How To Reduce Your DM2 Risk 31%

The results, published in Annals of Internal Medicine, were based on 4,746 adults between ages 55 and 75. All had overweight or obesity and metabolic syndrome, but none had diabetes or cardiovascular disease at the start of the study. Researchers followed participants for six years to see whether a more intensive Mediterranean based lifestyle plan could offer stronger protection against type 2 diabetes than the traditional Mediterranean diet alone.

One group followed a calorie reduced Mediterranean diet (about 600 kcal fewer per day), added moderate physical activity (brisk walking, strength and balance training), and received professional guidance. The comparison group followed a traditional Mediterranean diet without calorie restriction or exercise advice.

The difference between the two approaches was striking. Participants in the intervention group were 31% less likely to develop type 2 diabetes than those in the comparison group. Universidad de Navarra. “Scientists found a smarter Mediterranean diet that slashes diabetes risk by 31%.” ScienceDaily. https://www.sciencedaily.com/releases/2026/05/260519003103.htm (accessed May 23, 2026).

I just had my annual wellness check and got my lab results. All good except my fasting glucose.

Yikes. Memo to Self, get an A1C. Well, the very next day…

Doc says:

CMP (Comprehensive Metabolic Panel): Your creatinine (a measure related to kidney function) is low, and your blood sugar (glucose) is high; all other values are normal. This test checks how your kidneys and liver are working, your body salts, proteins, and blood sugar. Low creatinine can happen in people with less muscle and may be expected. The slightly high fasting blood sugar could indicate early changes in how your body handles sugar. Options include repeating the blood sugar test next visit.

I know my diet could be better. I know I should eat less, snack less and maybe, just maybe stop drinking beer. But also knowing my IFG is worsening I wondered if there was a diet (besides MedDiet) for IFG?

In recent years, low-calorie diets ranging from 800–1500 kcal/day have gained significant attention in managing type 2 diabetes8,1619. Studies have shown that low-calorie diets can lead to remission and substantial improvements in cardiometabolic risk factors for a significant proportion of individuals with type 2 diabetes8,1619. These diets are generally well-tolerated and safe, with only mild side effects reported. Table 1 summarizes the key low-calorie diet studies conducted in people with type 2 diabetes8,1619. Studies implementing low-calorie diets over a 2–5 month period, primarily high in protein and low in fat, have resulted in a mean weight loss of 7–15 kg (8–15% of initial body weight). This level of weight loss was accompanied by a notable reduction in hepatic fat and improved hepatic insulin sensitivity and first-phase insulin secretion. As a result, fasting plasma glucose levels decreased significantly by 27.8 to 43.2 mg/dL. This suggests that low-calorie diets may also be effective for individuals with i-IFG, as they target the pathophysiological defects characterizing this prediabetes phenotype8,1619. Figure 1 visually depicts the potential reversal of the twin cycle hypothesis through low-calorie diets in individuals with i-IFG. The twin cycle hypothesis20 postulates that chronic excess calorie intake results in increased accumulation of fat in the liver, leading to resistance against insulin’s suppression of hepatic glucose production. Additionally, excess liver fat increases lipid transportation to the pancreas, impairing β-cell function and further promoting hepatic glucose production. These self-reinforcing cycles between the liver and pancreas ultimately result  in the onset of hyperglycemia.

Low-calorie diets for people with isolated impaired fasting glucose – Commun Med (Lond) . 2024 Mar 1;4:35. doi: 10.1038/s43856-024-00466-2

The Plan

  • Eat less
  • Move more
  • Drink less beer

I like to keep things simple.

Metformin Should Not Be Used to Treat Prediabetes

Based on the results of the Diabetes Prevention Program Outcomes Study (DPPOS), in which metformin significantly decreased the development of diabetes in individuals with baseline fasting plasma glucose (FPG) concentrations of 110–125 vs. 100–109 mg/dL (6.1–6.9 vs. 5.6–6.0 mmol/L) and A1C levels 6.0–6.4% (42–46 mmol/mol) vs. <6.0% and in women with a history of gestational diabetes mellitus, it has been suggested that metformin should be used to treat people with prediabetes. Since the association between prediabetes and cardiovascular disease is due to the associated nonglycemic risk factors in people with prediabetes, not to the slightly increased glycemia, the only reason to treat with metformin is to delay or prevent the development of diabetes. There are three reasons not to do so. First, approximately two-thirds of people with prediabetes do not develop diabetes, even after many years. Second, approximately one-third of people with prediabetes return to normal glucose regulation. Third, people who meet the glycemic criteria for prediabetes are not at risk for the microvascular complications of diabetes and thus metformin treatment will not affect this important outcome. Why put people who are not at risk for the microvascular complications of diabetes on a drug (possibly for the rest of their lives) that has no immediate advantage except to lower subdiabetes glycemia to even lower levels? Rather, individuals at the highest risk for developing diabetes—i.e., those with FPG concentrations of 110–125 mg/dL (6.1–6.9 mmol/L) or A1C levels of 6.0–6.4% (42–46 mmol/mol) or women with a history of gestational diabetes mellitus—should be followed closely and metformin immediately introduced only when they are diagnosed with diabetes.

Metformin Should Not Be Used to Treat Prediabetes — Diabetes Care 2020 Sep; 43(9): 1983-1987. https://doi.org/10.2337/dc19-2221

Teaching Prediabetes an Uphill Battle

The study shows that in 2010, one in three adults age 20 and older (an estimated 79 million people) had prediabetes. In that condition, a person’s blood sugar level is higher than normal but is not high enough for a diabetes diagnosis, the CDC said.

Of those adults with prediabetes, only 11% were aware that they had the condition. Although that figure marks a slight improvement from 2005-06, when 7% of people reported knowing they had prediabetes, awareness of the condition is too low, researchers said.

People with prediabetes are more likely to develop type 2 diabetes than those without the condition, according to the American Diabetes Assn. If action is taken early, however, risk of type 2 diabetes can be significantly reduced by losing weight and exercising moderately, the ADA said.

via Teaching adults about prediabetes an uphill battle – amednews.com.

Eat less. Move more. Good luck.