Who is at risk of diabetes?
Currently type 1 diabetes can’t be prevented. However, current research is exploring ways to stop the autoimmune reaction that destroys the insulin producing beta cells. We also know that certain features in the environment can trigger type 1 diabetes in some individuals who have a genetic predisposition, and may be responsible for the increase in type 1 diabetes over the past 30 years. Therefore, studies are looking at these other factors which may increase the risk in some people.
It is not possible to identify all the people in the general community who have the genes that are associated with type 1 diabetes risk. Only 20 percent of people who develop type 1 diabetes have a relative that also has type 1 diabetes, so the number of people eligible for these prevention studies is small
Researchers from the Type 1 Diabetes Prevention Trial (formerly INIT II ) are looking for volunteers in a very important research project to try to prevent type 1 diabetes. Call (03) 9342 7672 or go to the INIT II trial website for more information.
Type 2 diabetes has reached epidemic status around the world and is the fastest growing chronic disease in Australia. Almost one in four Australian adults is either at risk or already has developed the condition. In Victoria 70 new cases of type 2 diabetes are diagnosed each day. A further 1.2 million Victorians are in the high risk category for developing type 2 diabetes.
Alarming as these statistics are, many people don’t know they are at risk of developing type 2 diabetes, don’t seem to think it’s a problem or worse still, have already developed it but have not yet been diagnosed.
In the past, type 2 diabetes was called ‘adult onset’ diabetes as those who developed the condition typically were middle-aged. These days it’s an unfortunately reality that people are being diagnosed with type 2 diabetes at a much younger age, some even as children. This is directly related to the lifestyles we’re living today.
Being physically inactive or overweight are major factors contributing to the increase in type 2 diabetes. Type 2 diabetes often runs in families, so if you have a family history of diabetes, you may be at increased risk.
It is important that you know your risk of developing type 2 diabetes. Assess your risk using the Australian Type 2 Diabetes Risk Assessment tool or call 13 RISK (13 7475).
- People who have a family history of type 2 diabetes
- People who are overweight or obese
- People who are inactive
- People with pre-diabetes (impaired glucose tolerance / impaired fasting glucose)
- People with high blood pressure and/or abnormal blood fats or a history of cardiovascular disease
- Aboriginal and Torres Strait Islander people
- People from certain ethnic backgrounds
- Women who have had diabetes while pregnant (gestational)
- Women with polycystic ovary syndrome and are overweight
- People taking antipsychotic medication
People who have a close relative with type 2 diabetes have an increased risk of developing type 2 diabetes. Those who have one parent with type 2 diabetes are over two times more likely to develop the disease than those without a family history.
People classified as overweight (body mass index (BMI) 25 or over) are twice as likely to develop type 2 diabetes and obese people (BMI 30 or over) are four times as likely to develop diabetes as people in the normal weight range. In 2000, 60 per cent of Australian adults were overweight or obese and Australian adults under 65 years gained an average of 1.8 kg over the five years from 2000 to 2005.
Waist circumference is an indicator of abdominal fat. Excess fat around the waist increases the risk of diabetes and cardiovascular disease (heart attack and stroke). Waist circumference measurements indicating increased risk are:
Ethnic group Male Female
European, African, Eastern Mediterranean 94 cm 80 cm
Middle Eastern, South Asian, Chinese, 90 cm 80 cm
Asian-Indian, South & Central American, Japanese
Men with a waist circumference of 102cm or more and women 88cm or more are at a substantially increased risk of diabetes.
In 2004-05 only 30 per cent of Australians 15 years and over undertook sufficient levels of physical activity. Physical inactivity increases the risk of developing diabetes.
Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are both conditions where blood glucose levels are higher then normal but not high enough for a diagnosis of type 2 diabetes.
The term ‘pre-diabetes’ is sometimes used to describe these conditions. People with pre-diabetes are 10 to 20 times more likely to develop diabetes than those with normal blood glucose levels.
People with type 2 diabetes often have high blood pressure and raised triglyceride levels and low levels of ‘good’ or protective HDL cholesterol (blood fats), which increases the risk of cardiovascular disease (heart and blood vessel) disease.
Reducing dietary fat, particularly saturated fat, eating more fibre from fruits, vegetables and whole grains, being more active and losing excess body fat, helps to reduce the risk of diabetes and cardiovascular disease.
The prevalence of diabetes in some Aboriginal communities may be as high as 30 per cent. Type 2 diabetes often occurs at a younger age in Aboriginal people, and can even develop in childhood or adolescence. Risk assessment should begin from age 18 in people from an Aboriginal or Torres Strait Islander background.
Groups at particular risk include people from Pacific Islander, Southern European, Middle Eastern, Northern African and Southern Asian backgrounds.
Gestational diabetes occurs in around five per cent of all pregnancies in Australia, though occurs more frequently in certain ethnic groups (see above). Increasing age, being overweight and having a family history of diabetes increases the likelihood a woman will develop gestational diabetes. The risk of gestational diabetes in subsequent pregnancies is increased and there is a high risk of type 2 diabetes later in life.
Studies estimate that 12 to 21 per cent of pre-menopausal women have PCOS, yet up to 70 per cent of women remain undiagnosed. Common symptoms of PCOS are:
- Irregular, or absent menstrual periods
- Increased body hair
- Thinning hair on the head
PCOS is associated with increased risk of obesity, insulin resistance, high blood pressure, cholesterol and diabetes.
Find out more information about PCOS
Smokers have a fifty per cent greater risk of diabetes than non-smokers. Smoking also causes damage to the heart, lungs and circulation and increases the risk of developing several types of cancer.
Certain antipsychotic medications used for the treatment of schizophrenia can raise blood glucose levels in some individuals. Some medications may also lead to weight gain which contributes an additional risk for developing type 2 diabetes. People taking these medications should be tested for diabetes. Antipsychotic medication should not be stopped Diabetes can be controlled, speak to your doctor if you are taking any of the medications.
Who should be tested?
Australian national guidelines state that the following people should be tested for diabetes:
- People with a history of cardiovascular disease
- Women who have had gestational diabetes
- Women with polycystic ovarian syndrome
- People who take antipsychotic medication
- People who score 12 or more on the Australian Type 2 Diabetes Risk Assessment tool
Assess your risk using the Australian Type 2 Diabetes Risk Assessment tool or call 13 RISK (13 7475).