Eighty-six million Americans — more than one in three adults — have a disorder that greatly increases their risk for type 2 diabetes and cardiovascular disease (CVD). Although this disorder, prediabetes, can easily be detected with a blood test covered by almost all health plans, 90% of those with this extremely common blood sugar abnormality are unaware of their peril, according to the CDC.

Also known as “insulin resistance” (IR), this condition is the root cause of about 70% of heart attacks and almost all cases of type 2 diabetes. The good news is that there is a lot you can do to avoid IR or to reverse it, if you are already prediabetic. With November marking American Diabetes Month, here are the BaleDoneen Method’s top 10 diabetes prevention tips.

  1. Know your risk. In the time it takes to watch a movie you can get the best screening test for diabetes, prediabetes and IR, which is covered by almost all health plans. The American Diabetes Association (ADA) advises screening if you’re 40 or older, or at a younger age if advised by your medical provider due to such factors as obesity or family history. The ADA rates the 2-hour oral glucose tolerance test (OGTT), in which you drink a sugary liquid after an overnight fast, as the “gold standard” in accuracy. Blood is drawn at the one- and two-hour marks to check glucose levels. Studies show that other widely used screening tests, such as the A1c test, which doesn’t require fasting, are much less accurate. For example, a 2011 BaleDoneen study found that of 547 patients checked with various blood sugar tests, the A1C test missed 63% of those with IR/prediabetes. Moreover, 27% of the patients classified as prediabetic by the A1C actually had normal blood sugar when checked with the highly accurate OGTT.
  2. Lose a few pounds. More than 90% of people who develop diabetes are overweight or obese. Research suggests that if you’re overweight, every 2.2 pounds lost cuts risk by 16%. Very large studies also show that shedding 5% to 7% of your body weight (7 to 10 pounds for someone who weighs 150) through diet and exercise cuts risk for developing full-blown by 70% — even if you are already pre-diabetic. Try our seven heart-smart weight-loss tips — they really work!
  3. Follow a plant-based diet. Many large studies have shown that an eating plan that is high in legumes, fruits, vegetables, nuts and seeds, and low in animal products, can significantly trim risk for diabetes. To optimize your heart and systemic health and maintain a healthy weight, the BaleDoneen Method recommends following a diet based on your DNA. For people with certain haptoglobin genotypes, we advise a gluten-free diet.
  4. Move more. Getting 30 minutes of moderate- to high-intensity exercise daily has been shown to be a safe and effective way to prevent diabetes. A recent study also found that working out regularly can prevent or manage more than 40 diseases, including coronary heart disease — even in people with high-risk genes, such as the 9P21 “heart attack gene.” Check with your medical provider before starting a new fitness regimen to make sure it’s right for you.
  5. Rethink your drink. Consuming just one or two sugar-sweetened beverages daily — such as energy drinks, fruit drinks, soda, or coffee drinks — raises risk for a heart attack or dying from CVD by 35 percent, diabetes risk by 26 percent, and stroke risk by 16 percent, according to a Harvard study. Sometimes called “liquid candy,” sweet drinks rank as the top source of added sugar in the U.S. diet. Quench your thirst with plain, sparkling or fruit-infused water.
  6. Avoid nicotine use or exposure. Smokers are up to 40% more likely to develop diabetes then nonsmokers, according to the CDC, which offers tips that have helped more than five million smokers kick the habit. Avoiding nicotine use or exposure will also dramatically reduce your risk for CVD, the leading killer of Americans, and many other potentially lethal diseases.
  7. Control your blood pressure. In a seven-year study of more than 4 million initially healthy people whose average age was 46, those with high blood pressure were 77% more likely to develop diabetes. Nearly half of U.S. adults (46%) — many of whom are undiagnosed — are considered to have high blood pressure under new guidelines. The good news is that high blood pressure is both preventable and highly treatable. Therapies include lifestyle and dietary changes and, in many cases, medication.
  8. Optimize your oral health. About 50% of adults ages 30 and older have periodontal disease (PD), a chronic oral infection that can lead to tooth loss. Also known as “gum disease,” PD has been shown to raise blood sugar levels in people with and without diabetes and has been linked to higher risk for developing the type 2 form of the disease. Here’s more motivation to take great care of your teeth and gums: A landmark peer-reviewed BaleDoneen study was the first to identify oral bacteria from PD as a contributing cause of CVD. Use our easy four-step plan to optimize your oral health and prevent heart attacks.
  9. Stress less. Having a moderate-to-high level of stress more than doubles a person’s risk for developing type 2 diabetes three years later, according to a 2017 study of 12,844 middle-aged women. The researchers theorize that by repeatedly activating the body’s “fight-or-flight” response, chronic tension may increase levels of inflammatory compounds and impair metabolism of glucose. One of the best ways to tame tension is practicing mindfulness, which has been shown to have powerful benefits for the heart, brain and arteries.
  10. Sleep well. Many studies have shown that people who sleep seven to eight hours a night have the lowest risk for type 2 diabetes, while slumbering for five or fewer hours — or more than nine — raises risk for the disease by up to 52%. Chronically skimping on slumber is linked to reduced production of insulin, a hormone that regulates blood sugar, and also increases risk for cardiovascular disease, obesity, depression and other chronic disorders. To make sure you get the restorative rest you need for optimal health, try our five natural ways to sleep better.