Nonmodifiable Risk Factors

The prevalence and incidence of type 2 diabetes are strongly related to age. In fact, about 50% of all type 2 diabetic patients are over 60 years old. Ethnicity is a strong determinant of diabetes occurrence. In Chinese the prevalence of type 2 diabetes is 1% whereas in Pima Indians it is > 50% in adult population probably due to genetic influence or due to interaction between genes and environment. No systematic effect of gender on the prevalence and incidence of type 2 diabetes is observed but in some ethnic groups the occurrence of diabetes might depend on gender. Previous abnormality of glucose tolerance, a history of gestational diabetes and a family history of type 2 diabetes are all strong predictors of type 2 diabetes. Interestingly, also the presence of other disease states or conditions, for example hypertension and dyslipidemia increase the risk of type 2 diabetes. In recent years interest has been focused also on low birth weight as a risk factor for type 2 diabetes.

Associations between low birth weight and increased risk of type 2 diabetes in adult life have been reported in various populations (46). Several explanations for this relationship have been presented. Long-term effects of nutritional deprivation in utero could affect fetal growth and the development of the endocrine pancreas. Genetic factors could cause both low birth weight and later abnormalities of insulin secretion or insulin sensitivity. Whether the relationship between diabetes and low birth weight is mediated through impaired insulin sensitivity or impaired insulin secretion remains to be determined.

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