Given the epidemic of diabetes sweeping the United States and many other countries, it can seem as though developing diabetes is inevitable. Not so. A landmark clinical trial called the Diabetes Prevention Program (DPP) showed that a healthy diet and regular exercise can prevent type 2 diabetes. This three year study found that people who lose 5% to 7% of their weight and exercise about 30 minutes a day can reduce diabetes risk by more than half.

The Look AHEAD study also showed that losing weight and exercising can be a powerful way to fend off diabetes. The trial compared lifestyle changes (portion-controlled diets with prepared meals and moderate-intensity exercise for at least 175 minutes a week) with simple diabetes education. After one year, people in the lifestyle group had lost an average of 8.6% of their body weight, compared with 0.7% in diabetes education group. With the combination of weight loss and exercise came improvements in blood sugar, blood pressure, and HDL (good) cholesterol. Later follow-up showed that these improvements extended over the first four years of the study.

Researchers at Boston University and Massachusetts General Hospital have developed a bionic pancreas. In an early test of the device, reported online this week in the New England Journal of Medicine, it helped control blood sugar levels in 20 adults and 32 teenagers with type 1 diabetes who went about their daily lives without the constant monitoring and injecting that’s required with type 1 diabetes. Right now, this artificial pancreas is essentially an app that runs on an iPhone wirelessly connected to a monitor worn on the abdomen that continually checks blood sugar and two pumps, one for insulin and one for glucagon. The team that developed the bionic pancreas have begun a second round of testing, and hope to have a more sophisticated version on the market in five years. While not a cure, the development of a bionic pancreas represents a bridge that would let people with type 1 diabetes control their blood sugar with less hassle, and more safely, than they do now.

Go ahead and say "yes" to another cup of coffee. Increasing your intake may help reduce your risk of type 2 diabetes. That's according to a study published online in the April 24, 2014, Diabetologia. Harvard researchers found that people who raised their coffee intake by more than one cup per day over a four-year period had an 11% lower risk for type 2 diabetes in the next four years compared with those who made no changes in consumption. Researchers also found that the opposite was true: lowering coffee consumption by more than a cup per day was associated with a 17% increased risk for type 2 diabetes. What is it about this savory brew that's so healthful? "It's unclear if it's something in the coffee beans or if it's in the caffeine. Some studies show reduced risk of type 2 diabetes with decaffeinated as well as caffeinated coffee, but the results have been more consistent for caffeinated coffee. Some possible explanations, beyond caffeine, include chlorogenic acid, which may delay glucose absorption, magnesium, and polyphenols," says Dr. JoAnn Manson, coauthor of the study and professor of medicine at Harvard Medical School. Want to try it? Just keep in mind that a cup is considered 8 ounces of coffee, either black or with a small amount of milk or sugar. Too much caffeine—more than 300 milligrams per day—may lead to insomnia, nervousness, and the jitters.

Q. I've heard that taking statins can raise your risk of diabetes. Is this really true?

A. While it's true that some research has shown a link between statin use and a higher risk of diabetes, that observation doesn't necessarily prove a cause-and-effect relationship. However, in a small number of people, statins may raise blood sugar levels—potentially enough to trigger a new diagnosis of diabetes. The risk appears to be greater with higher-potency statins, such as atorvastatin (Lipitor) and simvastatin (Zocor), according to some research.

For people with obesity and uncontrolled diabetes, weight-loss surgery can bring diabetes under control far more effectively than medications, a New England Journal of Medicine study has shown.

The study included 150 people with an average body mass index (BMI) of 36. Obesity is defined as a BMI of 30 or more. Their average HbA1c level (a long-term measurement of blood sugar) was 9.3%. Normal levels range between 4% and 5.6%.

In people at risk of both diabetes and heart disease, taking a cholesterol-lowering statin drug is still beneficial despite the medication's tendency to raise blood sugar, according to a study in the American Journal of Cardiology. The researchers examined 10 years of medical records for 9,000 people in the Taiwan National Health Insurance system. The participants already had elevated blood sugar, putting them at risk for being diagnosed with diabetes if their levels continued to rise. They were also at greater risk of heart attacks, strokes, and death from heart-related causes—mostly because of coronary artery disease.

It's well established that taking statins can moderately raise blood sugar, tipping prediabetic people over the threshold to a diagnosis. On the other hand, statins reduce the chance of heart problems and strokes. The researchers wanted to see if the benefits of statins outweighed the risks.

Here's a little incentive to start strengthening your muscles: a Harvard study published Jan. 14, 2014, in PLOS Medicine found that women who strengthen or condition their muscles more than 150 minutes per week have a 40% lower risk of developing type 2 diabetes than women who don't do muscle work. How does this happen? "Muscle-strengthening and conditioning activities may help to improve insulin sensitivity and glucose uptake by muscle," says Dr. JoAnn Manson, coauthor of the study and professor of medicine at Harvard Medical School. In other words, the more muscle you have, the more glucose (sugar) it will use. Otherwise, too much glucose in your blood can lead to diabetes. And if you really want to cut your risk of diabetes, add aerobic exercise. When study subjects did at least 150 minutes per week of aerobics as well as at least 60 minutes per week of muscle strengthening, they were about 70% less likely to develop type 2 diabetes as inactive women. You can get the benefits of strength training by doing any activity that places resistance on your muscles, such as yoga, stretching, toning exercises, and working with free weights, weight machines, or resistance bands. Strong muscles can also help improve your cholesterol levels, decrease body fat, strengthen your bones, maintain a healthy weight, reduce joint pain, and fight mild depression.

The diabetes–heart disease connection and what it means for you

Understand the interactions between these two conditions.

Decades ago, data from the historic Framingham Heart Study revealed that
having diabetes significantly increases your risk of developing cardiovascular disease. In the intervening years, scientists have learned more about how the two deadly diseases interact. But the magnitude of the problem has expanded as well. Currently, two-thirds of people with diabetes eventually die of heart disease or stroke.

Research we're watching

Obesity paradox? Just a myth

It's bad news for the people who have clung to the idea that obesity may protect certain people with diabetes (such as the very old or ill) against dying from a serious heart condition—the so-called obesity paradox. A major study in The New England Journal of Medicine found that in people with type 2 diabetes, excess body weight does not lower the risk of death from cancer, cardiovascular disease, and other causes.

The researchers looked at 11,000 people with type 2 diabetes who were part of two long-term studies. None had cancer or heart disease. Over the 15-year follow-up, researchers tracked participants' body mass index (BMI). BMI is a measure defined by both your weight and height; the range from 18.5 to 24.9 is considered normal.