For adults between 18 and 45, what are some risk factors for developing type 2 diabetes?
People between the ages 18 and 45, and with a body mass index of 25 or higher (for more about body mass index, or BMI, see the chapter “Diabetes and Obesity”) should be tested if they have one of the following risk factors for developing type 2 diabetes:
- The person has a mother, father, brother, or sister with diabetes.
- The person is physically inactive.
- The person is of African American, Asian American, Hispanic American, Native American, or Pacific Islander decent.
- The person has given birth to a baby weighing more than 9 pounds (4 kilograms) or has had gestational diabetes during pregnancy (for more about gestational diabetes, see the chapter, “Other Types of Diabetes”).
- The person has a blood pressure of around 140/90 mm Hg or higher or is being treated with blood pressure-lowering medications (for more about high blood pressure, see the chapter “How Diabetes Affects the Circulatory System”).
- The person has abnormal blood lipid (fat) levels, such as HDL cholesterol levels below 35 mg/dl or triglyceride levels over 250 mg/dl. (For more about cholesterol and triglycerides, see the chapter “How Diabetes Affects the Circulatory System.”)
- The person has measured levels that indicate impaired glucose tolerance or impaired fasting glucose after being tested for diabetes.
- A female has polycystic ovary syndrome or (males and females) a history of vascular problems.
- The person has an HbA1c level that is greater than 5.7 percent. (A reading of 5.7 percent means a person is not yet considered to have diabetes but has a higher chance of developing diabetes; health care professionals consider a person to be diabetic if the HbA1c number is greater than 6.5 percent.)
If one or more of these items fits a person, and he or she is found not to have diabetes, then the test should be repeated in three years or as the health care professional suggests—or repeated, of course, if the person starts to develop symptoms.
For a person older than 45, what are risk factors for developing type 2 diabetes?
There are several risk factors for type 2 diabetes for adults age 45 years or older. They include:
- A family history of diabetes, especially in the immediate family.
- Being overweight, and especially if a person is obese (generally a body mass index, or BMI, over 30; for more about BMI, see the chapter “Diabetes and Obesity”).
- A lack of regular exercise (often connected with a sedentary lifestyle in older people).
- Being from an ethnic or racial group that is more inclined to type 2 diabetes, including African Americans, American Indians, Hispanic Americans, Asian Americans, and Pacific Islanders.
Do people with type 2 diabetes ever need insulin injections instead of oral medication?
When people with type 2 diabetes have the disease for a long time, their use of oral medications may not work as well. Thus, one of the only ways to keep the blood glucose levels in balance is to begin using insulin. In combination with eating well, physical activity, and often other medications (including oral diabetes medicines), insulin becomes an additional help in controlling blood glucose levels. (For more about diabetes medications, see the chapter “Taking Charge of Diabetes.”)
What are some long-term complications of diabetes, especially type 2?
There are possible complications if a person has diabetes in the long term—in other words, the longer a person has diabetes, the more the possible risk of complications increases. These complications include heart attack, stroke, blindness, kidney failure, and amputations. But many of these risks can be mitigated or at least lessened by rigorous blood-sugar control and also by treating a diabetic for high blood pressure and/or high cholesterol if necessary.