You’ve heard it again and again: diabetes is on the rise in Canada. So, are you at risk? If you carry excess weight and work at a stressful job, you may well be.

“If you have 10 extra pounds, particularly around the waist, you have a dramatically increased risk of developing Type 2 diabetes,” says Michael Riddell, associate professor in the faculty of health at York University in Toronto. The good news? “Exercise will delay or even prevent Type 2 diabetes altogether.”

Understanding diabetes is the best way to prevent it. Type 1 diabetes commonly begins in childhood. In this type, the pancreas makes little or no insulin. Only about 10% of those with diabetes have this type and they require insulin to live.

Type 2 diabetes accounts for about 90% of cases and usually occurs in adulthood, although it is becoming common in younger people. Here, the pancreas does not produce enough insulin or the body does not effectively use the insulin. Without enough insulin, the body has trouble regulating blood sugar levels.

When experts talk about the obesity epidemic and skyrocketing rates of diabetes, they are referring to Type 2 diabetes, which can be prevented. The World Health Organization estimates 90% of Type 2 diabetes cases could be avoided with better nutrition, increased physical activity and the elimination of smoking. But most people who are pre-diabetic — with slightly high blood sugar levels — have no idea they are at risk.

“You can’t feel it. It is hidden in the background,” says Riddell, who adds that 15%-20% of Canadians are in this pre-diabetic state. “It clusters in those who are middle-aged, with extra weight around the middle, who are sedentary and who suffer from work stress. Yet, there are no symptoms.”

So, how do you know if you’re at risk? The Canadian Diabetes Association recommends anyone over the age of 40 have a glucose tolerance test every three years to check blood glucose levels. If you have known risk factors, such as obesity or a family history of the disease, you may need to be checked earlier and more often.

Symptoms of full-blown diabetes are blurred vision, transient weight loss, dizziness, frequent urination, lethargy and thirst. “By the time you have overt signs, you have Type 2 diabetes,” says Riddell.

Waiting to become sick is not a good option. Three-quarters of Canadians with diabetes also have other chronic health conditions such as heart disease, arthritis or a mood disorder.

Diabetes is on the rise. According to the Health Council of Canada, about 5% of Canadians aged 12 and older reported having diabetes in 2005, compared with only 3% a decade earlier. This rate of increase is expected to continue because so many Canadians are overweight or obese.

“We have to get people thinking about exercising for the health benefits. If we wait, in 10 years, people with diabetes will bankrupt the system,” says Riddell.

Proof that Type 2 diabetes can be prevented through better nutrition and exercise comes from two studies. Both showed that eating low-calorie, low-fat meals and doing moderately intense exercise for at least 2.5 hours a week resulted in a 58% reduction in the number of people who progressed from pre-diabetes to diabetes. A smaller study found that four hours of exercise a week resulted in an 80% reduction in the risk of developing diabetes.

If you and your doctor find that lifestyle changes are not enough to normalize your blood sugar, some medications have been shown to be safe and effective in preventing Type 2 diabetes. Among them are metformin and acarbose.

There is currently a debate raging among diabetes experts around the world over whether people at risk for developing Type 2 diabetes should be prescribed a class of drugs called the “glitazones” to prevent the disease. An international study reported last fall that giving the drug rosiglitazone, sold as Avandia, to those at high risk prevented the disease in 60% of cases. But the excitement generated by that trial has recently been tempered by researchers who argue that it is not a good idea to put so many people who aren’t sick on a medication when lifestyle modification is safer, cheaper and just as effective.

Riddell says diet and exercise are powerful tools against diabetes. He recommends exercising for at least 30 minutes on most days of the week. For best effect, he says, add resistance exercises such as lifting weights. The combination can lower blood sugar to a normal range, reduce fat around your middle and make your muscles more sensitive to insulin.

@page_break@He also suggests decreasing your intake of simple sugars and fat, and increasing your intake of fibre, fruits and vegetables. IE