Type 2 diabetes develops when the body can no longer produce enough insulin to keep blood sugar in a healthy range, or when cells become resistant to insulin's effects. It is preceded by prediabetes — a state of mildly elevated blood sugar that can persist for years. Prediabetes is reversible; type 2 diabetes, once established, is managed rather than cured.
The scale of the opportunity
An estimated 720 million people worldwide have prediabetes, and around 70% of them will develop type 2 diabetes within their lifetime if nothing changes. Yet the landmark prevention trials — the Diabetes Prevention Program (DPP) in the US and similar studies in Finland and China — showed that structured lifestyle change cuts that risk by more than half.
Medication (specifically metformin) also reduces risk, but lifestyle change outperforms it in every trial that has compared the two directly.
The five risk factors most within your control
- Excess body weight — particularly visceral (abdominal) fat, which is the most metabolically active
- Physical inactivity — even brief regular movement significantly improves insulin sensitivity
- Diet high in refined carbohydrates and ultra-processed foods
- Poor sleep quality or duration
- Chronic psychological stress
What the DPP trial actually showed
The Diabetes Prevention Program enrolled over 3,000 adults with prediabetes and assigned them to: intensive lifestyle intervention, metformin, or placebo. The lifestyle group — targeting a 7% weight loss and 150 minutes of moderate activity per week — reduced progression to diabetes by 58%. The metformin group achieved 31%.
Most importantly, the benefits of lifestyle change persisted for over 15 years of follow-up, long after the formal programme ended. The earlier the intervention, the greater and more durable the effect.
"Prediabetes is the single most actionable result in preventive medicine. The window is real, but it is not permanent."
Dr. Lina Haddad, CMO, Looms
Specific changes that reduce risk most
Weight loss of 5–7% of body weight is the most powerful single lever. For a 90 kg person, that is 4.5–6 kg. This does not require an extreme diet — a sustained daily caloric deficit of 300–400 kcal through food and activity achieves it over 3–6 months.
Dietary quality matters too. Reducing refined carbohydrates (white bread, white rice, sugary drinks), increasing fibre from vegetables, legumes and whole grains, and replacing saturated fats with unsaturated ones all improve insulin sensitivity independently of weight.
- Replace sugary drinks with water, tea or sparkling water
- Choose whole grain alternatives to white bread, pasta and rice
- Include vegetables in every meal — they add volume and fibre without adding glucose load
- Aim for at least 150 minutes of moderate activity per week — any combination of walking, cycling or swimming counts
- Sleep 7–9 hours per night — sleep deprivation raises cortisol and impairs insulin function
How to monitor your progress
If you have been told you are in the prediabetes range, ask your doctor for an HbA1c or fasting glucose every 6–12 months. A falling trend over 12 months is one of the most rewarding data points in preventive medicine. Logging your results in one place — alongside your weight and activity — makes that trend visible and motivating.