Risk Factors
More than 23 million American children and adults have diabetes. Up to 95% of these cases are type 2. In addition, 57 million Americans have pre-diabetes, a condition that increases the risk for developing diabetes. Type 2 diabetes used to mainly develop after the age of 40, but it is now increasing in younger people and children. Obesity is likely the major factor behind this dramatic growth rate.
According to the National Institutes of Health, the following are major risk factors for diabetes and pre-diabetes:
- Age 45 or older
- Family history of diabetes
- Overweight
- Inactive lifestyle (exercise less than 3 times a week)
- African-American, Hispanic/Latin American, American Indian and Alaska Native, Asian-American, or Pacific Islander ethnicity
- High blood pressure (140/90 mm Hg or higher)
- HDL (“good”) cholesterol less than 35 mg/dL or triglyceride level 250 mg/dL or higher
- Have had diabetes during pregnancy (gestational diabetes) or have given birth to a baby that weighed more than 9 pounds
- Polycystic ovary syndrome (metabolic disorder that affects female reproductive system)
- Acanthosis nigricans (dark, thickened skin around neck or armpits)
- History of disease of blood vessels to the heart, brain, or legs
- Diabetes test history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
Medical Conditions Associated with Increased Risk of Diabetes
Obesity and Metabolic Syndrome. Obesity is the number one risk factor for type 2 diabetes. Excess body fat appears to play a strong role in insulin resistance, but the way the fat is distributed is also significant. Weight concentrated around the abdomen and in the upper part of the body (apple-shaped) is associated with insulin resistance and diabetes, heart disease, high blood pressure, stroke, and unhealthy cholesterol levels. Waist circumferences greater than 35 inches in women and 40 inches in men have been specifically associated with a greater risk for heart disease and diabetes. (People with a "pear-shape" -- fat that settles around the hips and flank -- appear to have a lower risk for these conditions.) However, obesity does not explain all cases of type 2 diabetes. It is also common among people in countries where weights tend to be low, such as Asia or India.
A set of conditions referred to as metabolic syndrome (also called Syndrome X) is a pre-diabetic condition that is significantly associated with heart disease and higher mortality rates from all causes. The syndrome consists of obesity marked by abdominal fat, unhealthy cholesterol and triglyceride levels, high blood pressure, and insulin resistance.
Polycystic Ovary Syndrome. Polycystic ovary syndrome (PCOS) is a condition that affects about 6% of women and results in the ovarian production of high amounts of androgens (male hormones), particularly testosterone. Women with PCOS are at higher risk for insulin resistance, and about half of PCOS patients also have diabetes.
Depression. Severe clinical depression may modestly increase the risk for type 2 diabetes.
Schizophrenia. While no definitive association has been established, research has suggested an increased background risk of diabetes among people with schizophrenia. In addition, many of the new generation of antipsychotic medications may elevate blood glucose levels. Patients taking antipsychotic medications (such as clozapine, olanzapine, risperidone, aripiprazole, quetiapine fumarate, ziprasidone) should receive a baseline blood glucose level test and be monitored for any increases during therapy.
Gestational Diabetes Risk Factors
Gestational diabetes is a type of diabetes that develops during the last trimester of pregnancy. A pregnant woman's risk factors include:
- Family history of diabetes
- African-American, Hispanic, Asian, or Pacific Islander ethnicity
- Overweight
- Older than 25 years
- Gestational diabetes with past pregnancy
- Having given birth to a child weighing over 9 pounds
- Diagnosis of pre-diabetes
