Worried about diabetes? You’re not alone. Type 2 diabetes is a big health concern worldwide, and projected to affect 642 million people globally by 2040. But there’s good news: you can take steps to drastically lower your risk.

Think of it this way: some things, like getting older, we can’t change. But many things, like our weight and lifestyle, we can. Studies show that making healthy lifestyle changes can cut your risk of diabetes in half! However, it’s tougher to do this in our everyday lives than in a controlled study. That’s because real life is messy, and sticking to a healthy plan is hard when you’re dealing with work, family, and everything else.

Here’s the thing: your surroundings matter so It’s not just about your willpower. If your environment makes it hard to be healthy, it’s going to be a struggle. You can see that impact clearly when studies report that there is a 26% increased risk of developing diabetes for a non-diabetic partner but whose spouse is diabetic, this is possibly as a result of shared lifestyle and environment that affect the ease of making healthy choices.

How much do genes affect your type 2 diabetes risk?

Now, you might wonder, “What about my genes?” Well, genetics do play a role, but they’re not the whole story. While some people are more likely to develop diabetes because of their genes, lifestyle and environment are huge factors. It is estimated that genes accounting for only 15-20% of type 2 diabetes risk, while obesity contributes to approximately 48% of the risk, and smoking contributes about 10%.

Think of it like this: your genes might load the gun, but your lifestyle pulls the trigger.

Yes, People with a genetic predisposition to diabetes are more likely to develop the condition, even in favorable environments. For example, the Pima Indians, who have a strong genetic risk, have higher risk of developing diabetes even with a “normal” lifestyle or weight. However, when their non-Pima neighbors started experiencing negative changes in lifestyle and environment in recent years, their diabetes rates also increased.

Other Factors

The global rise in average body mass index (BMI) is a major contributor to the type 2 diabetes epidemic. Even if general obesity rates seem to stabilize in some areas, abdominal obesity is still increasing. A 13-year study in the U.S. showed that a moderately elevated BMI of 27 tripled the risk of diabetes compared to a BMI of 22, with abdominal obesity being a strong predictor of type 2 diabetes risk. This shows that the obesity epidemic we are experiencing now is a key factor in the increased number of people currently living with this condition.

However, it’s not just about your weight. Even if you’re not overweight, things like being inactive, stress levels, environmental pollution can still increase your risk. Keep reading to find out what you should incorporate in your diet and daily routine and what you should avoid or limit in your surrounding to reduce your risk of developing type 2 diabetes, or even reverse the condition.

In this article we will explore together all these factors that influence your risk of developing type 2 diabetes (T2D), focusing on lifestyle and environmental elements and how they interact with your body.

How Does Your Lifestyle Impact Your Risk Of Type 2 Diabetes?

Your weight

For those concerned about developing type 2 diabetes (T2D), lifestyle adjustments can significantly reduce risk. Studies have shown that focusing on moderate weight loss through dietary changes and increased physical activity is a key strategy. In one of the most impactful  clinical trials on the subject, high-risk individuals who followed these lifestyle changes saw a 58% decrease in diabetes incidence compared to control groups over 3-4 years. Notably, this benefit was achieved with only about a 5% body weight loss in the first two years.

This modest weight reduction appeared to specifically target visceral fat, a major factor in diabetes risk.

However, long-term follow-up from the initial prevention trial reveals a gradual decline in the intervention’s effectiveness after a number of years. This suggests that while lifestyle changes can delay T2D for several years, maintaining weight loss is crucial for sustained protection, as seen in individuals after bariatric surgery. Weight regain over time likely diminishes the long-term benefits of these interventions.

When considering weight and body fat, it’s important to understand that while overall weight, as measured by BMI, is a factor, the location of your body fat is more critical. Specifically, excess fat around your organs, known as visceral obesity, and fat accumulation in your liver, called ectopic fat, significantly elevates your T2D risk. Interestingly, individuals with a normal weight can still develop T2D if they have these types of fat accumulation, particularly common in Asian populations. Conversely, some obese individuals with minimal visceral or liver fat exhibit fewer metabolic problems.

How healthy and balanced your diet is?

Diet plays a significant role in T2D risk through various mechanism including weight control and the presence and balance of certain nutrients that regulate blood sugar and insulin secretion and the body’s response to insulin. Research demonstrates that even a 3% weight loss in obese individuals with recent-onset T2D, achieved through a very low-calorie diet, led to a 30% reduction in liver fat and normalized blood sugar within a week. Additionally, this diet improved pancreatic beta-cell function after eight weeks. A protein-rich, low-calorie meal replacement diet also showed considerable improvements in metabolic control, reduced medication needs, and lower body weight in individuals with insulin-treated T2D.

In terms of the type of food you should be focusing on, generally plant-based diets are associated with a lower risk compared to meat-heavy diets. Foods with lower energy density, meaning fewer calories per serving, are more protective than high-density foods. Refined grains and sugary drinks consistently increase the risk of obesity and T2D. However, a daily handful of nuts might offer some protection, despite their high calorie content. Fermented dairy such as yogurt and kefir, is more beneficial than non-fermented dairy for reducing T2D risk. The US government now emphasizes overall eating patterns, such as Mediterranean or vegetarian diets, rather than just strict limits on carbohydrates, fats, and proteins, as having a balanced diet with more emphasis on the protective foods is a key.

Notably, a four-year study, involving approximately 140 individuals with high cardiovascular risk, showed that a Mediterranean diet supplemented with olive oil or nuts reduced the progression to T2D by roughly 50% compared to a low-fat diet, even with minimal weight loss. Furthermore, the diets of centenarians, people who live to be over 100 years old, in places like Okinawa, Sicily, and Loma Linda, often feature a high intake of vegetables, fruits, and whole grains. However, it’s crucial to acknowledge that other factors, such as genetics, activity levels, and social support, also contribute to longevity.

How healthy is your gut?

Your gut microbiome plays a crucial role in T2D. Your gut bacteria influence inflammation, metabolism, and overall health. Changes in gut bacteria diversity and composition are linked to metabolic diseases, including T2D. A review of 42 studies identified Specific gut bacteria genera, such as  Ruminococcus, Fusobacterium, and Blautia as positively associated with T2D risk, while others such as  Bacteroides, Bifidobacterium, Akkermansia, Roseburia, and Faecalibacterium, appear to have a protective role against T2D.

These bacteria influence processes like inflammation and energy metabolism. Studies also report that lower diversity in your gut bacteria can be associated with increased risk of insulin resistance, weight gain, adiposity, and inflammation. Various lifestyle and environmental factors, such as diet, stress, use of antibiotics, sedentary lif, etc…, can impact your gut bacteria and consequently risk of diabetes.

The level and duration of your Physical activity

Moving beyond infections, lifestyle habits significantly impact T2D risk. Increasing your overall physical activity can reduce your risk by approximately 30%. This includes both leisure and occupational activities.

Notably, exercise enhances insulin sensitivity and blood sugar control, even in individuals without diabetes. A study report that replacing just 30 minutes of sedentary time with moderate to vigorous activity can improve insulin sensitivity by 15%. Moreover, the benefits of exercise extend beyond calorie expenditure, improving the body’s ability to utilize insulin.

How much screen time do you have? And how long do you spend time not moving?

Prolonged sedentary behavior, such as excessive sitting or television watching, increases T2D risk, even with regular exercise. In fact, prolonged sedentary time may double the risk of developing diabetes. One study highlighted that each hour of television watching increased diabetes risk by 3.4% over 3.2 years. However, even simple changes, like standing and moving more throughout the day, can yield positive metabolic effects, with energy expenditure doubling within minutes of standing and walking compared to a mere 5% increase while sitting.

Your consumption of coffee and alcohol

Well, if you like coffee, there is some good news here. Consuming three or more cups of coffee daily, whether caffeinated or decaffeinated, is associated with a 25-30% lower risk of T2D, although the precise mechanism remains unclear. Similarly, consuming green tea daily might modestly improve blood sugar control, with studies showing an average decrease of fasting blood sugar by 1.4 mg/dL and a 10-15% reduced risk with three or more cups a day.

However, it is crucial to understand that caffeine consumption, especially in high amounts, can have a lot of negative side effects, particularly if you have certain medical conditions. So generally only consume in moderation, and if you don’t already drink coffee, do not just start now without weighing the pros and cons and discussing with your physician beforehand.

Interestingly, alcohol consumption can have a dose dependent relationship with diabetes, a small to Moderate consumption, defined as 1-2 drinks per day, may reduce T2D risk by about 18%, particularly red wine and the effect is more prominent in women, but this might not apply to Asian populations, however when consumption is increased, it can significantly elevate the risk of diabetes.

But of course, alcohol in general has a plethora of adverse effects on the body, so I believe the mild good that it may do in regards to reduction of diabetes risk definitely doesn’t overweight the general risk it poses on your health. But if you are already a light or a social drinker, try to favor a glass of red wine over any other alcoholic drink, as the antioxidant and anti inflammatory effects of its components have been proven over and over again in various studies.

Do you smoke?

Smoking, both active and passive, increases T2D risk. If you are currently smoking, you are 30 to 40% more likely to develop diabetes than someone who doesn’t. Not just that, how much you smoke also plays a role, with studies reporting that heavy smokers face a higher risk, approximately 1.6 times greater, than lighter smokers or former smokers, whose risk is around 1.3 and 1.2 times greater, respectively.

How well do you Sleep?

Poor sleep quality and short sleep duration are significant risk factors. A meta-analysis of 11 studies including 482,502 participants concluded that sleeping 7–8 hours per night is associated with the lowest diabetes risk, with each hour below that increasing the risk by 9%. While the relationship between long sleep and daytime napping is less clear, sleep lab studies have shown that just five days of restricted sleep can decrease insulin sensitivity by 29%, and even a single night of four hours of sleep reduces glucose elimination rate, which is an important marker for insulin resistance and diabetes.

Previous or current Infections you may have

Certain infections, such as hepatitis C and Chlamydia pneumoniae, are linked to increased T2D risk. Hepatitis C can lead to liver complications and insulin resistance, while Chlamydia pneumoniae can impair insulin-producing cells due to systemic inflammation. Therefore, while a single infectious culprit is unlikely, chronic infections and the resulting inflammation can contribute to insulin resistance and eventually diabetes.

Your mental health affects your diabetes risk

Understanding how stress affects diabetes risk is complex, as individual perceptions and coping strategies greatly influence outcomes. While studies on general stress and type 2 diabetes (T2D) have shown inconsistent results, however, long-term research may provide clearer insights. A 35-year study on 7251 Swedish men found a notable link between perceived stress and later diabetes development. Similarly, men and women experiencing burnout syndrome at work also showed an increased risk.

More consistently, symptoms of depression and anxiety correlate with a higher diabetes risk. It appears this relationship is two-sided, meaning each can exacerbate the other. Additionally, social isolation plays a role, particularly for men. Research indicates that men living alone face a significant 89% elevated risk of T2D, this heightened risk was not observed in women.

Your Living and Working Environment Matter

Your Socioeconomic status, Social Circle and Neighborhood

Lower socioeconomic status, measured by education, occupation, or income has been linked to about 40% higher risk. In Europe, much of this increased risk is associated with higher BMI, while in Australia, smoking and lack of physical activity are major contributing factors. It is suggested that increasing income may reduce T2D risk if it leads to healthier diet and lifestyle changes. Furthermore, living in a deprived area can double the risk of type 2 diabetes, and moving to a low deprivation area has been shown to reduce HbA1c levels and reduce T2D risk.

Perceived crime in a neighborhood may be linked to increased T2D risk, but further research is needed. Importantly, social environment factors have strong links to lifestyle behaviors and obesity, and they may also influence T2D risk through chronic stress and inflammation.

How Walkable is Your Neighborhood?

Think about how easy it is to walk around where you live. Is it designed to encourage walking? Things like how close shops and services are, the layout of streets, and even how nice the area looks can make a big difference. A walkable neighborhood, characterized by density, mixed land use, good design, connectivity, accessible destinations, and often safety and aesthetics, can all positively impact diabetes risk.

Researchers call this “walkability.” Studies suggest that living in a more walkable area can actually lower your risk of developing type 2 diabetes. In fact, one study showed that a small increase in walkability can decrease your risk by about 12%. On the flip side, living in a place that’s not very walkable seems to increase the risk. Interestingly, women, long-term residents, and people who’ve recently immigrated might see an even stronger effect. So, take a look around your neighborhood—could you easily walk to get your daily needs met?

Do You Have Access to Places to Be Active?

Now, let’s talk about physical activity. Do you have easy access to parks, gyms, or other recreational places where you can get moving? Research has looked at this, and the findings are a little mixed. Studies show that having more access to these resources can lower your diabetes risk, with one study suggesting a 21% reduction with increased access.

However, other studies haven’t found a strong link. It seems that when researchers combine information about exercise with access to healthy food, they see a stronger effect. So, while having a gym nearby is great, it’s just one piece of the puzzle, as without healthy food habits, the effect may not be as significant.

What’s Your Food Environment Like?

We all know that what we eat is important. But have you ever considered how your neighborhood affects your food choices? Researchers have looked at the availability of healthy and unhealthy food options in different areas. Many studies show that having easy access to healthy food can significantly lower your risk of type 2 diabetes with one study reporting a 37% reduction in risk for those with the highest access to healthy foods compared to those with the lowest.

However, if you live in an area with a lot of fast-food restaurants and convenience stores, you might be at a higher risk. On the other hand, some studies couldn’t find a significant association, especially when taking into account that other factors such as your physical activity levels, diet, socioeconomic status, and BMI can reduce the impact of laving in a neighborhood with worse food options.

How Much Green Space Do You Have?

Do you live near parks or other green areas? It turns out that living in a greener neighborhood might be better for your health. Studies have shown that people who live in areas with more green space have a lower risk of type 2 diabetes. There might even be a sweet spot: some research suggests that having 40–60% green space in your area is ideal.

The Impact of Air Pollution

Air pollution has been consistently linked to an increased risk of type 2 diabetes. If you live in an area with high levels of Exposure to air pollutants, particularly particulate matter (PM) and nitrogen oxides (NO), you could be at a higher risk.

Studies examined the impact of PM2.5, NO2, PM10, and Nox on type 2 diabetes risk and found a clear association. One study found a 19% and 40% increased likelihood of developing diabetes per 10 μg/m3 increase in NO2 and PM10, respectively

The impact of air pollution appears to vary among different populations. A study in China also linked higher PM2.5 levels to increased T2DM prevalence, especially among males, less educated individuals, and those with higher BMI. While studies on women in Europe and the US observed a stronger effects of pollution among women compared to men, particularly those living closer to major roads and with lower education levels. The association also seemed more pronounced in all individuals with chronic obstructive pulmonary disease and those with higher BMI.

Noise, Traffic Proximity and Your risk

Have you ever considered that the constant hum of traffic or the drone of city life could be affecting more than just your peace of mind? Research is increasingly pointing to a connection between noise exposure and your risk of developing type 2 diabetes (T2DM). Two comprehensive systematic review and meta-analyses have confirmed a link between residential noise exposure and increased T2DM risk, but not as much when it comes to occupational noise.

Noise is considered an environmental stressor that can influence insulin secretion and sensitivity. If you’re wondering how noise can affect your health, it’s thought that it triggers stress responses in the body, potentially impacting insulin function. Studies highlight road traffic noise as a significant factor, with a large-scale study reporting that a 10-decibel increase in road noise can raise your T2DM risk by 8% to 11%. Another study even suggests a 35% jump in risk with higher road noise levels, so simply living near a busy road could be subtly increasing your chances.

Interestingly, this heightened risk appears more pronounced in specific groups: those already diagnosed with T2DM, women, and individuals with lower education levels. Also, if you’re someone who sleeps with open windows and often struggles with poor sleep, you might be particularly vulnerable. The connection to road noise persists even when accounting for air pollution, meaning noise in itself is a significant factor. While road traffic seems to be a main issue, research implies that railway and aircraft noise show weaker or no significant links, though daytime aircraft noise does show some effect.

Your exposure to certain Chemicals

Studies have established associations between chemical pollutants, such as persistent organic pollutants, pesticides, and heavy metals, and an increased risk of type 2 diabetes. These pollutants can originate from occupational hazards, air or water pollution, and food contaminants. Stronger associations have been noted in women and individuals with overweight or obesity.

How much Light you are exposed to, particularly at night?

Even something as simple as light exposure at night might affect your risk of type 2 diabetes. Do you spend too much time sitting in artificial light? Are you a night shift worker? A large study in Japanese care settings indicated a possible link, potentially due to sleep disruption and elevated glucose levels. This is because exposure to light at night can affect your circadian rhythm and your body’s ability to secret melatonin, disrupting your sleep and elevating inflammation and consequently your risk of developing diabetes.

The Lowdown

The path to diabetes prevention is a multifaceted journey, one that extends beyond simple blood sugar monitoring. We’ve explored the intricate web of environmental and lifestyle factors that significantly influence your risk, from the food on your plate to the air you breathe. It’s understandable to feel overwhelmed by the sheer number of elements at play, but remember, even small, consistent changes can make a profound difference.

My goal is to empower you with knowledge and support, not to burden you with unattainable perfection. Let’s focus on simple, actionable steps, and make sure your aim is consistent progress. Find a healthy, sustainable weight that is right for you, and nourish your body with whole, unprocessed foods, limiting sugary drinks and processed meals.

Incorporate at least 30 minutes of moderate exercise most days – find an activity you enjoy! Prioritize stress-reduction techniques like meditation or deep breathing, and ensure you’re getting 7-9 hours of quality sleep each night. Be mindful of your environment; limit exposure to air pollution when possible, and ensure good indoor air quality.

When you can, choose natural products to minimize exposure to harmful chemicals. Start by making one small change at a time. Perhaps it’s adding a daily walk, swapping sugary drinks for water, or practicing mindfulness to manage stress. Every step you take, no matter how small, is a step in the right direction.