How lifestyle changes can slow the progression of Type 2 diabetes

• Updated on: 2020-11-03
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If there’s one thing Liz Smith, R.D., CDCES, wants you to know about managing Type 2 diabetes, it’s this: Diet and exercise are critical to your health and wellbeing — and to altering the course the progressive disease will take.

“It’s like medicine, really,” said Smith, a clinical dietitian and diabetes education specialist at Vanderbilt University Medical Center. “Physical activity actually lowers blood sugar levels, just like medication would. And reaching a healthy weight, or reducing your weight by even 5 to 10 percent, can help delay the disease’s progression.”

But what do these “lifestyle changes” entail, exactly? For Smith, it’s simply this: You need to keep it simple. Here, we explain.

We know that obesity is a key risk factor for developing diabetes. Therefore, to help prevent the disease, maintaining a healthy weight is key. But once you’ve been diagnosed, achieving and maintaining a healthy weight — or even just losing weight— remains critically important.

And the earlier in the disease you can begin to make changes to your diet, the better.

Smith counsels her patients to avoid fad diets, which A) can be hard to sustain over the long haul, and B) can cause secondary issues, like elevated lipids or cholesterol. Instead, she walks them through the “Plate Method,” which is a more well-rounded approach to nutrition. At every meal, she says, we should be eating some healthy carbohydrates, some lean protein and as many non-starchy vegetables (greens, asparagus, peppers, broccoli, cauliflower and the like) as we want.

Many patients are surprised by the fact that they can eat carbohydrates. “We all need carbs because that’s our body’s prepared source of fuel,” Smith explained. “It’s all about finding the right balance for you — how much would be a safe amount. That needs to be individualized for every patient.”

Smith also recommends using a weight loss app that allows you to track calories: “They make it really easy because they give you a calorie budget specific to you, and as long as you stay within that range, it kind of does everything for you.”

When devising nutrition plans for patients, Smith thinks about where they currently are in their weight-loss journey and advises implementing small changes. “What are you currently eating and what small things could you do that might help?” she’s known to say. “Could you increase your vegetables? Could you decrease your fat, and therefore decrease your calories?” It all depends on the patient: where they are and what their goals are.

Regarding fitness, her message is the same. While the guidelines are to get at least 150 minutes of physical activity a week, Smith knows that the key to success is tailoring those guidelines to the patient. Maybe that means going for a 30-minute walk in the neighborhood five days a week. Maybe it’s shorter 15-minute walks, twice a day. How the plan takes shape isn’t what’s important. What matters is that the patient understands that this activity is absolutely crucial, and that it, combined with a healthy diet, contains the keys to staving off progression of diabetes.

“When I get my hands on a patient who has just been diagnosed and doesn’t want to take medication, that’s the perfect time to get started,” she said. “We can do a lot to delay the progression. The earlier you can start managing your disease, the slower it will progress, and the better your outcome will be.”