Risk factors for diabetes

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The increase in prevalence of type 2 diabetes is paralleled by the rising rate of obesity and metabolic syndrome. As body mass index (BMI) increases, the risk of developing type 2 diabetes increases correspondingly. The prevalence of type 2 diabetes is three to seven times higher in obese patients and is 20 times higher in those with a BMI greater 35 kg/m2 than in those with a BMI between 18.5 and 24.9 kg/m2 [7-8]. This increased prevalence, however, may vary among ethnic groups. Obesity is a component of metabolic syndrome. The National Cholesterol Education Program Adult Treatment Panel (NECP-ATP III) defines metabolic syndrome using the objective clinical criteria given in Table 1 [9].

Metabolic syndrome is defined as the presence of any three of the risk factors. The clustering of risk factors associated with this syndrome predicts development of manifest diabetes and cardiovascular disease. Hence, prevention of type 2 diabetes should aim to treat and prevent components of

Table 1

Clinical criteria for metabolic syndrome

Risk factor

Definition

Abdominal obesity

Elevated triglycerides HDL cholesterol

Elevated blood pressure

Fasting blood sugar

Men: waist circumference > 40 in Women: waist circumference > 35 in

> 150 mg/dL Men: < 40 mg/dL Women: < 50 mg/dL

> 130 mm Hg systolic and/or > 85 mm Hg diastolic or use of antihypertensive agent

> 110 mg/dL or use of hypoglycemic agent metabolic syndrome. Other risk factors for type 2 diabetes mellitus include age of 45 years or older, family history of diabetes (parent or siblings), physical inactivity, ethnicity (eg, Afro-American, Hispanic, Native American, Asian American, or Pacific Islander), impaired glucose tolerance, history of gestational diabetes or delivery of a baby weighing more than 9 lbs, hypertension (blood pressure > 140/90 mm Hg in adults), high-density lipoprotein (HDL) cholesterol level below 35 mg/dL and triglyceride level above 250 mg/dL, polycystic ovary syndrome, and history of vascular disease [10]. Park and Edington [11] applied a prediction model using sequential multilayered perception neural network architecture. High BMI was the most significant risk factor; other significant factors that predicted risk over time with variations in trajectory were elevated blood pressure, stress, elevated cholesterol levels, and fatty food intake.

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