Risk factors for prediabetes
Risk factors that you cannot control include:
- Family history. People who have a parent, brother, or sister with prediabetes or type 2 diabetes have a greater chance of getting these conditions. In the United States, adults who have a parent with type 2 diabetes are four times more likely to get the disease than adults without a parental history of the disease. The risk is nearly eight times higher when both parents have type 2 diabetes.1
- Age. The risk for developing prediabetes and type 2 diabetes increases with age. The American Diabetes Association reports that over 54 million Americans ages 40 to 74 have prediabetes.2 And the number of children being diagnosed with the disease is increasing. Usually, children who develop type 2 diabetes have a family history of the disease, are overweight, and are physically inactive.3
- Race and ethnicity. African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders are at greater risk than whites.4
- History of gestational diabetes or having a baby weighing more than 9 lb (4 kg). Women who have had gestational diabetes or who have had a large baby are at increased risk for developing type 2 diabetes later in life.4
- Low birth weight. People who weighed less than 5.5 lb (2.5 kg) at birth are more likely to develop type 2 diabetes later in life.1
Risk factors that you can change or get treatment for include:
- Being overweight. The risk for prediabetes and type 2 diabetes increases as weight (or body mass index, BMI) increases. People who have a large percentage of body fat in the abdominal area [waist circumference greater than 40 in. (102 cm) in men and greater than 35 in. (88 cm) in women] are at increased risk for type 2 diabetes, even if their BMI is within the normal range.5 In addition, weight gain of more than 22 lb (10 kg) after age 18 in women or 18 lb (8 kg) after age 21 in men further increases the risk for type 2 diabetes.1
- Lack of physical exercise. Participating in physical exercise less than once a week increases your chance of developing type 2 diabetes by 20% to 40%.1 One large study found that women who were sedentary, especially those who watched a lot of television, were at higher-than-average risk of obesity and type 2 diabetes.6
- High blood pressure (hypertension). People who have blood pressure levels above 140/90 millimeters of mercury (mm Hg) are at greater risk for developing prediabetes and type 2 diabetes than people who have normal blood pressure.4 The United States Preventive Services Task Force (USPSTF) recommends diabetes testing for people who have blood pressure higher than 135/80.7
- Abnormal cholesterol . People who have high-density lipoprotein (HDL) cholesterol levels of 35 milligrams per deciliter (mg/dL) or less or triglyceride levels of 250 mg/dL or more are at higher risk for developing type 2 diabetes.4
- An unhealthy diet. A diet high in sugary foods and low in fiber content raises your risk for prediabetes and type 2 diabetes.1 One large study found that a diet high in red meat, processed meat, high-fat dairy products, french fries, refined grains, and sweets increased men's risk for type 2 diabetes compared with a diet high in vegetables, fruits, fish, poultry, and whole grains.8
Other risk factors for prediabetes and type 2 diabetes, which are also associated with obesity and a lack of physical activity, include:
- Having polycystic ovary syndrome (PCOS), a hormone imbalance that interferes with normal ovulation.
- Having metabolic syndrome, a group of abnormal physical findings related to the body's metabolism.
If you have prediabetes, you are more likely to get heart and large blood vessel (cardiovascular) disease than a person who doesn't have this condition.9 Lowering your cholesterol to the recommended levels, keeping your blood pressure under 140/90 millimeters of mercury (mm Hg), and (if you smoke) giving up smoking may reduce your risk.
- Capes S, Anand S (2001). What is type 2 diabetes? In HC Gerstein, RB Haynes, eds., Evidence-Based Diabetes Care, pp. 151–163. Hamilton, ON: BC Decker.
- American Diabetes Association (2008). Standards of medical care in diabetes. Diabetes Care, 31(Suppl 1): S12–S54.
- American Diabetes Association (2000). Type 2 diabetes in children and adolescents. Pediatrics, 105(3): 671–680.
- American Diabetes Association (2004). Screening for type 2 diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S11–S14.
- National Heart, Lung, and Blood Institute, National Institutes of Health (2000). The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (NIH Publication No. 00-4084). Available online: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf.
- Hu FB, et al. (2003). Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA, 289(14): 1785–1791.
- U.S. Preventive Services Task Force (2008). Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 148(11): 846–854.
- Van Dam RM, et al. (2002). Dietary patterns and risk for type 2 diabetes mellitus in U.S. men. Annals of Internal Medicine, 136(3): 201–209.
- American Diabetes Association (2004). Frequently asked questions about pre-diabetes. Available online: http://www.diabetes.org/pre-diabetes/faq.jsp.
Last Updated: August 12, 2008
Author: Caroline Rea, RN, BS, MS