Are You At Risk of Diabetes?


What is type 2 diabetes?

Type 2 diabetes, formerly called adult-onset diabetes, is the most common type of diabetes. About 95 percent of people with diabetes have type 2. People can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes develops most often in middle-aged and older people. People who are overweight and inactive are also more likely to develop type 2 diabetes.

In type 2 and other types of diabetes, you have too much glucose, also called sugar, in your blood. People with diabetes have problems converting food to energy. After a meal, food is broken down into glucose, which is carried by your blood to cells throughout your body. With the help of the hormone insulin, cells absorb glucose from your blood and use it for energy. Insulin is made in the pancreas, an organ located behind the stomach.

Type 2 diabetes usually begins with insulin resistance, a condition linked to excess weight in which your body’s cells do not use insulin properly. As a result, your body needs more insulin to help glucose enter cells. At first, your pancreas keeps up with the added demand by producing more insulin. But in time, your pancreas loses its ability to produce enough insulin, and blood glucose levels rise.

Over time, high blood glucose damages nerves and blood vessels, leading to problems such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other problems of diabetes may include increased risk of getting other diseases, loss of mobility with aging, depression, and pregnancy problems.

Treatment includes taking diabetes medicines, making wise food choices, being physically active on a regular basis, controlling blood pressure and cholesterol, and for some, taking aspirin daily.

Can type 2 diabetes be delayed or prevented?

Yes. The results of the Diabetes Prevention Program (DPP) proved that weight loss through moderate diet changes and physical activity can delay or prevent type 2 diabetes. The DPP was a federally funded study of 3,234 people at high risk for diabetes. This study showed that a 5-to 7-percent weight loss, which for a 200-pound person would be 10 to 14 pounds, slowed development of type 2 diabetes.

People at High Risk for Diabetes

DPP study participants were overweight and had higher than normal levels of blood glucose, a condition called prediabetes. Many had family members with type 2 diabetes. Prediabetes, obesity, and a family history of diabetes are strong risk factors for type 2 diabetes. About half of the DPP participants were from minority groups with high rates of diabetes, including African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans.

DPP participants also included others at high risk for developing type 2 diabetes, such as women with a history of gestational diabetes and people age 60 and older.

 

Approaches to Preventing Diabetes

The DPP tested three approaches to preventing diabetes:

  • Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.
  • Taking the diabetes medicine metformin. Those who took metformin also received information about physical activity and diet.
  • Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medicine in it.

People in the lifestyle change group showed the best outcomes. But people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years. Lifestyle change was even more effective in those age 60 and older. People in this group reduced their risk by 71 percent. But people in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under National Institutes of Health (NIH) clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dpp Exit Disclaimer image.

Lasting Results

The Diabetes Prevention Program Outcomes Study (DPPOS) has shown that the benefits of weight loss and metformin last for at least 10 years. The DPPOS has continued to follow most DPP participants since the DPP ended in 2001. The DPPOS showed that 10 years after enrolling in the DPP,

  • people in the lifestyle change group reduced their risk for developing diabetes by 34 percent
  • those in the lifestyle change group age 60 or older had even greater benefit, reducing their risk of developing diabetes by 49 percent
  • participants in the lifestyle change group also had fewer heart and blood vessel disease risk factors, including lower blood pressure and triglyceride levels, even though they took fewer medicines to control their heart disease risk
  • the metformin group reduced the risk of developing diabetes by 18 percent

Even though controlling your weight with lifestyle changes is challenging, it produces long-term health rewards by lowering your risk for type 2 diabetes, lowering your blood glucose levels, and reducing other heart disease risk factors. More information about the DPPOS, funded under NIH clinical trial number NCT00038727, can be found at www.bsc.gwu.edu/dpp Exit Disclaimer image.

 

What factors increase my risk for type 2 diabetes?

To find out your risk for type 2 diabetes, check each item that applies to you.

  • I am age 45 or older.
  • I am overweight or obese.
  • I have a parent, brother, or sister with diabetes.
  • My family background is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American.
  • I have had gestational diabetes.
  • I gave birth to at least one baby weighing more than 9 pounds.
  • My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure.
  • My cholesterol levels are higher than normal. My HDL, or good, cholesterol is below 35, or my triglyceride level is above 250.
  • I am fairly inactive.
  • I have polycystic ovary syndrome, also called PCOS.
  • On previous testing, I had prediabetes—an A1C level of 5.7 to 6.4 percent, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT).
  • I have other clinical conditions associated with insulin resistance, such as a condition called acanthosis nigricans, characterized by a dark, velvety rash around my neck or armpits.
  • I have a history of cardiovascular disease.

The more items you checked, the higher your risk.

 

Are you at risk for diabetes?  I know I am. Diabetes runs in my family.  I used to not be concerned about weight loss.  But then when forty hit that suddenly became a real concern for me.  I started gaining weight at an alarming rate.  I knew I had to do something.  My dad went down that path and he did nothing to change it and payed a very high price.  He came down with type II diabetes and suffered greatly leading to kidney failure and he spent the last years of his life dependent on a dialysis machine.   That's not how I want to go.  So I did some research and I found something that works well for me.

 

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