthy behavior is an evidence-based way to stay on track with your health goals. By incorporating more healthy eating, physical activity, regular sleep, and mental health self-care practices into your weekly routine, you can better prevent or manage type 2 diabetes.





[5] Physical Activity Guidelines for Americans



Get More Diabetes Prevention Resources

Our diabetes prevention program has a variety of resources designed to help people at risk for type 2 diabetes manage or prevent the disease through a combination of healthy eating, exercise, and stress management.