Eat more fruit and vegetables, steer clear of fried foods, walk more, sit less and so on. Heard these messages a time or two? Although you know all too well that implementing one or more of these healthy behavior changes could help prevent or delay pre-diabetes or Type 2 diabetes, life’s challenges continue to get in the way of your best intentions time and time again.

Diabetes: A Special Report

“The leap from knowing to doing can loom as large as a step the size of Superman’s,” says Joan Bardsley, an assistant vice president at the MedStar Health Research Institute and president of the American Association of Diabetes Educators. “Pair this challenge with our high-fat-food-focused, technology-laden society that thwarts efforts at every turn to eat fewer calories and burn more,” Bardsley adds.

These nine steps can help you make those all-important behavior changes.

1. Be ready

You — not your spouse, parent or health-care provider — need to acknowledge that the habit you want to change is a problem. Experts call this readiness to change. People are ready to change different behaviors at different times. You may be ready to start walking 20 minutes at lunch, but don’t intend to change your menu options at lunch.

“Slowly and over time untangle your unhealthy habits to positively impact your weight, glucose levels,” says William Polonsky, an associate professor at University of California at San Diego and president of the Behavioral Diabetes Institute .

2. Take stock

Assess your food choices, eating habits and exercise habits. Keep records for a few days to see your reality in black and white. Be honest with yourself.

3. Choose a change or two

Change behaviors you want to change and ones that will benefit you in a meaningful way. Tie the trigger for the new behavior to an existing one. Example: If you want to eat more fruit and you regularly eat breakfast, include fruit with breakfast.

Believing a change is important and having the confidence to make it is critical. “Importance is having more reasons to change the behavior than to continue doing it. Confidence is your belief in yourself to change the behavior,” Polonsky says.

4. Set SMART (specific, measurable, attainable, realistic, time-frame specific) goals

Choose one to three small, meaningful changes you can live with long term. Set your goals honestly, specifically and realistically. If they’re too general or overly ambitious, you won’t achieve them.

5. Track progress

Most formal weight-management programs encourage the use of tracking tools to record your food intake, calories, time spent exercising and moods. These raise awareness and increase accountability.

6. Evaluate progress, revamp

To string together a series of behavior changes that eventually become a healthier lifestyle takes months, perhaps years. Gain insight from both positive and negative experiences. People repeatedly start these ventures with excitement. Then unexpected events occur, whether positive or negative. “Expect life to get in the way of your best intentions,” says Felicia Hill-Briggs, an associate professor at Johns Hopkins medical institutions and senior director of population health research and development at Johns Hopkins HealthCare. She encourages people to make a list of potential roadblocks and then think through solutions before beginning. This tactic prevents being blindsided by bumps along the way.

7. Experience success

Take simple steps to set yourself up for success. For instance, bring healthy snacks in controlled portions to work to minimize hunger and unhealthy deviations and set out your exercise clothes the night before. Success breeds success.

8. Repeat

“Keep biting off small changes that have meaningful benefit to you,” Hill-Briggs says. Implement one tiny habit change, then another. Continue to practice the changes you’ve made. Over time, collective changes build a healthier way of living.

9. Seek and find support

Most people maximize their success by surrounding themselves with a cheerleader or two. “Education and support delivered by a diabetes educator or other trained health professional can help you prioritize your goals and develop strategies to jump over hurdles and not be derailed by pitfalls,” Bardsley says.

To slow this epidemic of pre-diabetes and Type 2 diabetes, more workplaces, hospitals, community centers and places of worship are offering diabetes prevention and management programs. Look around. Or consider an online program. Do, however, make sure a knowledgeable counselor is available . Research shows it’s important to increase success.

People Who Changed Behavior and Found Success

Mary Buckley, 57
Chief information officer at Chester County Hospital in Pennsylvania

When Mary Buckley got married, she weighed 118 pounds, but after two pregnancies and a breast cancer diagnosis that she said caused her to treat herself to food for comfort, she topped 200. “I was disgusted with myself. I didn’t feel good, my feet hurt,” she says. Her doctor told her she was at risk for Type 2 diabetes, so she enrolled in a year-long diabetes-prevention program at a hospital funded through a grant from the Centers for Disease Control and Prevention to the American Association of Diabetes Educators.

“My heart was not in it at first,” she says. “I did just enough to lose a few pounds, but I couldn’t get my poor sleep and night binging under control.” Then she joined a gym and signed up for 10 sessions with a personal trainer who pushed her. “I felt good after working out and I wasn’t as apt to eat from dinnertime to bedtime and beyond.”

Buckley has shed 25 pounds. Her cardiologist said her blood pressure is under control and she is not taking any medication. She eats regularly rather than going hours without food and keeps healthy snacks with her.

“Don’t think you should be able to go this alone. It’s tough work. Find your champions and surround yourself with cheerleaders,” she says.

Robyn Wilson, 33
An administrator for Ahold USA retail from Harrisburg, Pa.

Robyn Wilson weighed 250 pounds when she turned 30. She had a strong family history of Type 2 diabetes and was diagnosed with it, too. Wilson dramatically changed her food choices and eating habits and largely stopped eating packaged foods, instead choosing fresh fruit and vegetables. “I said no to sweets, sugar-sweetened drinks and unhealthy carbohydrates,” Wilson says. She started drinking more water. She found that when she had a good night’s sleep, it tamped down cravings for unhealthy foods. She became an aerobics instructor and lost 80 pounds. Her weight has been holding steady at 170 and she no longer needs glucose-lowering medication. She attends a monthly diabetes group coordinated by a registered dietitian at her workplace, and she leads the support group’s monthly exercise. “Don’t eat things you don’t like or do activities you don’t enjoy,” Wilson says. “Do what puts a smile on your face.”

Warshaw, a registered dietitian and certified diabetes educator, is the author of numerous books published by the American Diabetes Association.


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