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illustration of the human body Am I at Risk for Type 2 Diabetes?
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Taking Steps To Lower the Risk of Getting Diabetes


What is diabetes?

Diabetes is a disease in which blood glucose levels are above normal. People with diabetes have problems converting food to energy. After a meal, food is broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use a chemical known as insulin, made in the pancreas, to help them process blood glucose into energy.

People develop diabetes for two reasons: the pancreas does not make enough insulin for the body's needs, or the cells in the muscles, liver, and fat do not use insulin properly, or both. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, leading to complications such as blindness, heart and kidney disease, nerve problems, gum infections, and amputation.

Although people with diabetes can prevent or delay complications by keeping blood glucose levels close to normal, preventing or delaying the development of diabetes in the first place is even better. The results of the Diabetes Prevention Program (DPP) show how to do so.

Types of diabetes

The three main kinds of diabetes are type 1, type 2, and gestational diabetes.

Type 1 diabetes

Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, exercising regularly, taking aspirin daily, and controlling blood pressure and cholesterol.

Type 2 diabetes

Type 2 diabetes, formerly called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. People can develop type 2 diabetes at any age--even during childhood. In type 2 diabetes, the pancreas does not make enough insulin and the fat, muscle, and liver cells do not use it properly. Being overweight and inactive can increase the chances of developing type 2 diabetes. Treatment includes taking diabetes medicines, making wise food choices, exercising regularly, taking aspirin daily, and controlling blood pressure and cholesterol.

Gestational diabetes

Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.


How can type 2 diabetes be prevented?

A recently concluded federally funded study of 3,234 people at high risk for diabetes, the Diabetes Prevention Program, showed that diet and exercise can sharply lower your risk of getting type 2 diabetes.

The DPP was a major clinical trial that studied ways to prevent or delay diabetes in people at high risk for type 2 diabetes. Participants were overweight and had higher than normal levels of blood glucose, called impaired glucose tolerance. Both conditions are strong risk factors for type 2 diabetes. Because of the high risk among some minority groups, about half of the DPP participants were African American, American Indian, Asian American, Pacific Islander, or Hispanic.

The DPP compared two approaches to preventing diabetes: an intensive healthy eating and exercise program and the diabetes drug metformin. People who engaged in moderate physical activity for about 30 minutes a day, followed a low-fat, low-calorie diet, and lost 5 to 7 percent of their body weight reduced their risk of getting type 2 diabetes by 58 percent, according to preliminary analysis of the results. Those receiving metformin reduced their risk by 31 percent.


What are the signs and symptoms of type 2 diabetes?

Many people have no signs or symptoms. Symptoms can also be so mild that you might not even notice them. Five million people in the United States have type 2 diabetes and do not know it. Here is what to look for:

  • increased thirst
  • increased hunger
  • fatigue
  • increased urination, especially at night
  • weight loss
  • blurred vision
  • sores that do not heal

Sometimes people have symptoms but do not suspect diabetes. They delay scheduling a checkup because they do not feel sick. Many people do not find out they have the disease until they have diabetes complications, such as blurry vision or heart trouble. It is important to find out early if you have diabetes because treatment can prevent damage to the body from diabetes.


Should I be tested for diabetes?

If you are 45 years old or older, you need to get tested for diabetes, even if you do not have any of the risk factors listed below. If you are younger than 45 and have one or more risk factors, you should also get tested. Ask your doctor for a fasting blood glucose test. The results of this blood test will tell your doctor how much glucose is in your blood. Your doctor may ask you to have the test twice.

Even if your blood glucose level is normal and you have no risk factors, if you are over 45, you may need to remind your doctor to check your blood glucose again in 3 years. If you have at least one of the risk factors below, have your blood checked more frequently.


What does it mean to be at risk for type 2 diabetes?

You are more likely to get type 2 diabetes if you are age 45 or older, are overweight, are inactive, or have high blood pressure or high cholesterol. You are also at high risk if diabetes runs in your family or if you are African American, American Indian, Asian American, Hispanic, or Pacific Islander. However, you can take steps to reduce your risk of developing diabetes.


What are my risk factors for developing type 2 diabetes?

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

checkbox I have a parent, brother, or sister with diabetes.
checkbox My family background is African American, American Indian, Asian American, Hispanic, or Pacific Islander.
checkbox I have had gestational diabetes or I gave birth to at least one baby weighing 9 pounds or more.
checkbox I have been told that my blood glucose is higher than normal but not high enough to be diagnosed with diabetes. In other words, I have impaired glucose tolerance or an impaired fasting glucose level.
checkbox I am overweight. My weight is at least 20 percent higher than it should be for my height. (See the body mass index table.)
checkbox I am fairly inactive. I exercise fewer than three times a week.
checkbox My blood pressure is 140/90 or higher, or I have been told that I have high blood pressure.
checkbox My cholesterol levels are not normal. My LDL cholesterol is higher than 100; my HDL cholesterol ("good" cholesterol) is 35 or lower; or my triglyceride level is 250 or higher.

If you checked one or more boxes, you are at risk for type 2 diabetes. If you checked more than three boxes, your chances of getting diabetes are high. It is important to lower your risk by working on the factors under your control.


What can I do about my risk factors?

You can do a lot to lower your chances of getting diabetes. Exercising regularly, reducing fat and calorie intake, and losing weight can all help you reduce your risk of developing type 2 diabetes. Lowering blood pressure and cholesterol levels also help you stay healthy.

If you checked

checkbox    I am overweight.

Then take these steps:

If you checked

checkbox    I am fairly inactive.

Then take this step:

If you checked

checkbox    My blood pressure is 140/90 or higher.

Then take these steps:

If you checked

checkbox    My cholesterol levels are not normal.

Then take these steps:




Doing my part: Getting started

Making big changes in your life is hard, especially if you are faced with more than one change. You can make it easier by taking these steps:

  • Make a plan to change behavior.
  • Decide exactly what you will do and when you will do it.
  • Plan what you need to get ready.
  • Think about what might prevent you from reaching your goals.
  • Find family and friends who will support and encourage you.
  • Decide how you will reward yourself when you do what you have planned.

Your doctor, a dietitian, or a counselor can help you make a plan. Here are some of the areas you may wish to change to reduce your risk of diabetes.

Reach and maintain a reasonable body weight

Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. It can also cause high blood pressure. The DPP showed that losing even a few pounds can help reduce your risk of developing type 2 diabetes because it helps your body use insulin more effectively. In the DPP, people who lost between 5 and 7 percent of their body weight significantly reduced their risk of type 2 diabetes. For example, if you weigh 150 pounds, losing about 10 pounds would make a difference.

Body mass index (BMI) is a measure of body weight relative to height. You can use BMI to see whether you are underweight, normal weight, overweight, or obese. Use the body mass index table below to find your BMI.

  • Find your height in the left-hand column.
  • Move across in the same row to the number closest to your weight.
  • The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese.

Body Mass Index Table

For a printer-friendly version of this table, use the pdf.*
  Normal Overweight Obese
BMI 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36
Height
(inches)
Body Weight (pounds)
58 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167 172
59 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173 178
60 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179 184
61 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185 190
62 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191 196
63 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197 203
64 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204 209
65 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210 216
66 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216 223
67 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223 230
68 125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230 236
69 128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236 243
70 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243 250
71 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250 257
72 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258 265
73 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265 272
74 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272 280
75 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279 287
76 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287 295

  Obese Extreme Obesity
BMI 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54
Height
(inches)
Body Weight (pounds)
58 177 181 186 191 196 201 205 210 215 220 224 229 234 239 244 248 253 258
59 183 188 193 198 203 208 212 217 222 227 232 237 242 247 252 257 262 267
60 189 194 199 204 209 215 220 225 230 235 240 245 250 255 261 266 271 276
61 195 201 206 211 217 222 227 232 238 243 248 254 259 264 269 275 280 285
62 202 207 213 218 224 229 235 240 246 251 256 262 267 273 278 284 289 295
63 208 214 220 225 231 237 242 248 254 259 265 270 278 282 287 293 299 304
64 215 221 227 232 238 244 250 256 262 267 273 279 285 291 296 302 308 314
65 222 228 234 240 246 252 258 264 270 276 282 288 294 300 306 312 318 324
66 229 235 241 247 253 260 266 272 278 284 291 297 303 309 315 322 328 334
67 236 242 249 255 261 268 274 280 287 293 299 306 312 319 325 331 338 344
68 243 249 256 262 269 276 282 289 295 302 308 315 322 328 335 341 348 354
69 250 257 263 270 277 284 291 297 304 311 318 324 331 338 345 351 358 365
70 257 264 271 278 285 292 299 306 313 320 327 334 341 348 355 362 369 376
71 265 272 279 286 293 301 308 315 322 329 338 343 351 358 365 372 379 386
72 272 279 287 294 302 309 316 324 331 338 346 353 361 368 375 383 390 397
73 280 288 295 302 310 318 325 333 340 348 355 363 371 378 386 393 401 408
74 287 295 303 311 319 326 334 342 350 358 365 373 381 389 396 404 412 420
75 295 303 311 319 327 335 343 351 359 367 375 383 391 399 407 415 423 431
76 304 312 320 328 336 344 353 361 369 377 385 394 402 410 418 426 435 443

Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.

* pdf versions require the free Adobe® Acrobat Reader software for viewing.

If you are overweight or obese, choose sensible ways to get in shape:

  • Avoid crash diets. Instead, eat less of the foods you usually have. Limit the amount of fat you eat.
  • Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week. (See below for easy suggestions.)
  • Set a reasonable weight-loss goal, such as losing 1 pound a week. Aim for a long-term goal of losing at least 7 percent of your total body weight.

Make wise food choices most of the time

What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.

  • Take a hard look at the serving sizes of the foods you eat. Reduce serving sizes of main courses (such as meat), desserts, and foods high in fat. Increase the amount of fruits and vegetables.
  • Limit your fat intake to about 25 percent of your total calories. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. Your doctor or a dietitian can help you figure out how much fat to have. You can check food labels for fat content too.
  • You may also wish to reduce the number of calories you have each day. Your doctor or dietitian can help you with a meal plan that emphasizes weight loss.
  • Keep a food and exercise log. Write down what you eat, how much you exercise--anything that helps keep you on track.
  • When you meet your goal, reward yourself with a nonfood item or activity, like watching a movie.

Be physically active every day

Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin effectively. People in the DPP who were physically active for 30 minutes a day reduced their risk of type 2 diabetes. Many chose brisk walking for exercise.

If you are not very active, you should start slowly, talking with your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active for at least 30 minutes a day most days of the week.

Choose activities you enjoy. Here are some ways to work extra activity into your daily routine:

  • Take the stairs rather than an elevator or escalator.
  • Park at the far end of the lot and walk.
  • Get off the bus a few stops early and walk the rest of the way.
  • Walk or bicycle instead of drive whenever you can.

Take your prescribed medications

Some people need medication to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor whether there are any medicines you can take to prevent type 2 diabetes.


Hope through research

We now know that regular exercise, weight loss, and a low-fat diet can prevent type 2 diabetes. However, scientists are still investigating whether type 1 diabetes can be prevented.

In the Diabetes Prevention Trial--Type 1, a study sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases, close relatives of people with type 1 diabetes are tested for their risk of getting the disease. Those at high risk will receive treatment that might prevent type 1 diabetes. More information about the study is available by calling 1-800-425-8361 or at www.niddk.nih.gov/patient/dpt_1/dpt_1.htm.

Other studies on preventing type 1 diabetes are under way. For up-to-date information on clinical trials, see clinicaltrials.gov.


National Diabetes Information Clearinghouse

 


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