Almost everyone in my family has diabetes. And almost everyone who has died has died of a diabetes complication.That said, from my teen years I’ve been wary of what I ate and even how much I drank.I’ve been conscious of the high risk I face of developing the condition myself and to date I’ve managed to stay ahead it, but I was shocked last week to learn that I may have to amp up my preventive measures.Dr Nestoras Mathioudakis, Associate Professor in the division of endocrinology and metabolism at Johns Hopkins University School of Medicine in Baltimore, Maryland, said studies have shown that the pancreas looses a whopping 40 percent of its function at the pre-diabetic stage.That’s right, that’s before you are even diagnosed as being diabetic. And what’s worse? You don’t get that pancreatic function back.The pancreas produces hormones that regulate blood sugar in the body. Diabetes develops when the body’s production of the hormone insulin becomes impaired or stops entirely.Of course if only a little more than a half of your pancreatic cells are working, there is increased demand on them to produce sufficient insulin for the body.This increases the stress on them and in turn the likelihood of further cell death and even less pancreatic function.Dr Mathioudakis was in Bermuda to speak to employees at Butterfield Bank about his research in diabetes. (He was not a part of the research that found 40 percent of pancreatic function is lost at the pre-diabetes stage — the stage at which blood glucose levels are deemed high enough to warrant concern that diabetes may develop.)Specialising in diabetes, he is a part of the second phase of the Diabetes Prevention Programme study that charted the results of lifestyle in reducing the risk of diabetes in 1,079 people over five years.In Dr Mathioudakis’ study — the Diabetes Prevention Programme Outcomes Study, the participants from the DPP are being followed for 15 years. The study is at the 11-year mark.At the ten-year mark the researchers revealed that there was a four-year gap in developing diabetes between those in a lifestyle of intense regular exercise and the group who took a placebo.According to Dr Mathioudakis, loosing weight is the key to managing diabetes. He said many people want to simply change their eating habits.“But diet alone is not as significant,” he said.What should we all be doing? “Exercise. Thirty minutes of moderate exercise five days a week, with no more than two days of being sedentary,” he said. “It’s important to raise your heart rate to 50 to 70 percent of it’s maximum. The key determinant is heart rate,” he added. “How fast you can get your heart rate going is based on your age.”