8 Practical Strategies to Lower Your Risk of Type 2 Diabetes

Across the diabetes prevention research covered on this site — food choices, coffee, the Mediterranean diet, exercise, obesity, and cholesterol — a handful of practical strategies keep surfacing as the ones that move the numbers most. This piece pulls them together into a single, practical list, with the actual figures behind each one.

The combined effect of diet and exercise

Before getting to individual strategies, it’s worth seeing what they add up to. An umbrella review in Nutrients (2020) measured the relative risk reduction from combining physical activity and a healthy diet, broken down by population group:

The pattern is notable: the risk reduction from combining diet and exercise was actually largest in the general population (57%) and in people with obesity (56%), and somewhat smaller — though still substantial — in people who already had prediabetes or diabetes (35-36%). The takeaway is that these combined strategies work best as prevention before diagnosis, though they still provide a meaningful reduction afterward.

With that context, here are eight specific strategies, each with odds ratios drawn from a 2025 systematic review and meta-analysis in BMC Public Health on progression from prediabetes to type 2 diabetes.

1. Get regular physical activity

Of every factor measured in that review, moderate physical activity carried the strongest single odds ratio: 0.24. That means people with regular moderate activity had substantially lower odds of progressing to diabetes than those without. This is covered in more depth in terms of exactly how much activity — and which activities — count, using MET values as the measure.

2. Eat a protective dietary pattern

“Eating healthy” carried an odds ratio range of 0.33 to 0.81 depending on the specific pattern measured — with the Mediterranean diet at the strong end of that range. This lines up with the food-level research on which specific items raise or lower risk, and with dedicated research on the Mediterranean diet’s effect on metabolic markers.

3. Maintain a healthy weight

Weight-related measures carried odds ratios from 1.21 (high BMI) up to 2.44 (high waist-to-hip ratio) when elevated — meaning maintaining a healthy weight, and particularly a healthy waist-to-hip ratio, is one of the more substantial levers available. The steepness of the BMI-to-risk curve is covered in detail separately, including why body shape matters as much as overall weight.

4. Reduce stress and anxiety

Psychosocial factors carried some of the largest odds ratios in the entire dataset: anxiety at 2.61 and depression at 1.88. Managing stress isn’t typically framed as a diabetes-prevention strategy in general health advice, but based on these figures, it arguably deserves to be treated as seriously as diet or exercise.

5. Get adequate sleep

Insufficient sleep carried an odds ratio of 1.36 — meaningful, though smaller than the psychosocial factors above. Prioritising consistent, adequate sleep is a comparatively low-effort strategy relative to its measured effect.

6. Quit smoking

Smoking carried an odds ratio of 1.31 in this dataset, and separate dedicated research shows current smokers have a 30-40% higher risk of diabetes overall, with risk rising further with cigarettes smoked per day. Quitting addresses one of the more clearly dose-dependent risk factors identified in this research area.

7. Limit alcohol intake

Drinking carried the smallest odds ratio among the lifestyle factors measured, at 1.07 — still a measurable increase in risk, but modest compared to the other factors on this list.

8. Consider your coffee habit

Coffee doesn’t appear in the risk-avoidance list from this particular review, but it’s worth including here given how consistently it appears elsewhere in diabetes prevention research — a pooled analysis of over 71,000 participants found regular coffee drinkers (3 or more cups a day) had meaningfully lower odds of developing type 2 diabetes than occasional drinkers, a finding covered in full elsewhere.

Putting it together

None of these eight strategies works in isolation in the research — they were measured as separate factors, but the combined diet-and-exercise data at the top of this article shows the effect of tackling more than one at once is where the largest risk reductions were observed. Rather than picking a single strategy, the research suggests the more of this list that’s addressed simultaneously, the better the combined effect is likely to be.

Frequently asked questions

Which single strategy has the strongest evidence behind it? Based on the odds ratios in this dataset, regular moderate physical activity (0.24) and a healthy dietary pattern (0.33-0.81 depending on pattern) carried the strongest associations with reduced risk, though psychosocial factors like anxiety and stress carried comparably large odds ratios in the opposite direction when present.

Is stress really as important as diet for diabetes prevention? Based on the reviewed odds ratios, anxiety (2.61) and depression (1.88) carried higher odds ratios than some individual lifestyle factors like smoking (1.31), suggesting psychosocial wellbeing deserves more attention in diabetes prevention than it typically receives.

Do these strategies matter if I already have prediabetes or diabetes? Yes, though the combined diet-and-exercise risk reduction was somewhat smaller in people already diagnosed with prediabetes (36%) or diabetes (35%) compared to the general population (57%) in this research — still a substantial effect, just not as large as prevention before diagnosis.

This article is for general information only and does not constitute medical advice. If you have a diagnosed diabetic or prediabetic condition, consult your doctor before making changes to diet, exercise, or lifestyle habits.