Diabetes Update: Risk Factors, Screening, Diagnosis, and Prevention of Type 2 Diabetes

Type 2 diabetes (T2D) is the result of insulin resistance. Significant differences are noted in the prevalence of T2D among races. Screening recommendations vary by subspecialty society. Asian Americans should be screened for T2D at a lower body mass index (BMI) (ie, 23 kg/m²) than other racial groups. Risk factors for T2D include high-risk ethnicity, obesity, taking of certain drugs (including statins), and gestational diabetes. Health disparities and genetics also influence risk of T2D, although these complexities continue to be poorly understood. Lifestyle changes, weight loss, and increased exercise are proven to decrease the risk of T2D. There also is strong evidence that bariatric surgery reduces the risk. Current debate focuses on whether BMI should continue to be used to determine candidacy for bariatric surgery, or whether patients at risk of T2D with nonobese BMIs also might benefit from these procedures.