What’s your risk of developing diabetes?

Diabetes occurs when there is damage to the insulin-producing cells of the pancreas, and here we explain how you can determine if you are at risk of developing diabetes.

In the healthy body, our glucose (sugar) levels are kept constant. If we eat a chocolate cake, the body simply puts out hormones, including insulin, that tell the body to start using glucose at the same rate as it is absorbed from food. So the glucose levels in the blood stay the same.

When we’re not eating, the body slowly releases its glucose stores to drip-feed the brain at the same rate at which it uses glucose. Again, so the glucose levels in the blood stay in balance.

Diabetes is the state in which this balance fails, and sugar levels start to rise.

In children and adolescents the immune system can inadvertently destroy the insulin-producing cells of the pancreas. This is called type 1 diabetes, or insulin dependent diabetes (IDDM), because you need insulin injections to survive.

Insulin-producing cells can also become burnt out in aging adults by too many years or too many calories. This is called type 2 diabetes.

Unlike type 1 diabetes, the body retains the ability to produce a little insulin, at least initially. This may be enough to cope with small meals, but there is inadequate reserve to deal with additional demands. So the first sign of trouble may be when glucose levels rise after a big meal. This is called impaired glucose tolerance (also known as pre-diabetes).

Even if you don’t have any symptoms, you should undergo regular tests to determine your risk of developing diabetes. This test involves a blood test, sometimes after taking a sugary drink.

You can also easily calculate your risk of developing diabetes using the AUSDRISK calculator.

Do you have a heightened risk?

People at high risk of type 2 diabetes include:

  • those over 60 years of age (and all people of Asian, Pacific Islander, Hispanic, Indian or Middle eastern nationality over 50)
  • those over age 40 with too much around their middle: Find the mid-point between your bottom rib and the top of your hip bone, breathe out normally and measure your circumference with a tape measure across this point. (This may not be the narrowest part of your waist or exactly in-line with your belly button.
    • For men:
      • 94cm (37 inches) or more = increased risk of developing diabetes
      • 102 cm (40 inches) or more = substantially increased risk
    • For women:
      • 80 cm (32 inches) or more =  increased risk of developing diabetes
      • 88 cm (35 inches) or more = substantially increased risk
    • (Note: Different targets are appropriate for Asians and other ethnic groups.)
  • those who have heart disease or high risks for it, such as high blood pressure or high cholesterol
  • those with a family history of diabetes
  • women with polycystic ovarian syndrome (PCOS)
  • those regularly taking certain mediations (e.g. steroids, antipsychotic pills, beta-blockers, etc)

Diabetes is worth preventing, especially if we want to live long and prosper. For every year we have type 2 diabetes, we can effectively add a year to our age, so a 60-year-old who has had diabetes for 10 years has, on average, the same life expectancy as a 70-year-old.

If we have diabetes, all the elements of aging are enhanced and all the diseases of aging happen at an earlier age, including cognitive decline, heart disease, stroke, hypertension, kidney failure, vision loss, arthritis, impotence, some cancers and even grey hair.

One way we can slow aging is by not allowing it to speed up with diabetes.

Last reviewed 15/May/2017

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Dr Merlin Thomas

Professor Merlin Thomas is Professor of Medicine at Melbourne’s Monash University, based in the Department of Diabetes. He is both a physician and a scientist. Merlin has a broader interest in all aspects of preventive medicine and ageing. He has published over 270 articles in many of the worlds’ leading medical journals

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