How to prevent diabetes (type 2): small daily changes that work

Diabetes means there is too much sugar (glucose) in your blood. Type 2 diabetes is the kind most people get: WHO says more than 95 in every 100 people with diabetes have it. It is often preventable, or can be pushed back by years.

It is common here. In the 2023 National Nutrition Survey, about 22 in 100 Filipino adults aged 20 to 59, and 36 in 100 people aged 60 and over, had a fasting blood sugar in the prediabetes range: above normal but not yet diabetes. About 8 in 100 adults aged 20 to 59, and 17 in 100 people aged 60 and over, had a result in the diabetes range, and the survey found this is becoming more common.

Most of these people feel well. High sugar can stay silent for years while it harms the eyes, kidneys, nerves and heart. The US National Institutes of Health (NIH) notes that these problems become more likely the longer you have diabetes, so even a delay of a few years helps.

Type 1 diabetes is different. It comes from a problem with the immune system, not from food or habits, and WHO says no way to prevent it is known yet. Our types of diabetes guide explains the difference.

The Philippine diabetes guidelines (UNITE for Diabetes, 2011) say testing should be considered for every adult over 40, and earlier if you have one or more of these:

• A parent, brother or sister with type 2 diabetes
• Overweight: for Asians, a body mass index (BMI, your weight compared with your height) of 23 or more
• A big waist: more than 80 cm (about 31.5 inches) for women, more than 90 cm (about 35.5 inches) for men
• Little exercise, or sitting most of the day
• High blood pressure, a past stroke or heart disease
• Diabetes during pregnancy, or a baby who weighed 8 pounds (about 3.6 kg) or more at birth
• PCOS (polycystic ovary syndrome), or dark, velvety skin on the neck or armpits
• Low "good" HDL cholesterol, high triglycerides, or a past result in the prediabetes range

You cannot change your age or your family, but you can change your weight, food, activity and smoking. NIH adds that a large waist raises the risk even when your BMI is normal. Some medicines, such as steroids, can also raise blood sugar: ask your doctor about the ones you take, but don't stop any medicine on your own.

The best proof comes from a large US study, the Diabetes Prevention Program (DPP). Its volunteers were at high risk of type 2 diabetes. One group was coached to eat less fat and fewer calories, move 150 minutes a week, and lose about 7% of their weight. After about 3 years, they were 58% less likely to get type 2 diabetes than a group given a dummy pill (placebo). For people aged 60 and over, the drop was 71%. The benefit got smaller over the years but lasted: 10 years later, the coached group still got diabetes about 4 years later, on average.

The plan:

1. Lose a little weight if you are overweight. Losing 5 to 7% helps: for someone who weighs 70 kg, that is about 3.5 to 5 kg. Then keep it off.
2. Move for at least 150 minutes a week.
3. Eat smaller portions with less sugar and fat, and more vegetables, fruit and whole grains.
4. Don't smoke. Smoking makes your body respond less to insulin, the hormone that lowers blood sugar.
5. Check your blood sugar if you are at risk.

The UK guideline body NICE calls losing 5 to 10% of your weight within a year a realistic first goal. Involve your family. NICE advises getting a relative or friend to help, for example by walking with you or changing the family's meals. It also says that family members of someone with type 2 diabetes should get their own risk checked.

You don't need special "diabetic" food, just everyday Filipino meals in better amounts.

Rice. You don't have to give up kanin. Take a smaller serving, for example one cup instead of two or three, and skip unli-rice deals. Mix in brown rice (pinawa): WHO lists it as a whole grain, and the NHS advises wholegrain starchy foods because they have more fibre. Avoid piling other starches, like pancit or bread, on top of rice in the same meal.

Drinks. NIH advises water instead of sweetened drinks. Cut down on soft drinks, milk tea, juice drinks and 3-in-1 coffee. WHO counts the sugar in fruit juice and honey as "free sugar" too, so keep even pure juice small.

Vegetables and fruit. WHO advises at least 400 grams a day; the NHS counts this as about five portions. Add gulay to every meal, such as kangkong, sitaw, talong, upo or malunggay. Saging, papaya or bayabas make a better merienda than cake or sweet bread.

Fat and fried food. WHO suggests steaming or boiling instead of frying. Fatty meat, lard and coconut and palm oil are high in saturated fat, so keep lechon, chicharon and crispy pata for special days. Choose fish, skinless chicken, tokwa and munggo more often. WHO also advises limiting fried and baked foods and packaged snacks, such as doughnuts, cookies, biscuits and wafers, which can contain unhealthy trans fat.

Activity lowers blood sugar and helps with weight. NICE says moving more lowers your risk even if it is the only change you make.

• Aim for 150 minutes a week of moderate activity, like brisk walking: NIH suggests 30 minutes on 5 days.
• Any amount beats none. If 150 minutes feels too much for now, NICE says even a small increase helps and is a start you can build on.
• Everyday movement counts. WHO counts housework, work that keeps you moving, and walking or cycling to get places.
• Sit less. WHO links a lot of sitting to a higher chance of type 2 diabetes. Stand up and walk around often, for example at lunch break.

Easy ideas: get off the jeepney one stop early, take the stairs at malls and MRT stations, or join a barangay Zumba or walking group.

If you have been inactive, have joint pain or a heart problem, start slowly and ask your doctor or nurse what is safe.

Prediabetes and early type 2 diabetes usually have no symptoms, so a blood test is the only way to know.

• Fasting blood sugar (FBS): no food or drinks for at least 8 hours first (plain water is usually allowed, but follow the clinic's instructions). In mg/dL, 99 or lower is normal, 100 to 125 is prediabetes, and 126 or higher is in the diabetes range. These are the cut-offs the Philippine survey used too.
• HbA1c: your average sugar over about 3 months, no fasting needed. Below 5.7% is normal, 5.7% to 6.4% is prediabetes, 6.5% or higher is in the diabetes range.
• OGTT (oral glucose tolerance test): your blood sugar is checked before and after you drink a measured glucose drink.

A high result is usually confirmed with a second test.

How often to retest depends on your risk. The UK guideline body NICE suggests a blood test at least once a year if your result was in the prediabetes range, a recheck at least every 3 years if you have risk factors but a normal result, and a risk check at least every 5 years for everyone else. Your doctor may advise differently.

Prediabetes is a warning, not a sentence: healthy changes can delay or prevent diabetes. Our diabetes symptoms guide lists signs that mean you should be tested soon.

PhilHealth YAKAP (the expanded Konsulta package) is for every Filipino who registers with a YAKAP clinic. In May 2026, PhilHealth reported 4,287 accredited YAKAP clinics nationwide. Ask your rural health unit (RHU) or city health center whether it is one.

• Check-ups with health education: ask the doctor or nurse for a plan for food, weight and exercise.
• Blood sugar tests: FBS, OGTT and HbA1c are on PhilHealth's covered lab list (Konsulta benefit table, 2024), along with a lipid profile, when your YAKAP doctor orders them.
• Follow-up visits to recheck your weight, waist, blood pressure and sugar.
• Medicines, if your YAKAP doctor prescribes them, from accredited GAMOT pharmacies, up to ₱20,000 worth a year.

Cost (PhilHealth FAQ, July 2025): free at public YAKAP clinics; a private YAKAP clinic may charge up to ₱900 per patient for the year.

To start: have your PhilHealth Identification Number (PIN), choose a YAKAP clinic in the eGovPH app, the PhilHealth Member Portal, a PhilHealth office or the clinic, then go for your first visit and ask for a diabetes risk check.

See our PhilHealth YAKAP guide and annual check-up guide. Find a health center near you, or ask your barangay health station where the nearest YAKAP clinic is.

Diabetes in pregnancy (gestational diabetes) usually goes away after birth, but WHO notes that these mothers, and possibly their children, have a higher risk of type 2 diabetes later. NIH advises:

• A blood sugar test 6 to 12 weeks after giving birth, then every 3 years if normal.
• Being active and eating well to return to a healthy weight.
• Breastfeeding if you can; it also helps you burn calories.

NIH notes that the higher risk lasts: type 2 diabetes can appear within 5 to 10 years. Tell every new doctor about it, even years later. Planning another baby? See our prenatal check-ups guide.

In the DPP study, a diabetes medicine called metformin also lowered the risk, but less than healthy habits did: by 31%, compared with 58%.

MedlinePlus says a doctor may suggest a diabetes medicine for some people at high risk, and NIH advises women who had diabetes in pregnancy to ask their doctor about metformin. NICE adds that long-term healthy habits can work better than medicine. Metformin is a prescription medicine: take it only if a doctor prescribes it for you, and never borrow a relative's.

"Nasa lahi namin, wala na akong magagawa." (It runs in the family; nothing can be done.) Family history raises your risk, but healthy habits still lower it. Your genes are not your fate.

"Bawal lang ang matamis." (Just avoid sweets.) Big rice servings, fried food, sitting all day and smoking matter too.

"Payat naman ako." (I'm thin, so I'm safe.) Belly fat, age and family history count even if your weight looks normal.

"Herbal tea lang, okay na." (My herbal tea protects me.) WHO says lifestyle changes are the best way to prevent type 2 diabetes. Teas and capsules are not a replacement, and only a blood test shows your sugar.

"Baka meron na ako, ayaw ko malaman." (I'd rather not know.) That fear is natural, but finding prediabetes early gives you the best chance to stop it.

Want a plan for your routine? Talk to our prevention assistant or book a call with a nurse.