American Medical Association Family Medical Guide - American Medical Association [609]
Risk Factors
You are at increased risk of developing type 2 diabetes if you have any of the following risk factors:
• You have a family history of type 2 diabetes—for example, a parent or sibling with the disease.
• You are obese—you have a body mass index (BMI; see page 11) of 27 or higher. Having too much body fat, especially around the abdomen, can make your cells resistant to the effects of insulin, causing glucose to build up in the blood.
• You are Native American or of African, Asian, or Hispanic descent.
• You are 45 or older. The risk of type 2 diabetes tends to increase with age.
• You have been diagnosed with impaired fasting glucose, detected by a blood test showing a glucose level between 110 milligrams per deciliter (mg/dL) and 126 mg/dL.
• You have high blood pressure, defined as blood pressure readings consistently higher than 120/80 millimeters of mercury (mm Hg).
• Your level of HDL (good) cholesterol is 40 mg/dL or lower, or your triglyceride level is 250 mg/dL or higher (see page 146).
• You developed diabetes during a pregnancy (called gestational diabetes; see page 521), or you gave birth to an unusually large baby (weighing more than 9 pounds).
• You get little or no exercise most days.
• You carry more weight around your abdomen than on your hips and thighs and your waist is 40 inches or larger (if you’re a man) or 35 inches or larger (if you’re a woman). Waistline obesity reduces the ability of insulin to get glucose into cells.
If you have any of these risk factors, talk to your doctor about having a blood glucose test for type 2 diabetes.
Symptoms
Because the elevated level of glucose in the blood develops gradually, symptoms often do not occur for several years and frequently go unnoticed. When symptoms develop, they include frequent urination; unusual thirst; weight loss, sometimes even while eating excessively; and blurred vision.
Q & A
Type 2 Diabetes
Q. Both of my parents are overweight and both have type 2 diabetes. Does that mean I will get it too?
A. Because your parents have this form of diabetes, which tends to run in families, you are at increased risk of developing the disorder. But this does not mean that you are destined to get it. Your genes only make you more susceptible than a person who doesn’t have the genes. You can avoid type 2 diabetes by not becoming overweight like your parents, and by exercising regularly and eating a healthy diet.
Q. My 6-year-old son is extremely overweight and I’m getting worried about his health. What can I do?
A. You are right to be concerned about your son’s health. Obesity during childhood begins the processes that can lead to heart disease, high blood pressure, and type 2 diabetes. Alarmingly, increasing numbers of American children are developing type 2 diabetes as teenagers and even younger. This form of diabetes used to occur only in people over 40. To help your son avoid diabetes, work closely with his doctor to develop a plan to help your son lose weight. The plan will include a nutritious, low-fat, high-fiber diet and ways to encourage your son to be more active.
Q. I’m currently taking a medication that lowers my blood glucose level. Is there any way to control my glucose level without medication?
A. Yes, there is, but it requires a great deal of effort on your part. Many people with type 2 diabetes have been able to go off their medication by losing weight and increasing their level of activity. If you want to give it a try, work closely with your doctor to develop a weight-loss plan, including a diet and exercise program that will be effective for you.
Diagnosis
To diagnose type 2 diabetes, doctors use blood tests to measure the level of glucose in the blood. Because a number of factors (such as the medications a person is taking) can affect blood glucose levels, a doctor