NatioNal Diabetes iNformatioN CleariNghouse 

Am I at 

Risk for 

Type 2 

Diabetes? 

Taking Steps to 

Lower Your Risk of 

Getting Diabetes 

 

U.S. Department 

of Health and 

Human Services 

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse 

Am I at Risk for
 

Type 2 Diabetes?
 

Taking Steps to Lower Your Risk 

of Getting Diabetes 

 

U.S. Department 

of Health and 

Human Services 

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse 

Taking Steps to Lower Your Risk of Getting Diabetes 

Table of Contents 

What is type 2 diabetes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
 

Can type 2 diabetes be prevented? . . . . . . . . . . . . . . . . . . . . . . 1
 

What are the signs and symptoms of type 2 diabetes? . . . . . . 4
 

Should I be tested for diabetes? . . . . . . . . . . . . . . . . . . . . . . . . 4
 

What does having pre-diabetes mean? . . . . . . . . . . . . . . . . . . . 5
 

Besides being older and overweight, what other 


factors increase my risk for type 2 diabetes? . . . . . . . . . . . . . . 5
 

How can I reduce my risk? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
 

Making Changes to Lower My Risk . . . . . . . . . . . . . . . . . . . . . 7
 

Hope through Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
 

 

 

 

 

 

 

 

 

 

Taking Steps to Lower Your Risk of Getting Diabetes 

What is type 2 diabetes? 

Diabetes is a disease in which blood glucose levels are above 

normal . People with diabetes have problems converting food 

to energy . After a meal, food is broken down into a sugar 

called glucose, which is carried by the blood to cells throughout 

the body . Cells use the hormone insulin, made in the pancreas, 

to help them process blood glucose into energy . 

People develop type 2 diabetes because the cells in the muscles, 

liver, and fat do not use insulin properly . Eventually, the 

pancreas cannot make enough insulin for the body’s needs . 

As a result, the amount of glucose in the blood increases 

while the cells are starved of energy . Over the years, high 

blood glucose damages nerves and blood vessels, leading to 

complications such as heart disease, stroke, blindness, kidney 

disease, nerve problems, gum infections, and amputation . 

Can type 2 diabetes be prevented? 

Research has demonstrated that people at risk for type 2 

diabetes can prevent or delay developing type 2 diabetes by 

losing a little weight . The results of the Diabetes Prevention 

Program (DPP) showed that weight loss 

through moderate diet changes and physical 

activity can delay and prevent type 2 

diabetes . Participants in this federally 

funded study of 3,234 people at high risk 

for diabetes experienced a 5- to 7-percent 

weight loss . For example, a 5- to 7-percent 

weight loss for a 200-pound person would be 

10 to 14 pounds . 

1 
 

 

 

 

 

 

2 

Am I at Risk for Type 2 Diabetes? 

Family history and overweight are strong risk factors for type 2 

diabetes . DPP study participants were overweight and had 

higher than normal levels of blood glucose, a condition called 

pre-diabetes, also called impaired glucose tolerance . Both prediabetes and obesity are strong risk factors for type 2 diabetes . 

Because of the high risk for diabetes among some minority 

groups, about half of the DPP participants were African 

American, Alaska Native, American Indian, Asian American, 

Pacific Islander, or Hispanic/Latino . 

DPP participants also included others at high risk for 

developing type 2 diabetes, such as women with a history of 

gestational diabetes and individuals aged 60 and older . 

The DPP tested two approaches to preventing diabetes: 

lifestyle change—a program of healthy eating and physical 

activity—and the diabetes drug metformin . People in the 

lifestyle change group exercised about 30 minutes a day 5 days 

a week, usually by walking, and lowered their intake of fat and 

calories . Those who took the diabetes drug metformin received 

information on physical activity and diet . A third group only 

received information on physical activity and diet . 

The results showed that people in the lifestyle 

change group reduced their risk of getting type 2 

diabetes by 58 percent . In the first year of the 

study, people lost an average of 15 pounds . 

Lifestyle change was even more effective 

in those aged 60 and older . They reduced their 

risk by 71 percent . People receiving metformin 

reduced their risk by 31 percent . 
3 

Taking Steps to Lower Your Risk of Getting Diabetes 

Types of Diabetes 

The three main kinds of diabetes are type 1, type 2, and 

gestational diabetes . 

Type 1 Diabetes 

Type 1 diabetes, formerly called juvenile diabetes or insulindependent diabetes, is usually first diagnosed in children, 

teenagers, or young adults . In this form of diabetes, the 

beta cells of the pancreas no longer make insulin because 

the body’s immune system has attacked and destroyed them . 

Treatment for type 1 diabetes includes taking insulin shots or 

using an insulin pump, making wise food choices, exercising 

regularly, controlling blood pressure and cholesterol, and 

taking aspirin daily—for some . 

Type 2 Diabetes 

Type 2 diabetes, formerly called adult-onset or noninsulindependent diabetes, is the most common form of diabetes . 

People can develop type 2 diabetes at any age, even during 

childhood . This form of diabetes usually begins with insulin 

resistance, a condition in which fat, muscle, and liver cells 

do not use insulin properly . At first, the pancreas keeps 

up with the added demand by producing more insulin . In 

time, however, it loses the ability to secrete enough insulin in 

response to meals . People who are overweight and inactive 

are more likely to develop type 2 diabetes . Treatment 

includes taking diabetes medicines, making wise food 

choices, exercising regularly, controlling blood pressure 

and cholesterol, and taking aspirin daily—for some . 

Gestational Diabetes 

Some women develop gestational diabetes late in pregnancy . 

Although this form of diabetes usually goes away after 

the baby is born, a woman who has had gestational 

diabetes is more likely to develop type 2 diabetes later in 

life . Gestational diabetes is caused by the hormones of 

pregnancy or a shortage of insulin . 
 

 

 

 

 

 

 

 

 

 

 

 

Am I at Risk for Type 2 Diabetes? 

What are the signs and symptoms of 

type 2 diabetes? 

Nearly 6 million people in the United States have type 2 

diabetes and do not know it . Many have no signs or symptoms . 

Symptoms can also be so mild that you might not even notice 

them . Some people have symptoms but do not suspect diabetes . 

Symptoms include 

•	 increased	thirst

•	 increased	hunger	

•	 fatigue

•	 increased	urination,	especially	at	night

•	 weight	loss	

•	 blurred	vision	

•	 sores	that	do	not	heal

Many people do not find out they have the disease until they 

have diabetes complications, such as blurry vision or heart 

trouble . If you find out early that you have diabetes, then you 

can get treatment to prevent damage to your body . 

Should I be tested for diabetes? 

Anyone 45 years old or older should consider getting tested 

for diabetes . If you are 45 or older and overweight—see the 

BMI chart on pages 10 and 11—getting tested is strongly 

recommended . If you are younger than 45, overweight, and 

have one or more of the risk factors on page 5, you should 

consider getting tested . Ask your doctor for a fasting blood 

glucose test or an oral glucose tolerance test . Your doctor 

will tell you if you have normal blood glucose, pre-diabetes, or 

diabetes . 

4 
 

 

 

 

 

 

 

 

Taking Steps to Lower Your Risk of Getting Diabetes 

What does having pre-diabetes mean? 

Pre-diabetes means your blood glucose is higher than normal 

but lower than the diabetes range . In 2007, at least 57 million 

American adults had pre-diabetes . Having pre-diabetes also 

means you are at risk for getting type 2 diabetes and heart 

disease . However, you can reduce the risk of getting diabetes 

and even return to normal blood glucose levels with modest 

weight loss through healthy eating and moderate physical 

activity . If you are told you have pre-diabetes, have your blood 

glucose checked again in 1 to 2 years . 

Besides being older and overweight, what other 

factors increase my risk for type 2 diabetes? 

To find out your risk for type 2 diabetes, check each item that 

applies to you . 

q	 I have a parent, brother, or sister with diabetes . 

q	 My family background is Alaska Native, American Indian, 

African American, Hispanic/Latino, Asian American, 

or Pacific Islander . 

q	 I have had gestational diabetes, or I gave birth to at least 

one baby weighing more than 9 pounds . 

q My blood pressure is 140/90 mm Hg or above, or I have 

been told that I have high blood pressure . 

q	 My cholesterol levels are not normal . My HDL 

cholesterol—“good” cholesterol—is below 35 mg/dL, or my 

triglyceride level is above 250 mg/dL . 

q	 I am fairly inactive . I exercise fewer than three times 

a week . 

5 
 

 

Am I at Risk for Type 2 Diabetes? 

q	 I have polycystic ovary syndrome, also called PCOS— 

women only . 

q	 On previous testing, I had impaired fasting glucose (IFG) 

or impaired glucose tolerance (IGT) . 

q	 I have other clinical conditions associated with insulin 

resistance, such as a condition called acanthosis nigricans, 

characterized by a dark, velvety rash around my neck or 

armpits . 

q	 I have a history of cardiovascular disease . 

The more items you checked, the higher your risk . 

How can I reduce my risk? 

You can do a lot to lower your chances of getting diabetes . 

Exercising regularly, reducing fat and calorie intake, and losing 

a little weight can help you reduce your risk of developing 

type 2 diabetes . Lowering blood pressure and cholesterol 

levels also helps you stay healthy . 

If you are overweight 

Then take these steps: 

•	 Reach	and	maintain	a	reasonable	body	weight	(see	page	8).

•	 Make	wise	food	choices	most	of	the	time	(see	page	9).

•	 Be	physically	active	every	day	(see	page	12).

If you are fairly inactive 

Then take this step: 

•	 Be	physically	active	every	day	(see	page	12).

6 
 

 

 

Taking Steps to Lower Your Risk of Getting Diabetes 

If your blood pressure is too high 

Then take these steps: 

•	 Reach	and	maintain	a	reasonable	body	weight	(see	page	8).

•	 Make	wise	food	choices	most	of	the	time	(see	page	9).

•	 Reduce	your	intake	of	sodium	and	alcohol	(see	page	9).

•	 Be	physically	active	every	day	(see	page	12).

•	 Talk	with	your	doctor	about	whether	you	need	medicine	to		

control your blood pressure (see page 12) . 

If your cholesterol or triglyceride levels are too high 

Then take these steps: 

•	 Make	wise	food	choices	most	of	the	time	(see	page	9).

•	 Be	physically	active	every	day	(see	page	12).

•	 Talk	with	your	doctor	about	whether	you	need	medicine	to	

control your cholesterol levels (see page 12) . 

Making Changes to Lower My Risk 

Making big changes in your life is hard, especially if you are faced 

with more than one change . You can make it easier by taking 

these steps: 

•	 Make	a	plan	to	change	behavior.

•	 Decide	exactly	what	you	will	do	and	when	you	will	do	it.

•	 Plan	what	you	need	to	get	ready.

•	 Think	about	what	might	prevent	you	from	reaching	your	goals.

•	 Find	family	and	friends	who	will	support	and	encourage	you.

•	 Decide	how	you	will	reward	yourself	when	you	do	what	you	

have planned . 

Your doctor, a dietitian, or a counselor can help you make a plan . 

Consider making changes to lower your risk of diabetes . 

7 
 

 

 

 

 

 

 

Am I at Risk for Type 2 Diabetes? 

Reach and Maintain a Reasonable Body Weight 

Your weight affects your health in many ways . Being 

overweight can keep your body from making and using insulin 

properly . Excess body weight can also cause high blood 

pressure . 

Body mass index (BMI) is a measure of body weight relative to 

height . You can use BMI to see whether you are underweight, 

normal weight, overweight, or obese . Use the table on pages 

10 and 11 to find your BMI . 

•	 Find	your	height	in	the	left-hand	column.

•	 Move	across	in	the	same	row	to	the	number	closest	to	your	

weight . 

•	 The	number	at	the	top	of	that	column	is	your	BMI.		Check	

the word above your BMI to see whether you are normal 

weight, overweight, or obese . 

If you are overweight or obese, choose sensible ways to get in 

shape . 

•	 Avoid	crash	diets.		Instead,	eat	less	of	the	foods	you	usually	

have . Limit the amount of fat you eat . 

•	 Increase	your	physical	activity.		Aim	for	at	least	30	minutes	

of exercise most days of the week . (See page 12 for 


suggestions .)
 

•	 Set	a	reasonable	weight-loss	goal,	such	as	losing	1	pound	a	

week . Aim for a long-term goal of losing 5 to 7 percent of 

your total body weight . 

8 
 

 

 

 

 

 

 

 

 

Taking Steps to Lower Your Risk of Getting Diabetes 

Make Wise Food Choices Most of the Time 

What you eat has a big impact on your health . By making wise 

food choices, you can help control your body weight, blood 

pressure, and cholesterol . 

•	 Take	a	look	at	the	serving	sizes	of	the	foods	you	eat.		

Reduce serving sizes of main courses such as meat, 

desserts, and foods high in fat . Increase the amount of 

fruits and vegetables . 

•	 Limit	your	fat	intake	to	about	25	percent	of	your	total	

calories . For example, if your food choices add up 

to about 2,000 calories a day, try to eat no more than 

56 grams of fat . Your doctor or a dietitian can help you 

figure out how much fat to have . You can also check food 

labels for fat content . 

•	 Limit	your	sodium	intake	to	less	than	2,300	mg—about	

1 teaspoon of salt—each day . 

•	 Talk	with	your	doctor	about	whether	you	may	drink	

alcoholic beverages . If you choose to drink alcoholic 

beverages, limit your intake to one drink—for women— 

or two drinks—for men—per day . 

•	 You	may	also	wish	to	reduce	the	number	of	calories	you	

have each day . People in the DPP lifestyle change group 

lowered their daily calorie total by an average of about 450 

calories . Your doctor or dietitian can help you with a meal 

plan that emphasizes weight loss . 

•	 Keep	a	food	and	exercise	log.		Write	down	what	you	eat,	

how much you exercise—anything that helps keep you 

on track . 

•	 When	you	meet	your	goal,	reward	yourself	with	a	nonfood	

item or activity, like watching a movie . 

Continued on Page 12 

9 
 

Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes 

Body Mass Index Table
 

Normal Overweight Obese Extreme Obesity 

BMI 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 

Height 

(inches) 

Body Weight 

(pounds) 

 5891 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167 172 177 181 186 191 196 201 205 210 215 220 224 229 234 239 244 248 253 258 

 5994 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173 178 183 188 193 198 203 208 212 217 222 227 232 237 242 247 252 257 262 267 

 6097 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179 184 189 194 199 204 209 215 220 225 230 235 240 245 250 255 261 266 271 276 

 61100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185 190 195 201 206 211 217 222 227 232 238 243 248 254 259 264 269 275 280 285 

 62104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191 196 202 207 213 218 224 229 235 240 246 251 256 262 267 273 278 284 289 295 

 63107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197 203 208 214 220 225 231 237 242 248 254 259 265 270 278 282 287 293 299 304 

 64110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204 209 215 221 227 232 238 244 250 256 262 267 273 279 285 291 296 302 308 314 

 65114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210 216 222 228 234 240 246 252 258 264 270 276 282 288 294 300 306 312 318 324 

 66118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216 223 229 235 241 247 253 260 266 272 278 284 291 297 303 309 315 322 328 334 

 67121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223 230 236 242 249 255 261 268 274 280 287 293 299 306 312 319 325 331 338 344 

 68125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230 236 243 249 256 262 269 276 282 289 295 302 308 315 322 328 335 341 348 354 

 69128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236 243 250 257 263 270 277 284 291 297 304 311 318 324 331 338 345 351 358 365 

 70132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243 250 257 264 271 278 285 292 299 306 313 320 327 334 341 348 355 362 369 376 

 71136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250 257 265 272 279 286 293 301 308 315 322 329 338 343 351 358 365 372 379 386 

 72140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258 265 272 279 287 294 302 309 316 324 331 338 346 353 361 368 375 383 390 397 

 73144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265 272 280 288 295 302 310 318 325 333 340 348 355 363 371 378 386 393 401 408 

 74148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272 280 287 295 303 311 319 326 334 342 350 358 365 373 381 389 396 404 412 420 

 75152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279 287 295 303 311 319 327 335 343 351 359 367 375 383 391 399 407 415 423 431 

 76156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287 295 304 312 320 328 336 344 353 361 369 377 385 394 402 410 418 426 435 443 

Source: Adapted from Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: 

The Evidence Report. 

10 11
12

Am I at Risk for Type 2 Diabetes?

 

 

 

 

 

 

 

 

 

 

 

Am I at Risk for Type 2 Diabetes? 

Be Physically Active Every Day 

Regular exercise tackles several risk factors at once . It helps 

you lose weight, keeps your cholesterol and blood pressure 

under control, and helps your body use insulin . People in 

the DPP who were physically active for 30 minutes a day, 

5 days a week, reduced their risk of type 2 diabetes . Many 

chose brisk walking for exercise . 

If you are not very active, you should start slowly . Talk with 

your doctor first about what kinds of exercise would be safe 

for you . Make a plan to increase your activity level toward the 

goal of being active at least 30 minutes a day most days of the 

week . 

Choose activities you enjoy . Some ways to work extra activity 

into your daily routine include the following: 

•	 Take	the	stairs	rather	than	an	elevator	or	escalator.

•	 Park	at	the	far	end	of	the	parking	lot	and	walk.

•	 Get	off	the	bus	a	few	stops	early	and	walk	the	rest	of	

the way . 

•	 Walk	or	bicycle	whenever	you	can.

Take Your Prescribed Medications 

Some people need medication to help control their blood 

pressure or cholesterol levels . If you do, take your medicines 

as directed . Ask your doctor about medicines to prevent 

type 2 diabetes . 

12 
 

 

 

 

 

 

 

 

 

 

 

Taking Steps to Lower Your Risk of Getting Diabetes 

Hope through Research 

We now know that many people can prevent type 2 diabetes 

through weight loss, regular exercise, and lowering their intake 

of fat and calories . Researchers are intensively studying 

the genetic and environmental factors that underlie the 

susceptibility to obesity, pre-diabetes, and diabetes . As they 

learn more about the molecular events that lead to diabetes, 

they will develop ways to prevent and cure the different stages 

of this disease . DPP researchers continue to monitor DPP 

participants to learn more about the study’s long-term effects 

through the Diabetes Prevention Program Outcomes Study . 

People with diabetes and those at risk for it now have easier 

access to clinical trials that test promising new approaches to 

treatment and prevention . Participants in clinical trials can 

play a more active role in their own health care, gain access 

to new research treatments before they are widely available, 

and help others by contributing to medical research . For 

information about current studies, visit www.ClinicalTrials.gov . 

13 
Am I at Risk for Type 2 Diabetes? 

For More Information 

National Diabetes Education Program 

1 Diabetes Way 

Bethesda, MD 20814–9692 

Phone: 1–888–693–NDEP (6337) 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndep@mail .nih .gov 

Internet: www .ndep .nih .gov 

American Diabetes Association 

1701 North Beauregard Street 

Alexandria, VA 22311 

Phone: 1–800–DIABETES (342–2383) 

Fax: 703–549–6995 

Email: AskADA@diabetes .org 

Internet: www .diabetes .org 

14 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

National Diabetes Information Clearinghouse 

1 Information Way 

Bethesda, MD 20892–3560 

Phone: 1–800–860–8747 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: ndic@info .niddk .nih .gov 

Internet: www .diabetes .niddk .nih .gov 

The National Diabetes Information Clearinghouse (NDIC) is a 

service of the National Institute of Diabetes and Digestive and 

Kidney	Diseases	(NIDDK).		The	NIDDK	is	part	of	the	National	

Institutes of Health of the U .S . Department of Health and 

Human Services . Established in 1978, the Clearinghouse provides 

information about diabetes to people with diabetes and to their 

families, health care professionals, and the public . The NDIC 

answers inquiries, develops and distributes publications, and works 

closely with professional and patient organizations and Government 

agencies to coordinate resources about diabetes . 

Publications produced by the Clearinghouse are carefully reviewed 

by	both	NIDDK	scientists	and	outside	experts.		This	booklet	was	

originally reviewed by David G . Marrero, Ph .D ., Indiana University 

School of Medicine, Diabetes Research and Training Center, 

and Michael L . Parchman, M .D ., M .P .H ., Associate Professor, 

Department of Family and Community Medicine, University of 

Texas Health Science Center . 

This publication is not copyrighted . The Clearinghouse 

encourages users of this booklet to duplicate and distribute as 

many copies as desired . 

This booklet is also available at www.diabetes.niddk.nih.gov. 

This publication may contain information about medications . 

When prepared, this publication included the most current 

information available . For updates or for questions about any 

medications, contact the U .S . Food and Drug Administration 

toll-free at 1–888–INFO–FDA (463–6332) or visit www.fda.gov . 

Consult your doctor for more information . 
 –

 

 

U .S . DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No . 09 4805 

November 2008