Chapter 2: Diabetes Mellitus – A Practical Guide for Patients
Risk Factors and Prevention of Diabetes
Type 2 diabetes develops due to a combination of genetic susceptibility and lifestyle factors. Many cases can be prevented or delayed through healthy lifestyle changes.
Table 1. Non-modifiable Risk Factors
| Risk Factor | Comments |
| Age ≥35 years (South Asians) | Risk increases with age |
| Family history | First-degree relative increases risk |
| South Asian ethnicity | Higher risk at lower BMI |
| Previous gestational diabetes | High future risk |
| PCOS | Associated with insulin resistance |
Table 2. Modifiable Risk Factors
| Risk Factor | Effect | How to Reduce Risk |
| Overweight/Obesity | Insulin resistance | Lose 5–10% body weight |
| Physical inactivity | Reduced insulin sensitivity | ≥150 min/week exercise |
| Unhealthy diet | Weight gain & high glucose | Plate method, whole grains |
| Smoking | ↑ Cardiovascular risk | Stop smoking |
| Poor sleep | Insulin resistance | 7–9 hours/night |
Figure 1 (Placeholder)
[Infographic: Diabetes Risk Wheel showing obesity, family history, inactivity, unhealthy diet, smoking, hypertension, PCOS and gestational diabetes.]
Prevention Checklist
| Recommendation | Target |
| Healthy weight | BMI individualized; avoid central obesity |
| Exercise | ≥150 min/week + strength training 2–3 days/week |
| Diet | Vegetables, fruits, whole grains, legumes |
| Sugary drinks | Avoid |
| Screening | Annual if high risk |
Clinical Pearl
The Diabetes Prevention Program (DPP) showed that intensive lifestyle intervention reduced the risk of developing type 2 diabetes by approximately 58% in people with prediabetes.
Key Messages
• Most type 2 diabetes is preventable.
• Obesity and physical inactivity are the strongest modifiable risk factors.
• Early screening is especially important in South Asian populations.
References
- ADA Standards of Care in Diabetes (latest edition).
- Knowler WC, et al. N Engl J Med. 2002;346:393–403.
- IDF Diabetes Atlas, 11th Edition.
- WHO. Diabetes.