Risk Factors and Diagnosis of Diabetes

When you are newly diagnosed with diabetes, understanding the risk factors and how your diagnosis was made is a crucial first step. This guide covers the key risk factors for Type 1 and Type 2 diabetes and explains standard diagnostic tests. This article links you to additional resources on topics such as Types of Diabetes, Diabetes Care, Blood Sugar Testing, Diet and Nutrition Plans, Your Healthcare Team, and Staying Motivated.

Risk Factors for Type 1 Diabetes

Medical experts believe that two primary factors contribute to the development of Type 1 Diabetes: an imbalance in the immune system and exposure to a trigger, such as a virus or environmental toxin. This combination may cause insulin or beta cells to become a target for an overactive immune response.

One theory involves heat shock proteins, which play a role in properly folding insulin into its active form. These proteins may become damaged during a viral or toxic event, releasing abnormally shaped insulin molecules. These abnormal molecules can attract the immune system, gradually destroying beta cells. Symptoms of Type 1 diabetes typically appear when only 10% of beta cells remain functional.

Genetic Factors

Genetics also play a role in Type 1 diabetes risk. The strongest genetic links are associated with the HLA-DR and HLA-DQ regions of DNA, which increase the risk of Type 1 diabetes tenfold compared to other genetic regions. However, these genes account for only one-third of the total risk. Even if both parents have Type 1 diabetes, the likelihood of passing it to a child is only 20%. Approximately 70% of those diagnosed with Type 1 diabetes have a weak or no clear genetic link.

Risk Factors for Type 2 Diabetes

Type 2 diabetes is influenced by a combination of genetic, lifestyle, and environmental factors. It is often preventable or manageable through lifestyle changes. The National Institutes of Health (NIH) recommends that individuals aged 45 and older get tested for diabetes, and the American Diabetes Association (ADA) advises testing every three years.

Major Risk Factors for Type 2 Diabetes

  • Age and Weight: Being over 45 and overweight increases the risk.
  • Family History: Having a parent or sibling with Type 2 diabetes raises the likelihood of developing the condition.
  • Ethnic Background: Higher risk among African American, American Indian, Asian American, Pacific Islander, and Hispanic American/Latino populations.
  • Gestational Diabetes: A history of gestational diabetes or delivering a baby over 9 pounds increases risk.
  • Blood Pressure and Cholesterol: High blood pressure (140/90 mm Hg or higher) and abnormal cholesterol levels (HDL 35 or lower and/or triglycerides 250 or higher).
  • Sedentary Lifestyle: Exercising less than three times a week.
  • Additional Factors: Chronic stress, poor sleep, and certain medical conditions, such as Polycystic Ovary Syndrome (PCOS).

How is Diabetes Diagnosed?

1. Fasting Plasma Glucose (FPG) Test

The FPG test measures blood glucose levels after fasting (12-14 hours). Regular fasting triggers insulin release to regulate blood sugar, but this response is impaired in people with diabetes.

  • Pre-diabetes: Fasting blood glucose between 100-125 mg/dl.
  • Diabetes: Fasting blood glucose 126 mg/dl or higher.

2. Oral Glucose Tolerance Test (OGTT)

This test measures blood glucose after fasting and two hours after consuming a glucose-rich drink.

  • Pre-diabetes: Two-hour blood glucose between 140-199 mg/dl.
  • Diabetes: Two-hour blood glucose 200 mg/dl or higher.

3. A1C Test

The A1C test measures average blood glucose levels over the past 2-3 months.

  • Pre-diabetes: A1C between 5.7% and 6.4%.
  • Diabetes: A1C 6.5% or higher.

Steps After Diagnosis

If you or a loved one has been diagnosed with diabetes, explore more resources to help manage your condition:

Learning about risk factors and diagnostic processes is an important step toward effectively managing diabetes and maintaining a healthy lifestyle.