The 13 Risk Factors for Type 2 Diabetes

by David Mendosa Patient Advocate

You probably have prediabetes unless you already have type 2 diabetes. More than half of American adults had either diabetes or prediabetes in 2012, a study in JAMA says. More than 30 million of us already have diabetes. Getting diabetes is getting easier. When I wrote about the risk factors for diabetes in 1998 for The Dallas Morning News, 16 million of us had it.

stepping on scale

Being overweight

A primary risk factor for type 2 diabetes is being overweight. If your body mass index, or BMI, is more than 25 (or 23 for Asian Americans), you are at risk. The more fatty tissue you have, the more resistant your cells become to insulin. But you don't have to be overweight to develop type 2 diabetes.

Eating popcorn on couch in sweats.

Being inactive

The less active you are the greater your risk. When you get physical activity, controlling your weight gets easier. Being active uses up glucose as energy, the Mayo Clinic says, and that makes your cells more sensitive to insulin.

prediabetes concept, syringe, monitor, measuring tape and fruit.

Having prediabetes

When your fasting blood glucose level is between 100 and 125 mg/dL in more than one test, you have prediabetes, which you can reverse. An A1C between 5.7 and 6.5 percent or an oral glucose tolerance test (OGTT) between 140 and 200 mg/dL can also indicate prediabetes. But if you go above the ranges on these tests, you have diabetes, and that isn’t reversible.

Taking blood pressure with cuff.

Having high blood pressure

You are more likely to get diabetes when you have hypertension, or high blood pressure. The National Heart, Lung, and Blood Institute defines it as more than 140 mm Hg (your systolic number) over 90 mm Hg (your diastolic number). If you have other cardiovascular risk factors, hypertension is also considered when you blood pressure is over 130 mm Hg (systolic) and 80 mm Hg.


Having a low HDL cholesterol level

If your HDL cholesterol level is below 35 mg/dL, you are at risk of diabetes. HDL stands for high-density lipoprotein and is the so-called good cholesterol.


Having a high triglyceride level

Besides HDL, the other lipid level that can lead to diabetes is having lots of triglycerides in your blood. If that level is above 250 mg/dL, you are at risk of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases.


Eating the wrong food

Eating lots of high-glycemic carbohydrates is another risk factor that you can control. A study in JAMA of 65,173 female American nurses concluded that a this diet appears to be a diabetes risk factor in women. Likewise, a study in Diabetes Care of 42,759 male health professionals showed that it increased the risk for men.


Unmodifiable risk factors for women

The seven risk factors above are each something you can change. Women, however, have three more risks that aren’t modifiable. The risks include (1) having a baby who weighs more than nine pounds at birth, (2) having been diagnosed with gestational diabetes, and (3) having polycystic ovary syndrome, or PCOS.


Uncontrollable risk factors

The seven risk factors above are each something you can change. But for both women and men there are three more risk factors aren’t modifiable. They are (1) having a family history of diabetes, (2) being of Hispanic, African-American, or Native American descent, and (3) being 45 or older, which “may be because you tend to exercise less, lose muscle mass and gain weight as you age.”


The bottom line

You need to know about these 13 risk factors — even those you can’t change — so that you can concentrate on the ones you can change. If you are 45 or older, it’s a good idea to get tested to see if you have prediabetes or already have diabetes. If you are also overweight or obese, testing is strongly recommended. Anyone who is overweight or obese and has another risk factor also needs to be tested.

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.