Since I stopped practicing general family medicine and started dedicating myself exclusively to aging issues, there is one disease process that comes up again and again.  It’s the one on which I probably spend the lion’s share of my time as a clinical physician. That process is adult-onset, or Type II, diabetes. No mistake about it, it’s a killer and in America’s adult population, it’s a full blown epidemic. 

People worry a great deal about cancer, but your chances of getting cancer pale beside the one-in-three shot you have of developing diabetes before you die. People tend to overlook diabetes since the disease has been manageable for decades. But managed or not, over the long term it will still ravage your heart, eyes, and circulatory system. 

The thing that’s so crazy about diabetes is that we still have a tendency to view and treat adult-onset diabetes as a purely genetic disorder. The truth is, however, diabetes is like heart disease in that your genetics can certainly be a contributing factor but it is lifestyle that really makes the difference. A sedentary lifestyle and endless chili cheese fries can destroy the best of hearts and a series of poor lifestyle choices can make a diabetic of the very best of us. 

The good news here is that, just like with heart disease, even if you lost the genetic lottery and happen to have inherited a set of genes that make you highly susceptible to diabetes, the right lifestyle choices can seriously mitigate your risk of developing it.  Better yet, even if you’ve already developed a case of full blown diabetes, the right lifestyle choices can go a long way towards minimizing its impact. In fact, in virtually every case I’ve dealt with (and I deal with a lot) you can functionally eliminate the disease most of the time. Genetics can put you at increased risk. But it is your lifestyle that is going to make the difference in being at risk and actually having the disease.

At this point, you are probably wondering what lifestyle choices you need to make in order to avoid the onset of diabetes. Let me tell you in three simple steps. All three are simple to understand, but will require that you make consistent adjustments to how you live.

1. Lose the belly fat

I can’t stress this one enough. A spare tire around your belly for men or women is a huge predictor for who will or won’t develop diabetes. It’s also worth remembering that your body won’t burn off your tummy first just because you choose to work your abs. If you want to burn fat with exercise, working your legs or any other muscle is just as effective. This leads naturally to step 2.

1. Build muscle

Muscle burns blood sugar voraciously and without insulin. It’s part of the reason you could eat whatever you wanted when you were 18, never gain an ounce of fat, and weren’t diabetic…and why kids today are so much pudgier than my generation.  Physical labor and physical play are practices we need to rediscover. We do much less of both as we get older, just about the time we need to do more of it to get the same benefit. (There are ways around that too, but that’s a whole other blog)

1. Avoid sugar and take your medications

I know…you thought the whole point here was to get better so you wouldn’t have to do this one. Sorry. Just like someone who’s had a heart attack may one day get off their heart meds, you too may one day get off diabetes medications. However, that comes after you’ve lost the belly and built some muscle. For now you need to focus on staying healthy enough to do that and that means taking your medicine. As for the simple carbohydrates, one day you may be able to handle them again. But for now, all of your carbohydrates need to be in the form of vegetables and fresh, woody fruits such as apples and pears.

These are not easy changes we’re talking about here. You’re going to have missteps and fall off the wagon. The trick is not to allow yourself to get discouraged when that happens. You just pick yourself up and start over. You have to. Your life really does depend on it.