Type 2 diabetes continues to impact millions across the United States, and while the condition is serious, it is also largely preventable. According to the Centers for Disease Control and Prevention, over 37 million Americans live with diabetes, with about 90–95% of those cases being type 2. One in five people with diabetes are unaware they have it. As the number of diagnoses climbs, particularly among younger populations, understanding how to prevent type 2 diabetes has never been more important. This article explores insights from Dr. Kate Kirley, a family physician and director of chronic disease prevention at the American Medical Association (AMA), who emphasizes that prevention is not only possible but essential.

One of the first distinctions Dr. Kirley makes is between type 1 and type 2 diabetes. Type 1 is an autoimmune disease in which the body attacks insulin-producing cells in the pancreas. Type 2, on the other hand, stems from the body’s inability to respond properly to insulin, leading to elevated blood glucose levels. While research into preventing type 1 diabetes is ongoing, type 2 diabetes has clearer, evidence-based prevention strategies.

I found this detail striking: many people with prediabetes—a condition where blood sugar levels are higher than normal but not yet in the diabetes range—are unaware of their risk. Prediabetes is one of the strongest predictors for developing type 2 diabetes, and recognizing it early can open the door to effective interventions. Other risk factors include obesity, a family history of diabetes, and a history of gestational diabetes during pregnancy.

Dr. Kirley also highlights a critical issue of health inequity. Certain racial and ethnic groups face a higher risk of developing type 2 diabetes, not due to inherent biological differences, but because of systemic factors such as unequal access to healthy food, safe environments for physical activity, and quality healthcare. Addressing these disparities is vital for meaningful prevention efforts.

For those who had gestational diabetes, the risk of developing type 2 diabetes later in life is significantly increased. Dr. Kirley stresses the importance of long-term follow-up care for these individuals, noting that they may benefit from more frequent monitoring and even preventive medications. Ensuring that all healthcare providers involved in a patient’s care are aware of this history is key to ongoing risk management.

When it comes to lifestyle changes, the message is clear: even modest improvements can have a meaningful impact. Dr. Kirley advises against the “blame game” and instead encourages people to identify realistic, manageable changes. For example, losing just five to ten pounds can significantly reduce the risk of developing type 2 diabetes. This is particularly relevant for those dealing with obesity, a major risk factor for the disease.

Importantly, Dr. Kirley reminds us that not all risk factors are within an individual's control. Genetics and environmental influences play a significant role, and feeling guilty over one's risk is neither helpful nor warranted. Instead, a combination of individual, community, and systemic approaches is necessary to effectively reduce the incidence of type 2 diabetes.

Cardiovascular health is another major concern. Type 2 diabetes increases the risk of heart disease and stroke, as it damages blood vessels throughout the body. In fact, cardiovascular disease is the leading cause of death among people with type 2 diabetes. Managing blood pressure, cholesterol, and weight are essential steps not only for diabetes prevention but also for protecting heart health.

For those struggling with obesity, medical treatments such as bariatric surgery and FDA-approved anti-obesity medications can be part of a comprehensive prevention plan. Newer injectable medications like semaglutide (marketed as Ozempic and Wegovy) and tirzepatide (Mounjaro) have shown promising results in supporting weight loss and improving metabolic health. While tirzepatide is currently approved for type 2 diabetes treatment, its potential as a weight loss medication is gaining attention.

Preventing type 2 diabetes doesn't have to be a solo effort. Dr. Kirley emphasizes the power of family support in making and sustaining healthy behavior changes. Whether it's meal planning or increasing physical activity, involving the entire household can lead to better outcomes for everyone. This approach acknowledges the interconnected nature of family health and the importance of shared responsibility.

Accessing guidance and support is another important step. Physicians can connect patients to resources like the Diabetes Prevention Program, which offers structured support for improving nutrition, increasing physical activity, and achieving sustainable weight loss. Community organizations, including YMCAs and faith-based groups, also offer valuable programs aimed at chronic disease prevention.

Finally, understanding your personal risk is essential. Dr. Kirley recommends visiting DoIHavePrediabetes.org to take a simple risk assessment. This tool can help individuals identify whether they may have prediabetes and guide conversations with their healthcare providers. For those with risk factors, a blood test every three years is recommended, and for those already diagnosed with prediabetes, annual testing is advised to monitor progression.

Preventing type 2 diabetes is a multifaceted effort that involves awareness, action, and support. While not every risk factor is within our control, many are—and even small steps can lead to significant improvements in health. By staying informed, engaging with healthcare providers, and involving our communities, we can work toward reducing the impact of this chronic condition.

Read more at ama-assn.org