Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia and abnormalities in carbohydrate, fat, and protein metabolism.
Diabetes is classified into three types namely Type 1, Type 2 and Gestational Diabetes.
Type 1 diabetes: Body does not produce insulin at all. People with this form of diabetes require daily injections of insulin in order to control the levels of glucose in their blood.
Type 2 diabetes: This is the most common type of diabetes. The body produces some insulin, but not enough. This type of diabetes used to be seen only in adults but it is now also occurring increasingly in children and adolescents. It is seen in those with a family history of diabetes, excess body weight, lack of physical activity, and as people grow older.
Gestational diabetes: Diabetes which occurs among women during pregnancy. Has a risk of complications during pregnancy and delivery. The children of women with Gestational Diabetes are at an increased risk of type 2 diabetes in the future.
Risk Factors for Type 2 Diabetes
Your chances of developing type 2 diabetes depend on a combination of risk factors such as your genes and lifestyle. Although you can’t change risk factors such as family history, age, or ethnicity, you can change lifestyle risk factors around eating, physical activity, and weight. These lifestyle changes can affect your chances of developing type 2 diabetes.
You’re at risk for developing type 2 diabetes if you:
- are overweight or obese
- are age 45 or older
- have a family history of diabetes
- are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
- have high blood pressure
- have a low level of HDL (“good”) cholesterol, or a high level of triglycerides
- have a history of gestational diabetes or gave birth to a baby weighing 9 pounds or more
- are not physically active
- have a history of heart disease or stroke
- have depression
- have polycystic ovary syndrome , also called PCOS
- have acanthosis nigricans—dark, thick, and velvety skin around your neck or armpits
If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.
Family history of diabetes
Genetics plays a role in risk factors for type 2 diabetes. You’re more at risk for it if you have a family history of type 2 diabetes, especially if a parent or sibling has it. Gene mutations have also been linked with type 2 diabetes, but mutations only account for a small portion of those diagnosed with the condition.
The genetic component is thought to interact strongly with environmental risk factors, as well. But when parents establish nutrient-dense, balanced diets and encourage staying active, they can then pass on these routines to their children, which can help reduce their risk for developing type 2 diabetes.
Race and ethnicity
According to the CDC, diabetes has a higher prevalence in Black, Hispanic/Latinx American, American Indian, and Alaska Native communities, as well as some Pacific Islander and Asian American communities.
Many different fact ors contribute to this. They can be biological, clinical factors, as well as social factors and systemic healthcare inequity.
Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome PCOS is a condition that affects your ovaries. Ovaries are part of the female reproductive system that store and release eggs ready to be fertilised. Each egg develops in a small fluid filled swelling called a follicle before it is released by the ovary. In PCOS, several follicles can develop but none of these become an egg that can be fertilised. These follicles can become cysts.
Women who have PCOS are at an increased risk of developing type 2 diabetes. PCOS is associated with insulin resistance and therefore higher levels of insulin circulating in the blood.
Women with PCOS should be offered an oral glucose tolerance test on diagnosis, as recommended by NICE. If found to have impaired fasting glucose or impaired glucose tolerance, this test should be repeated annually.
Drinking too much alcohol is associated with an increased risk of type 2 diabetes. Current guidelines recommend not regularly drinking more than 14 units per week and that these units should be spread evenly over 3-4 days.
Drinking heavily on one or two days per week will also increase the risk of other health conditions such as certain types of cancer. Evidence seems to show drinking in moderation is associated with a lower risk of developing type 2 diabetes.
People age 45 years or older are more at risk for developing type 2 diabetes. This is because as you get older, insulin secretion decreases, and changes in your body composition make it more insulin resistant. Both of these can lead to high blood sugar levels.
If you have gestational diabetes it is important to have your blood glucose levels tested regularly after as you have an increased risk of developing type 2 diabetes. Arrange a blood glucose test at your six week postnatal check and annually with your GP surgery. Also look out for any symptoms of diabetes.
Women can also hugely reduce their risk of developing gestational diabetes by managing their weight, eating healthily and keeping active.
If you spend long periods of time sitting, (this does not include sleeping) this is known as a ‘sedentary’ lifestyle. Being sedentary is associated with an increased risk of type 2 diabetes.
It is important to remember that even if you do the recommended amount of exercise per week you can still have a sedentary lifestyle. This is because being sedentary is different to being physically inactive. Being ‘physically inactive’ means not doing enough physical activity. Being ‘sedentary’ means sitting or lying down for long periods.
Examples of a sedentary behaviours include:
- Working at a desk for long periods without standing up
- Sitting down while studying at school or home
- Sitting or lying down while watching television or playing video games.
- Sitting while driving a vehicle, or while travelling
You should try to break periods of sitting as often as possible, by doing some light activity such as walking. If you sit at a desk or screen all day try some chair based exercises.
Certain medical conditions can increase your risk for developing type 2 diabetes. These medical conditions can include:
- high blood pressure
- polycystic ovary syndrom (PCOS)
- history of gestational diabetes or giving birth to a baby weighing more than 9 pounds
Many of these conditions can contribute to insulin resistance. When it’s unclear what the direct link is, it’s often associated with having obesity, which is another risk factor for type 2 diabetes.
Acanthosis nigricans (a skin condition with dark, thick patches on the neck or armpits), high triglycerides, or low HDL (the “good” cholesterol) can be signs of insulin resistance and risk for diabetes.
What can I do to prevent type 2 diabetes?
You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk.