Diabetes Mellitus (DM) is a group of conditions in which blood glucose (BG) levels are elevated.
The 3 most common types of diabetes are:
- Type 1 DM in which the body does not produce insulin and therefore blood glucose (BG) levels are high and the body cells and tissues cannot use glucose to generate energy.
- Type 2 DM in which the body produces insulin, but the cells and tissues do not respond to insulin. BG is therefore high as the body cannot use glucose as fuel.
- Gestational diabetes is usually diagnosed during pregnancy and resolves shortly after delivery. In these patients, the hormones produced during pregnancy interfere with the ability of cells and tissue to respond to insulin, thus leading to high BG levels.
DM may lead to serious complications. The best strategy is to try and prevent DM from occurring. Therefore, it is useful to understand who is at risk of developing DM and should be proactive and diligent about preventive measures.
Type 1 DM risk factors include:
- Family history: If you have a parent, sibling or, first-degree relatives who have type 1 diabetes, your risk of developing type 1 diabetes increases. In the absence of a family history, the risk of developing type 1 diabetes is about 0.4%
If your father has type 1 diabetes, your risk of developing DM is 3-8%
If your mother has type 1 diabetes, and your risk of developing DM is 1-4%
If both parents have type 1 DM, your risk of developing DM may increase to 25-30%.
If you have a non-twin sibling with type 1 diabetes, your risk of developing DM is 3-6% by age 20 and 10% by age 60 years.
- Other autoimmune diseases: Certain autoimmune diseases are present with higher frequency in patients who type 1 diabetes. These conditions include Hashimoto’s thyroiditis, Addison’s disease, celiac disease, and vitiligo. A family history of these conditions may also increase your risk of developing type I DM.
Type II DM risk factors include:
- Age (45 years or older)
- Being overweight
- Not very active
- Family history of type 2 diabetes
- Metabolic syndrome (prediabetes, high blood pressure, and high blood triglyceride levels)
- Polycystic ovarian syndrome
- Previous gestational diabetes (or if you had a big baby >9 lbs.)
- Ethnic minorities, such as African-Americans, Latinos, American Indians, and Asian American.
Unlike type 1 diabetes, you can prevent or reverse type 2 diabetes by improving your lifestyle (losing weight, eating a healthy diet, and regular physical activity). In certain high risk patients, taking medications such as metformin or GLP-1 medications (such as Mounjaro®, Ozempic®, Saxenda® & Wegovy®) may reduce risk of developing type 2 diabetes.
Gestational DM risk factors include:
- 25 years or older.
- Overweight
- Have a family history of type 2 diabetes
- Have a previous history of gestational diabetes
- Previously given birth to a baby weighing over 9 pounds
- Previously had polycystic ovarian syndrome
- Is African-American, Latino, American Indian, Pacific Islander, or Asian American
If you have any of these risk factors, you can prevent gestational diabetes before conceiving by making some lifestyle changes (losing weight, eating a healthy diet, and doing regular physical activity). Sometimes taking metformin may also help.
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