risk factors for diabetes mellitus type 2 & risk factor reduction
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Etiology
risk factors
- age > 45 years
- obesity
- increased weight gain relative to height during an infant's first 3 months of life[3]
- weight gain after 50 years of age[7]
- greatest risk factor[10]
- increased waist circumference, waist-to-hip ratio, central adiposity[12]
- western culture diet
- not whole grains
- not brown rice: confers lower risk than white rice[6]
- lack of exercise
- sedentary lifestyle, including watching TV[16]
- previous gestational diabetes
- chronic glucocorticoid use, including
- impaired glucose tolerance
- higher fasting plasma glucose within the normal range is a risk factor for young men[1]
- black, hispanic or native American ethnicity
- habitual sleep duration of < 6 hours/night
- hypertension
- use of diuretics[2][13]
- nighttime hypertension
- taking antihypertensives at bedtime reduces risk[20]
- dyslipidemia - use of statins[13]
- smoking (see CARDIA study)
- low serum sex-hormone binding globulin (serum SHBG)[5]
- sweetened beverages[17][18]
- risk associated with sugar-sweetened beverages & artificially-sweetened beverages[17]
- 18% higher risk per 1 serving daily of sugar-sweetened beverage[18]
- sugar-sweetened beverages associated with excess risk for type 2 diabetes & cardiovascular disease[30]
- moderate alcohol consumption may lower risk
- lowest risk amoung Danish men consuming 14 drinks/week & women consuming 9 drinks/week[22]
- long-term use of proton pump inhibitors is associated with increased risk of type 2 diabetes[31]
- from QDiabetes[25]
* risk-scoring systems with positive predictive values < 50%[4]
Management
- diet & excercise is the best strategy[19]
- fruits & vegetables, Mediterranean diet
- a diet rich in antioxidants may help decrease the risk of type 2 diabetes[23]
- a plant-based diet may reduce risk of type 2 diabetes[27]
- weight reduction
- exercise
- lifestyle intervention including behavioral strategies for >= 150 minutes of moderate physical activity/week more effective than metformin in preventing type 2 diabetes
- lifestyle intervention (diet & exercise) reduces incidence of type 2 diabetes by 27% vs 18% for metformin, relative to placebo[19]
- diet & exercise intervention not enhanced by support from trained lay volunteers with type 2 diabetes[28]
- after adjustment for physical activity & other confounders, each hour spent watching TV associated with a 3.4% increase in risk[16]
- moderate to vigorous physical exercise can reduce incidence of diabetes in obese patients by ~50%[29]
- metformin may benefit high-risk patients[15]
- lifestyle modification & weight-reduction & insulin-sensitizing medications (metformin) lower risk for developing diabetes (NNT=24) but results fade with time[24]
- coffee may confer lower risk, see coffee & risk of diabetes
- plain water, low-fat milk, & coffee is associated with lower risk[30]
- replacing sweetened beverages with unsweetened one[17]
- green leafy vegetables, confers lower risk
- whole fruits, including apples, grapes, & blueberries, may lower risk for type 2 diabetes[11]
- night time light exposure between 12:30 AM & 6 AM increased risk of type 2 diabetes, as much as 1.5-fold[32]
- Tianqi*, a capsule containing 10 Chinese herbal medicines, delays progression to diabetes in high-risk patients[14]
* Tianqi is used in China for treatment of type 2 diabetes
More general terms
Additional terms
References
- ↑ 1.0 1.1 Tirosh A, Shai I, Tekes-Manova D, Israeli E, Pereg D, Shochat T, Kochba I, Rudich A; Israeli Diabetes Research Group. Normal fasting plasma glucose levels and type 2 diabetes in young men. N Engl J Med. 2005 Oct 6;353(14):1454-62. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16207847
- ↑ 2.0 2.1 Internal Medicine World Report vol 21, 2006
- ↑ 3.0 3.1 Leunissen RW et al Timing and Tempo of First-Year Rapid Growth in Relation to Cardiovascular and Metabolic Risk Profile in Early Adulthood. JAMA. 2009;301(21):2234-2242. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19491185
- ↑ 4.0 4.1 Kahn HS et al. Two risk-scoring systems for predicting incident diabetes mellitus in U.S. adults age 45 to 64 years. Ann Intern Med 2009 Jun 2; 150:741. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19487709
- ↑ 5.0 5.1 Ding EL et al Sex hormone-binding globulin and risk of type 2 diabetes in women and men. N Engl J Med 2009 Sep 17; 361:1152. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19657112
- ↑ 6.0 6.1 Sun Q et al. White rice, brown rice, and risk of type 2 diabetes in US men and women. Arch Intern Med 2010 Jun 14; 170:961 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20548009 <Internet> http://dx.doi.org/10.1001/archinternmed.2010.109
- ↑ 7.0 7.1 Biggs ML et al. Association between adiposity in midlife and older age and risk of diabetes in older adults. JAMA 2010 Jun 23/30; 303:2504 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20571017
- ↑ Carter P et al, Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis BMJ 2010;341:c4229 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20724400 <Internet> http://www.bmj.com/cgi/content/full/341/aug18_4/c4229
Mann J and Aune D Can specific fruits and vegetables prevent diabetes? BMJ 2010;341:c4395 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20724401 <Internet> http://www.bmj.com/cgi/content/extract/341/aug18_4/c4395 - ↑ 9.0 9.1 Suissa S et al. Inhaled corticosteroids and the risks of diabetes onset and progression. Am J Med 2010 Nov; 123:1001. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20870201
- ↑ 10.0 10.1 Reis JP et al. Lifestyle factors and risk for new-onset diabetes: A population-based cohort study. Ann Intern Med 2011 Sep 6; 155:292 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21893622
- ↑ 11.0 11.1 11.2 Muraki I et al Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ 2013;347:f5001 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23990623 <Internet> http://www.bmj.com/content/347/bmj.f5001
- ↑ 12.0 12.1 Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 13.0 13.1 13.2 Shen L et al Role of diuretics, beta-blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study. BMJ 2013;347:f6745 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24322398 <Internet> http://www.bmj.com/content/347/bmj.f6745
- ↑ 14.0 14.1 Lian F, Li G, Chen X et al Chinese Herbal Medicine Tianqi Reduces Progression From Impaired Glucose Tolerance to Diabetes: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial. Journal of Clinical Endocrinology & Metabolism. Jan 16, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24432995 <Internet> http://press.endocrine.org/doi/abs/10.1210/jc.2013-3276
- ↑ 15.0 15.1 Sussman JB et al Improving diabetes prevention with benefit based tailored treatment: risk based reanalysis of Diabetes Prevention Program. BMJ 2015;350:h454 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25697494 <Internet> http://www.bmj.com/content/350/bmj.h454
- ↑ 16.0 16.1 16.2 Orciari Herman A, Sadoughi S, Saitz R More TV Watching Associated with Higher Diabetes Risk Physician's First Watch, April 2, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Rockette-Wagner B et al The impact of lifestyle intervention on sedentary time in individuals at high risk of diabetes. Diabetologia. March 2015 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25851102 - ↑ 17.0 17.1 17.2 17.3 O'Connor L et al Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia. Spring 2015 http://www.diabetologia-journal.org/files/OConnor.pdf
- ↑ 18.0 18.1 18.2 Imamura F et al. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: Systematic review, meta-analysis, and estimation of population attributable fraction. BMJ 2015; 351:h3576 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26199070
- ↑ 19.0 19.1 19.2 Diabetes Prevention Program Research Group Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. Lancet Diabetes & Endocrinology. Sept 13, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26377054 <Internet> http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2815%2900291-0/abstract
Misra A Prevention of diabetes: more answers, more questions. Lancet Diabetes & Endocrinology. Sept 13, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26377053 <Internet> http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2815%2900331-9/abstract - ↑ 20.0 20.1 Hermida RC et al Sleep-time BP: prognostic marker of type 2 diabetes and therapeutic target for prevention. Diabetologia. First online: 23 September 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26399403 <Internet> http://link.springer.com/article/10.1007/s00125-015-3748-8
Hermida RC et al Bedtime ingestion of hypertension medications reduces the risk of new-onset type 2 diabetes: a randomised controlled trial. Diabetologia. First online: 23 September 2015. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26399404 <Internet> http://link.springer.com/article/10.1007/s00125-015-3749-7 - ↑ 21.0 21.1 White J, Swerdlow DI, Preiss D et al. Association of lipid fractions with risks for coronary artery disease and diabetes. JAMA Cardiol 2016 Aug 3 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27487401
- ↑ 22.0 22.1 Orciari Herman A, Sofair A, Chavey WE Drinking Alcohol 3 to 4 Days a Week Tied to Lowest Risk for Diabetes Physician's First Watch, July 28,2017 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Holst C, Becker U, Jorgensen ME et al Alcohol drinking patterns and risk of diabetes: a cohort study of 70,551 men and women from the general Danish population. Diabetologia. July 27, 2017 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28748324 https://link.springer.com/article/10.1007/s00125-017-4359-3 - ↑ 23.0 23.1 23.2 Hackethal V New Study Shows Antioxidant-Rich Foods Diminish Diabetes Risk. Medscape - Nov 10, 2017. https://www.medscape.com/viewarticle/888350
- ↑ 24.0 24.1 Haw JS, Galaviz KI, Straus AN et al. Long-term sustainability of diabetes prevention approaches: A systematic review and meta-analysis of randomized clinical trials. JAMA Intern Med 2017 Nov 6; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/29114778 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2661704
- ↑ 25.0 25.1 25.2 Hippisley-Cox J, Coupland C. Development and validation of QDiabetes-2018 risk prediction algorithm to estimate future risk of type 2 diabetes: Cohort study. BMJ 2017 Nov 20; 359:j5019. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29158232 Free PMC Article <Internet> http://www.bmj.com/content/359/bmj.j5019
- ↑ 26.0 26.1 Andersen YMF, Egeberg A, Ban L et al. Association between topical corticosteroid use and type 2 diabetes in two European population-based adult cohorts. Diabetes Care 2019 Jun; 42:1095 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30936111 <Internet> http://care.diabetesjournals.org/content/42/6/1095
- ↑ 27.0 27.1 Qian F, Liu G, Hu FB et al Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes. A Systematic Review and Meta-analysis. JAMA Intern Med. Published online July 22, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31329220PMID: 31329220 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2738784
- ↑ 28.0 28.1 Sampson M, Clark A, Bachmann M et al Lifestyle Intervention With or Without Lay Volunteers to Prevent Type 2 Diabetes in People With Impaired Fasting Glucose and/or Nondiabetic Hyperglycemia: A Randomized Clinical Trial. JAMA Intern Med. 2020 Nov 2:e205938 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33136119
- ↑ 29.0 29.1 Chen Y et al. Effect of moderate and vigorous aerobic exercise on incident diabetes in adults with obesity: A 10-year follow-up of a randomized clinical trial. JAMA Intern Med 2023 Jan 30; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36716009 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2801011
- ↑ 30.0 30.1 30.2 Ma L et al. Beverage consumption and mortality among adults with type 2 diabetes: Prospective cohort study. BMJ 2023 Apr 19; 381:e073406. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37076174 PMCID: PMC10114037 Free PMC article https://www.bmj.com/content/381/bmj-2022-073406
- ↑ 31.0 31.1 Loosen SH et al. Long-term use of proton pump inhibitors (PPIs) is associated with an increased risk of type 2 diabetes. Gut. 2022. Aug;71(8):1687-1688 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34725199
- ↑ 32.0 32.1 Windred DP, Burns AC, Rutter MK et al Personal light exposure patterns and incidence of type 2 diabetes: analysis of 13 million hours of light sensor data and 670,000 person-years of prospective observation. Lancet. Regional Health Europe. 2024. June 4. https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(24)00110-8/fulltext#%20