Studies including the landmark Diabetes Prevention Program have shown that lifestyle changes can prevent or delay the onset of type 2 diabetes in people with a high risk. Some of the most common strategies include:

• Eating a good diet. Dietitians typically recommend a balanced diet low in sugar, high in fiber, low in saturated fats, and adequate in monounsaturated fats, omega-3 fats and protein.
  
  
• Losing weight and maintaining a healthy weight. Fat makes cells more resistant to insulin. Most cases of type 2 diabetes occur in people who are overweight or obese. Losing weight can make cells more receptive to insulin and restore glucose (blood sugar) levels to a normal range. Even a modest weight loss of 10 to 15 pounds can be enough to make a difference. People at a healthy weight should maintain it.
  
  
• Exercising. Engaging in regular exercise lowers glucose levels and helps the body to use insulin. Even moderate exercise, such as walking for 30 minutes five days a week, can also contribute to weight loss, keep blood pressure down and reduce cholesterol levels. Patients should consult with their physician before starting an exercise program. This is particularly important if someone has a history of heart disease, high blood pressure, vascular disease such as atherosclerosis, or disorders of the feet or legs.
  
  
• Controlling cholesterol. A person’s total cholesterol level (which includes LDL, HDL and triglycerides) should be no more than 200 milligrams per deciliter (mg/dL) and no more than five times the HDL level. Regular exercise and a heart-healthy diet can reduce levels of total cholesterol, LDL cholesterol and triglycerides. If these strategies are unsuccessful, a physician may prescribe cholesterol-reducing drugs. Researchers reported in 2005 that one fibrate, a type of cholesterol drug, may postpone the onset of type 2 diabetes in obese people.

• Controlling high blood pressure (hypertension). The target blood pressure for most people is below 120/80 millimeters of mercury (mm Hg). Hypertension can be controlled through self-monitoring, eating a heart-healthy, low-salt diet, engaging in regular exercise and taking blood pressure medications if necessary.  ACE inhibitors and angiotensin-II receptor blockers (ARBs) might lower the risk of developing type 2 diabetes.
  
  
• Watching intake of alcohol. Alcohol affects the clearance of fat from the liver, increases high blood pressure and raises levels of triglycerides in the blood. It is also high in calories and may contribute to weight gain. Some studies have found that modest consumption of alcohol may reduce risk of diabetes and cardiovascular disease, but heavy consumption is a risk factor for diabetes and many other health problems.
  
  
• Quitting smoking (or not starting to smoke). In addition to causing lung disease, smoking raises blood pressure and raises blood glucose levels.
  
  
• Breastfeeding. Two major studies involving more than 157,000 women found that the longer women breastfed, the more they lowered their risk of developing type 2 diabetes.