Researchers followed over 5,600 people with type 2 diabetes for more than 11 years to see how lifestyle choices affected their health. They created a score based on 20 diet and lifestyle factors that measure how well someone’s body handles harmful molecules called free radicals. People with higher scores—meaning better lifestyle habits—were significantly less likely to develop serious diabetes complications like kidney disease, nerve damage, and eye problems. The study suggests that making smart choices about what you eat and how you live can help protect people with diabetes from these dangerous complications.

The Quick Take

  • What they studied: Whether people with type 2 diabetes who follow healthier lifestyle habits (eating better foods, exercising, managing stress) have fewer serious health problems caused by their diabetes
  • Who participated: 5,635 adults with type 2 diabetes from the UK Biobank who didn’t have diabetes complications when the study started. Researchers tracked them for an average of 11.5 years
  • Key finding: People with the healthiest lifestyle habits were 28% less likely to develop diabetes complications overall, and 50% less likely to develop kidney disease specifically. For every point increase on the health score, the risk of complications dropped by about 2%
  • What it means for you: If you have type 2 diabetes, making improvements to your diet and lifestyle choices may significantly reduce your chances of developing serious complications. However, this study shows association, not that lifestyle changes definitely prevent complications—talk to your doctor about what changes are right for you

The Research Details

This was a long-term follow-up study using data from the UK Biobank, a large health database. Researchers identified over 5,600 people with type 2 diabetes who didn’t have complications at the start. They created an “oxidative balance score” based on 20 different lifestyle and diet factors—things like eating fruits and vegetables, physical activity, sleep quality, and smoking status. A higher score meant someone had healthier habits overall.

The researchers then tracked these people for an average of 11.5 years to see who developed diabetes complications. They used statistical methods to compare people with different scores and see if those with higher scores (better habits) had fewer complications. They also looked at blood markers to understand how lifestyle might protect against complications.

This approach is important because it looks at real-world lifestyle patterns rather than just one single habit. Most people don’t change just one thing—they change multiple habits together. By measuring 20 different factors together, the study captures how people actually live. The long follow-up period (11.5 years) is also important because diabetes complications develop slowly, so researchers needed time to see them develop

This study has several strengths: it’s large (over 5,600 people), it followed people for over a decade, and it used a well-established health database. The researchers also checked whether their findings held up when they adjusted for other factors that might affect the results. However, the study only included people from the UK, so results might differ in other populations. Also, the study shows that healthier lifestyles are linked to fewer complications, but it can’t prove that the lifestyle changes directly caused the protection

What the Results Show

Over the 11.5-year study period, about 1,500 people developed diabetes complications. People in the highest group for healthy lifestyle habits were 28% less likely to develop any diabetes complications compared to those with the lowest scores. The protection was even stronger for kidney disease—people with the best lifestyle scores were 50% less likely to develop kidney problems.

When researchers looked at the numbers more carefully, they found that for every single point increase on the health score, the risk of developing complications dropped by about 1.9%. For kidney disease specifically, each point increase reduced the risk by 4.3%. This suggests that even small improvements in lifestyle habits might help.

The study identified three main types of complications: kidney disease (873 cases), nerve damage (317 cases), and eye disease (646 cases). The lifestyle score showed the strongest protection against kidney disease, moderate protection against eye disease, and some protection against nerve damage.

The researchers also looked at blood markers to understand how lifestyle habits might protect people. They found that seven different blood markers—including HbA1c (a measure of blood sugar control) and cystatin C (a kidney function marker)—helped explain why healthier lifestyles reduced complications. This suggests that lifestyle habits work partly by improving blood sugar control and kidney function, but also through other protective mechanisms in the body

Previous research has shown that oxidative stress (damage from harmful molecules) contributes to diabetes complications. This study builds on that knowledge by showing that lifestyle factors that reduce oxidative stress are linked to fewer complications. The findings align with other research showing that diet, exercise, and sleep quality all matter for diabetes health, but this study is unique in combining all these factors together and following people for over a decade

The study shows that healthier lifestyles are linked to fewer complications, but it can’t prove that lifestyle changes directly cause the protection—people with healthier habits might differ in other ways too. The study only included people from the UK, so results might not apply to other populations. Also, the study relied on health records to identify complications, which might miss some cases. Finally, the lifestyle score was measured only at the beginning of the study, so researchers couldn’t track how changes in habits over time affected outcomes

The Bottom Line

If you have type 2 diabetes, focus on improving multiple lifestyle habits together: eat more fruits and vegetables, exercise regularly, get adequate sleep, manage stress, and avoid smoking. The evidence suggests these combined changes may significantly reduce your risk of serious complications. However, these findings should complement, not replace, medical treatment. Work with your doctor to develop a personalized plan that includes both lifestyle changes and appropriate medications

This research is most relevant for people with type 2 diabetes who want to reduce their risk of complications. It’s also important for healthcare providers managing diabetes patients. People without diabetes might also benefit from these lifestyle habits for overall health. However, people with type 1 diabetes should discuss these findings with their doctor, as their condition differs from type 2 diabetes

Diabetes complications develop slowly over years, so don’t expect immediate results. The study followed people for 11.5 years on average. However, some benefits like improved blood sugar control can appear within weeks to months of lifestyle changes. Most people should see meaningful improvements in blood markers within 3-6 months of consistent lifestyle changes

Want to Apply This Research?

  • Track your daily habits across these categories: servings of fruits and vegetables, minutes of physical activity, hours of sleep, stress level (1-10 scale), and smoking status. Calculate a weekly score to see if you’re improving your overall lifestyle balance
  • Start by picking two habits to improve this week—for example, adding one extra serving of vegetables daily and taking a 20-minute walk. Once these feel routine (usually 2-3 weeks), add another habit. This gradual approach is more sustainable than trying to change everything at once
  • Check your progress monthly by reviewing your habit tracking data. Every 3 months, take a step back and assess which habits are easiest for you to maintain and which need more support. Share your progress with your healthcare provider at regular appointments to discuss how lifestyle changes are affecting your blood sugar and other health markers

This research shows an association between healthy lifestyle habits and reduced diabetes complications, but cannot prove that lifestyle changes directly prevent complications. Individual results vary based on genetics, medications, and other health factors. This information should not replace medical advice from your healthcare provider. If you have type 2 diabetes, consult your doctor before making significant lifestyle changes or adjusting medications. People with kidney disease, neuropathy, or retinopathy should work closely with their healthcare team to develop an appropriate management plan.