Preventing type 2 diabetes

Before type 2 diabetes, most people spend years with prediabetes: blood sugar higher than normal but not yet in the diabetes range. It usually has no symptoms, and most people who have it do not know.

The good news

Large studies of people with prediabetes found that a structured lifestyle program, modest weight loss plus regular activity, cut the number who went on to develop type 2 diabetes by more than half over three years. In older adults the effect was larger still. You do not have to become an athlete. You have to move the needle.

The levers that matter

• Move most days. Work toward about 150 minutes a week of activity that leaves you a little out of breath. A 20-minute walk after dinner counts. Walking the 2K at the run counts.
• Lose a little, if you carry extra weight. Even 5 to 7 percent of body weight makes a real difference to blood sugar.
• Cut the sugary drinks. Water or unsweetened tea in place of soda and sweet juice is one of the highest-impact single changes on Guam, and it is one the island’s Non-Communicable Disease Consortium has made a priority.
• Protect your sleep and manage stress. Both push blood sugar up when they go wrong.
• Get tested. A simple blood test (A1C or fasting glucose) tells you where you stand. Ask for it if you are over 35, carry extra weight, have a family history, or had gestational diabetes.

Eat local

The traditional Chamorro diet was built on reef and ocean fish, taro, breadfruit, pandanus, banana, yams, and local greens. Guam public health and food researchers have documented how those foods have been replaced at the everyday table, and at the fiesta table, by white rice, imported potatoes, and processed products that carry less fiber and fewer nutrients. Bringing local starches and fish back onto the plate, growing something in a home or community garden, and buying from island farms are all named in Guam’s health plans as ways to push back on diabetes. The FAO’s Let’s Go Local guidance for the Pacific makes the same case.

Make it a family thing

Habits run in households. Cooking one healthier meal together, walking a few evenings a week, or signing the whole family up for the 2K does more than any one person trying alone. That is why the run’s group rate is built the way it is: register a group of five and one entry is free.