Many College Students Underestimate Diabetes Risk. 
College students form long-lasting diet and health behaviors that are associated with an increased lifetime risk of type 2 diabetes.  Thus, colleges and universities can be critical settings to increase awareness of diabetes risk and for nutrition education and health interventions.  However, it is not clear if high-risk students recognize the likelihood of diabetes in their future.  To assess personal risk perceptions of a sample of multiracial college students with three or more known risk factors for diabetes, and to identity characteristics of students with an unrealistic perception of their future risk.  Self-reported data on health and behavior were collected from 1,579 students from three urban colleges.  The students at high risk (n=541) for diabetes were categorized as having either a realistic or unrealistic perception of their future risk of diabetes.  Characteristics of the two groups were examined using multivariate logistic regression.  Approximately 61% of the high-risk students recognized they were more likely to develop diabetes than others, while the remaining 39% did not perceive their personal risk to be high.  The under-estimators were significantly more likely to be male (p=0.010), have no family history of diabetes (p=0.029), and be born outside the United States (p<0.001).  The under-estimators, an unrealistically optimistic high-risk group, warrant attention, as an unrealistic perception may reduce their likelihood of taking preventive actions to diminish the threat.  There is a pressing need to heighten knowledge and awareness of diabetes risk and to develop models of health education and behavior change that are both relevant and effective for young adults.