Preventing Diabetes

November 12, 2026

Can you prevent diabetes? What the latest science tells us

Diabetes is becoming increasingly common, but here's something encouraging: type 2 diabetes isn't always inevitable.

Even if you have a family history of diabetes, have been told you have prediabetes, or are noticing changes in your metabolic health, there are things you can do to reduce your risk.

And we're learning that preventing type 2 diabetes involves much more than simply cutting back on sugar.

The latest research highlights the importance of how we move, how well we sleep, our muscle health, stress levels, body composition and, of course, what we eat.

So, what does the science actually tell us, and which changes are worth making?

First, what exactly is diabetes?

Diabetes is a condition in which glucose (sugar) builds up in the bloodstream because the body either doesn't produce enough insulin or cannot use it effectively.

Insulin is a hormone produced by the pancreas. Think of it as a key that helps glucose move from your bloodstream into your cells, where it can be used for energy.

When this system stops working properly, blood glucose levels can become too high, potentially damaging blood vessels, nerves and organs over time.

What are the different types of diabetes?

Type 1 diabetes

An autoimmune condition in which the immune system attacks the insulin-producing cells in the pancreas. People with type 1 diabetes need insulin treatment to survive. It can develop at any age and is not caused by eating too much sugar or having an unhealthy lifestyle. There is currently no established way to prevent it through lifestyle changes.

Type 2 diabetes

The most common form of diabetes. It develops when the body's cells become less responsive to insulin (known as insulin resistance) and the pancreas eventually struggles to produce enough insulin to compensate.

Genetics, ageing, body fat distribution and lifestyle factors can all contribute. The encouraging news is that type 2 diabetes can often be prevented or delayed.

Gestational diabetes

Diabetes that develops during pregnancy when the body cannot produce enough insulin to meet increased demands. It usually resolves after pregnancy, but having gestational diabetes increases the risk of developing type 2 diabetes later in life.

Prediabetes

Not technically a type of diabetes, but an important warning sign. Blood glucose levels are higher than normal, although not yet in the diabetes range. It provides an opportunity to make changes before type 2 diabetes develops.

The important connection between insulin resistance and type 2 diabetes

One of the most interesting things about type 2 diabetes is that it often begins developing years before blood glucose reaches the diabetes range.

In the early stages of insulin resistance, your pancreas may compensate by producing more insulin to keep blood glucose under control.

This means blood sugar results can look normal even when your body is working harder than it should to maintain them.

Over time, if insulin resistance increases and the pancreas can no longer keep up, glucose levels begin to rise.

This is why metabolic health is about more than blood sugar alone.

Waist circumference, blood pressure, triglycerides, HDL cholesterol and family history can all provide useful clues about someone's risk of developing type 2 diabetes.

Importantly, insulin resistance can also occur in people who aren't overweight.

How much difference can lifestyle changes really make?

Quite a lot, according to one of the most influential diabetes prevention studies ever conducted.

The landmark Diabetes Prevention Program followed people at high risk of developing type 2 diabetes.

Participants who took part in an intensive lifestyle programme reduced their risk of developing type 2 diabetes by 58% over approximately three years, compared with those receiving a placebo.

The programme focused on improved nutrition, physical activity and modest weight loss.

For participants aged 60 and over, the reduction was even greater, at 71%.

Long-term follow-up showed that the benefits of lifestyle changes could persist for many years.

The takeaway? Small, sustainable changes can make a meaningful difference, particularly when several healthy habits work together.

Source: US National Institute of Diabetes and Digestive and Kidney Diseases – Diabetes Prevention Program

7 evidence-based ways to reduce your risk of type 2 diabetes

1. Build muscle – it's one of your best tools for managing blood sugar

We tend to associate exercise with burning calories and managing weight, but muscles have another incredibly important role.

Your muscles are one of the body's biggest consumers of glucose.

When you move, your muscles can take up glucose from the bloodstream, including through mechanisms that don't rely directly on insulin.

Over time, regular exercise can improve insulin sensitivity, meaning your body can use insulin more effectively.

And here's something particularly relevant as we age: we naturally tend to lose muscle mass unless we actively work to maintain it.

That's one reason strength training deserves a place alongside walking, swimming, cycling and other aerobic activities.

Try incorporating resistance exercise two or three times a week. You don't need a gym membership – bodyweight exercises, resistance bands, lifting weights and even some everyday activities can help build strength.

The 2026 American Diabetes Association guidelines support combining aerobic activity with resistance training for metabolic health.

2. Move more throughout the day – not just during exercise

You might go for a 30-minute walk every morning, but what happens during the remaining waking hours?

Research increasingly suggests that long periods of uninterrupted sitting aren't ideal for blood glucose regulation, even when we exercise regularly.

A 2026 systematic review and meta-analysis found that short activity breaks during prolonged sitting reduced glucose and insulin responses after meals.

Walking breaks were particularly effective.

What does this mean in everyday life?

Get up and move regularly if you work at a desk.
Take a short walk after lunch or dinner.
Stand up during phone calls.
Break up long periods of television watching.
Aim for at least 150 minutes of moderate physical activity each week.

You don't have to do everything at once. Even short bursts of movement can contribute to better metabolic health.

And a ten-minute walk after dinner might be one of the easiest habits to introduce.

Research: Activity breaks, glucose and insulin – systematic review and meta-analysis, 2026

3. Eat for better blood sugar regulation – without following a complicated diet

Food is important in diabetes prevention, but there isn't one perfect diet that everyone needs to follow.

The 2026 American Diabetes Association guidelines recognise several evidence-based dietary patterns, including Mediterranean-style and lower-carbohydrate eating.

What these approaches generally have in common is an emphasis on nutritious foods and fewer highly refined, heavily processed products.

Some practical changes include:

Choose carbohydrates more carefully. Refined carbohydrates such as white bread, sugary cereals, sweet drinks and many packaged snack foods can be easy to overconsume and may raise blood glucose quickly.

Include protein with meals. Eggs, fish, meat, legumes, nuts and seeds can contribute to satisfying, balanced meals.

Eat more fibre. Vegetables, berries, legumes, nuts and seeds provide fibre, which supports gut health and can help moderate blood glucose responses.

Choose minimally processed foods more often. Foods closer to their natural form generally provide a better combination of nutrients and fibre than many ultra-processed alternatives.

Be mindful of liquid sugar. Soft drinks, energy drinks and even some fruit juices can deliver substantial amounts of sugar without being particularly filling.

Reducing refined carbohydrates can be a useful strategy, particularly for people with insulin resistance, but it doesn't mean eliminating every carbohydrate.

The amount and type of carbohydrate that works best will vary between individuals.

And remember, what you eat most of the time matters far more than the occasional treat.

4. Prioritise sleep – your blood sugar depends on it

Sleep often gets overlooked in discussions about diabetes prevention.

Yet it's becoming increasingly clear that poor sleep is closely connected with metabolic health.

Research has linked short sleep duration, poor sleep quality and disrupted sleep patterns with a higher risk of developing type 2 diabetes.

Sleep restriction can affect insulin sensitivity, appetite regulation and the hormones involved in managing energy.

The 2026 American Diabetes Association guidelines specifically highlight sleep health as an important consideration for people at risk of diabetes.

Aiming for around seven to nine hours of good-quality sleep is a sensible starting point for most adults.

Try maintaining a consistent bedtime, limiting late-night screen time, keeping your bedroom cool and dark, and avoiding caffeine too late in the day.

If you regularly snore heavily, wake up exhausted or experience daytime sleepiness, it's also worth discussing possible sleep apnoea with your healthcare provider.

Sleep isn't simply downtime. It's an important part of keeping your metabolism functioning well.

5. Don't underestimate chronic stress

When you're stressed, your body releases hormones such as cortisol and adrenaline.

These hormones help prepare you for action by making more energy available, including increasing glucose in the bloodstream.

This is useful when dealing with an immediate threat, but ongoing stress can influence sleep, appetite, physical activity and glucose regulation.

The relationship between stress and diabetes is complex. Stress reduction alone hasn't been shown to prevent diabetes in the same way that structured lifestyle programmes have.

Nevertheless, managing stress is an important part of looking after overall health.

Walking outdoors, spending time with friends, breathing exercises, gardening, mindfulness and making space for enjoyable activities are all worthwhile.

The goal isn't to eliminate stress completely – that's unrealistic – but to create opportunities for your body and mind to recover.

6. Pay attention to waist circumference and body composition

We often focus on the number on the scales, but where body fat is stored can matter too.

Excess visceral fat – the fat stored around internal organs in the abdomen – is strongly associated with insulin resistance and an increased risk of type 2 diabetes.

This is one reason waist circumference can provide useful information beyond body weight alone.

For people carrying excess weight, research shows that losing even a modest amount can significantly reduce diabetes risk.

The 2026 diabetes prevention guidelines recommend targeting approximately 5–7% weight loss for adults with overweight or obesity who are at high risk of type 2 diabetes.

But weight loss isn't the only goal.

Building muscle, improving fitness, sleeping well and eating more nutritious foods can all support better metabolic health, whether or not the scales change dramatically.

And because genetics and other factors influence diabetes risk, people of all body sizes can benefit from looking after their metabolic health.

7. Know your numbers – don't wait for symptoms

Type 2 diabetes often develops gradually, and many people feel perfectly well in its early stages.

That's why screening is so valuable, particularly if you have risk factors.

In New Zealand, an HbA1c blood test is commonly used to screen for and diagnose diabetes.

It provides an indication of your average blood glucose over approximately the previous two to three months.

Important: New Zealand changed its HbA1c diagnostic thresholds on 1 July 2026.

HbA1c result	Interpretation
Below 42 mmol/mol	Below the prediabetes range
42–47 mmol/mol	Prediabetes
48 mmol/mol or higher	Diabetes range

Depending on the result and whether symptoms are present, confirmatory testing may be needed.

It's also worth knowing your blood pressure and cholesterol results and discussing your family history with your GP.

People with a history of gestational diabetes, polycystic ovary syndrome (PCOS), or a strong family history of type 2 diabetes may need more regular screening.

In New Zealand, Māori, Pacific and South Asian communities also experience a greater burden of type 2 diabetes, including diagnosis at younger ages.

Early detection provides more opportunities to take action.

Source: Diabetes New Zealand – changes to HbA1c diagnostic criteria

What is the latest thinking on preventing diabetes?

One of the biggest shifts in diabetes prevention is moving away from looking at blood glucose in isolation.

Researchers and healthcare professionals increasingly recognise that metabolic health involves multiple interconnected systems.

Muscle, liver, pancreas, body fat, sleep, physical activity and nutrition all influence how effectively the body manages glucose.

The 2026 diabetes guidelines reinforce several important messages:

There is no single ideal diet for everyone at risk of diabetes.
Resistance training and reducing sedentary time matter alongside aerobic exercise.
Sleep health deserves attention as part of metabolic care.
Modest, sustainable lifestyle changes can have lasting benefits.
Structured prevention programmes and ongoing support can help people maintain changes.

We needn't become obsessed with every blood sugar fluctuation, although maintaining stable blood sugar is important. Looking after our metabolic health and preventing Type 2 diabetes requires a broader lifestyle approach than just eating less sugar.

Frequently asked questions about diabetes prevention

Can type 2 diabetes really be prevented?

Yes, type 2 diabetes can often be prevented or delayed, particularly in people with prediabetes or other risk factors. However, prevention isn't guaranteed because genetics, age and other factors also influence risk.

Can you have insulin resistance without having diabetes?

Absolutely. Insulin resistance can develop years before blood glucose reaches the prediabetes or diabetes range. Your body may initially compensate by producing more insulin.

What's the best exercise to prevent type 2 diabetes?

A combination of aerobic exercise and strength training is a good approach. Walking, cycling and swimming support cardiovascular health, while resistance training helps maintain muscle and improve insulin sensitivity. Reducing prolonged sitting is also beneficial.

Does eating sugar cause diabetes?

Type 2 diabetes isn't caused by sugar alone. It develops through a combination of genetic, metabolic, environmental and lifestyle factors. However, regularly consuming excess energy and sugar-sweetened drinks does contribute to increased risk.

Can prediabetes be reversed?

Blood glucose levels can return below the prediabetes range through lifestyle changes and, in some cases, medical treatment. This is encouraging, although continued healthy habits and appropriate monitoring are still important.

Do you have to follow a low-carb diet to prevent diabetes?

No, although lower-carbohydrate diets can be effective for some people, but Mediterranean-style and other nutritious dietary patterns also have evidence supporting diabetes prevention. The one thing that does seem to be important is focusing on whole foods that are minimally processed. Food quality, sustainability and individual needs matter.

The bottom line: small changes really do add up

Preventing type 2 diabetes isn't about following a perfect diet, exercising every day or completely changing your life overnight.

It's about making choices that support your body's ability to regulate blood glucose and respond effectively to insulin.

Eating more whole foods, building muscle, moving regularly, prioritising sleep and managing stress are all steps in the right direction.

And perhaps most importantly, you don't have to wait until you have prediabetes or diabetes to start looking after your metabolic health.

The earlier you begin, the more opportunities you have to protect your long-term health.

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Written by Ianthe Jones, MSc – nutritionist and health coach, Wholo Foods.

This article is intended for general education and is not a substitute for personalised medical advice. If you're concerned about your blood glucose, diabetes risk or symptoms, speak with your GP or another qualified healthcare professional. Diabetes risk is influenced by many factors, and lifestyle changes cannot guarantee prevention.

References and further reading

1. American Diabetes Association (2026). Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes—2026. Diabetes Care, 49, S50–S60.

Read the research

2. American Diabetes Association (2026). Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026. Diabetes Care, 49, S89–S131.

Read the research

3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Diabetes Prevention Program (DPP) and Outcomes Study. Covers the landmark research showing a 58% reduction in type 2 diabetes incidence through intensive lifestyle intervention.

Read the study overview

4. Gale, J. T., Martin, H., Haszard, J. J., & Peddie, M. C. (2026). The Acute Effects of Interrupting Prolonged Sitting With Regular Activity Breaks on Postprandial Glucose and Insulin in Adults: A Systematic Review and Meta-Analysis. Obesity Reviews, 27(11), e70152.

Read the research on PubMed

5. Diabetes New Zealand (2026). HbA1c for diagnosing diabetes is lowering. Explains the new New Zealand HbA1c diagnostic thresholds introduced on 1 July 2026.

Read the New Zealand guidelines

6. World Health Organization (2026). Diabetes – Questions and Answers. Updated 1 September 2026. Covers diabetes types, prevention, diagnosis and management.

Read the WHO information