Diabetes kills more people each year than breast cancer and AIDS combined, and 79 million Americans are at high risk for developing Type 2 diabetes, according to the Centers for Disease Control and Prevention and the American Diabetes Association.
Yet there are simple steps that everyone can take to reduce their risk of developing this deadly disease, says Dr. Craig Stump , interim director of the Diabetes Research Program  at the University of Arizona College of Medicine - Tucson , where he is chief of the Section of Endocrinology, Diabetes and Hypertension, and associate professor of medicine and nutritional sciences. He also is an endocrine specialist with the Southern Arizona VA Health Care System.
"The evidence is fairly clear that the rise in diabetes, pre-diabetes and obesity are due at least in part to changes in behavior over the past couple decades," Stump said. Given today's "effort-saving technologies" and inexpensive foods that are high-calorie, it's harder for people to maintain a healthy weight and metabolic health without a conscious effort to select healthy foods and get extra physical activity, he noted.
These changes are subtle but they add up, he notes. Just 20 extra calories a day for 20 years can lead to 40 to 50 extra pounds of body fat. Twenty calories would be about a dozen raisins.
"In my estimation, dietary and physical activity can prevent 90 percent of the Type 2 diabetes we currently see," Stump said. "Nearly all of the research participants in the landmark Diabetes Prevention Program  who performed the prescribed exercise and approached their weight loss targets avoided progression to diabetes. For all but a select few it is not whether diet and exercise are effective; it is whether the individual at risk adheres to the exercise prescription and dietary recommendations."
The Diabetes Prevention Program was a three-year multicenter clinical research study involving more than 3,000 participants. It found that modest weight loss through dietary changes and increased physical activity could prevent or delay the onset of Type 2 diabetes in study participants. Nearly half of the participants were from minority groups – including African American, Native American and Hispanic – at increased risk of developing diabetes.
These techniques do work, as evidenced locally in a recent National Institutes of Health -funded diabetes prevention pilot study, "Feasibility of a Diabetes Prevention Intervention in Mexican-Americans,"  conducted at the UA by Principal Investigator Deborah Vincent, an associate professor in the College of Nursing. Stump served as co-investigator.
Just a few simple lifestyle and diet changes can help people avoid developing diabetes, maintain control of their diabetes, or avoid and delay progression of the disease. Stump suggests:
- Begin walking (or another physical activity with similar exertion). Start with 15 minutes a day and gradually work up to 60 minutes a day. Walk outside or walk at a mall, but develop the habit. Stop and rest until you build stamina. The first step out the door is the hardest.
- Limit carbohydrate intake, especially highly processed carbohydrates. Avoid the "white" foods such as white noodles, white potatoes, white rice, white bread, etc. (And don't reward yourself for exercising with an ice cream treat!) Leave food on your plate. Not a single starving child will be helped if you eat everything on your plate.
- Ask a family member or friend to join you. With so many people at risk, it won't be difficult to find a partner, and it will be easier to tackle the problem together.
"Start as soon as possible. Don't wait until you are pre-diabetic, especially if there is diabetes in your family, especially in parents or siblings," Stump said. "Just like saving for retirement, early and regular contributions will pay the biggest dividends in the end, but it is never too late to receive some benefit."