There are a number of major risk factors for

type 2 diabetes.
Although some diabetic risks come from our genetics,
many are preventable.

Unfortunately, many people do not know what these are or clearly understand
the signs of them. For this reason, below is a list
of top type 2 diabetes risk factors.

• Also see:
  
  the symptoms of diabetes

Obesity

Obesity is the major type 2 diabetes risk, with millions of people throughout the world facing obesity. Almost a quarter of adults in the UK are recorded as being obese.

Furthermore, the numbers continue to climb, both amongst adults and children.

The number of children being diagnosed with type 2 diabetes caused by obesity is climbing everywhere. In the UK, about one in three children are classed as obese.

• Read more on
  
  diabetes and obesity

Lack of exercise and sedentary way of life

Living a sedentary lifestyle without sufficient exercise is seriously damaging to health.

Being inactive often leads to being overweight, which can lead to pre-diabetes and type 2 diabetes.

Staying active
decreases insulin resistance and helps bodily insulin
to be more effective.

• Read more on
  
  diabetes and obesity

Eating a ‘Western’ diet

Eating unhealthily is a major cause of type 2 diabetes,
as over 90 per cent of type 2 diabetics are overweight.

A so called Western diet, with a reliance on processed foods, poor quality fats and little fibre content, is thought to be a major contributor to diabetes and

metabolic
syndrome

Eating
well, in conjunction with exercise, can prevent or reverse the development
of type 2 diabetes.

Picking a healthy diet can sometimes be confusing, with so many mixed messages, and its often not helped by so-called

diabetic food
which are not necessarily a healthier option.

High blood pressure

High cholesterol
and

blood pressure levels
are risks for many diseases, one of which is type 2 diabetes. Both are also major symptoms of

pre-diabetes

Gestational diabetes

Gestational diabetes
is another major risk, and affects about 2 to 5 per cent of women who fall pregnant.

Those women who suffer from it face greater later-life risks of developing type 2 diabetes, as do their children.

Family history

Having a close family member with type 2 diabetes can raise your own risk of developing the condition.

Unfortunately, you cannot do much about your genetic history, but you can be ready by being aware of the

symptoms of type 2 diabetes

Also, many ethnic minorities
are more prone to suffer from diabetes.

• For more on this, please read
  
  diabetes
  and ethnicity

Aging

As the population of the world ages, diabetes rates are soaring.

Unfortunately, the older we are, the greater the risk of developing type
2 diabetes is. The pancreas, according to some scientists, begins to produce
insulin less effectively as we age.

Furthermore, bodily resistance to insulin
increases with age.

Obesity is a long-term medical condition where excess body fat builds up to the point that it may have a negative effect on health.

The accumulation of an excessive amount of body fat can cause type 2 diabetes and the risk of type 2 diabetes increases linearly with an increase in body mass index.

Obesity is a complex, chronic condition influenced by genetics, behaviour, environment and social factors.

It’s typically measured using the Body Mass Index (BMI), which compares a person’s weight to their height.

A BMI of 30 or above is considered obese (or 27.5 for South Asians) while a BMI between 25 and 29.9 is classed as overweight.

However, BMI doesn’t always tell the full story — where fat is stored in the body, especially around the abdomen, can play a big role in disease risk.

How does obesity develop?

Obesity develops over time when a person consistently consumes more calories than their body uses.

These excess calories are stored as fat. Although this sounds simple, the causes of obesity are anything but. It’s not just a matter of willpower — a range of physical, emotional, environmental and social factors come into play.

Modern life makes it easy to gain weight. Many people work in sedentary jobs, spend hours in front of screens and rely on convenience foods that are high in calories but low in nutrients.

Stress, poor sleep and certain medications can also lead to weight gain.

People living in deprived areas may find it harder to access healthy food or safe places to exercise.

Genetics can influence how your body stores fat, how hungry you feel and how your metabolism works. The result is that millions of people struggle with obesity, even when they’re trying to live a healthy life.

• Body Mass Index (BMI) Calculator

Obesity in the UK

The UK has the highest level of adult obesity in Western Europe.

According to the latest Health Survey for England, around 26% of adults are classified as obese and an additional 38% are overweight.

That means nearly two-thirds of adults in the UK are carrying excess weight.

The numbers are equally concerning for children, with nearly one in three children aged 10 to 11 now classed as overweight or obese.

Forecasts suggest that by 2040, more than 70% of UK adults could be overweight or obese if action isn’t taken. Obesity is now one of the leading causes of preventable ill health and early death in the UK — and it’s also placing enormous strain on the NHS.

• Preadolescent obesity risk in offspring reduced by breastfeeding
• Research shows weight loss doubles with early use of anti-obesity medication
• New fat cell subtypes could transform obesity care

Symptoms and signs of obesity

Obesity doesn’t always present immediate symptoms, but it can gradually affect how you feel and function.

Many people with obesity experience:

• Breathlessness
• Tiredness
• Low energy
• Joint pain or
• Sleep problems like snoring and sleep apnoea.

Emotionally, obesity can take a toll too, often leading to low self-esteem, anxiety, or depression. Over time, the physical effects of obesity can lead to much more serious health complications.

Diagnosis and measuring obesity

Common methods of assessment include:

Body Mass Index (BMI)

• 18.5–24.9: Healthy weight
• 25–29.9: Overweight
• 30–34.9: Obese (Class I)
• 35–39.9: Obese (Class II)
• 40+: Obese (Class III or severe obesity)

Waist circumference

Risk is increased in men with >94 cm (37 inches) and in women with >80 cm (31.5 inches).

Body fat

Body fat percentage is assessed with body composition tools.

Blood tests

Blood tests to assess metabolic health, insulin resistance or prediabetes.

Link between obesity and type 2 diabetes

Obesity is the most significant modifiable risk factor for type 2 diabetes.

In fact, around 80–85% of people with type 2 diabetes are overweight or obese.

When there’s too much fat — particularly around the belly — the body’s cells can become resistant to insulin, the hormone that helps regulate blood sugar.

This condition, known as insulin resistance, means glucose builds up in the bloodstream, eventually leading to type 2 diabetes if not managed.

Research shows that people with obesity are up to 80 times more likely to develop type 2 diabetes than people with a BMI under 22.

Central obesity where one carries excess fat around the waist is particularly high risk.

Even before type 2 diabetes develops, many people pass through a stage called prediabetes, where blood sugar levels are raised but not high enough to be classed as diabetes. Prediabetes is often reversible, especially with early intervention and weight loss.

Other health risks associated with obesity

Obesity increases the risk of a wide range of serious conditions. These include:

• Type 2 diabetes with a 3–7x higher risk
• Cardiovascular disease (CVD) due to increased risk of stroke, hypertension, heart attack
• Breast, bowel, pancreatic, liver, and endometrial cancer
• Osteoarthritis due to increased wear and tear on joints
• Infertility, especially in women (linked to PCOS)
• Sleep apnoea, due to fat deposits around the neck
• Mental health disorders such as depression, anxiety, and low self-esteem

Can obesity be treated?

Yes — obesity is treatable and even modest weight loss can have a major impact on your health.

A 5% reduction in body weight can significantly improve insulin sensitivity, reduce blood pressure and lower cholesterol levels.

This in turn reduces your risk of developing type 2 diabetes by more than 50%, according to NHS data.

Lifestyle changes

Treatment starts with lifestyle changes.

A healthy, balanced diet that is lower in processed foods and refined sugars, combined with regular physical activity, forms the foundation.

Behavioural strategies — like tracking your meals, setting goals and managing emotional eating — can also help.

Structured digital tools like the Gro Health app can support these lifestyle changes by providing personalised support, education and motivation.

• Mediterranean Diet and 7 Day Meal Plan
• Low Carb Diet: Beginner’s Guide
• Intermittent Fasting: Guide to Fasting and How it Works

Weight loss medication

In some cases, medications such as GLP-1 receptor agonists may be prescribed including:

• Semaglutide (Wegovy)
• Tirzepatide (Mounjaro)

These medications help regulate appetite and have shown significant weight loss results in clinical trials. For those with severe obesity or related health complications, bariatric surgery may be considered.

Obesity in children and young people

Obesity is no longer an adult-only issue.

Worryingly, it’s becoming increasingly common in younger age groups.

Nearly a third of children aged 2 to 15 are now classed as overweight or obese and children from more deprived communities are disproportionately affected.

Obesity during childhood is likely to continue into adulthood and increases the risk of developing health problems earlier in life, including type 2 diabetes, heart disease and mental health issues.

Prevention through healthy eating, physical activity and education is critical — not only for the child but for the entire family.

Tackling obesity

Obesity prevention requires action on multiple fronts.

This includes education around healthy eating and physical activity, creating supportive environments in schools and communities and ensuring that people can access affordable, healthy food.

Local councils and healthcare providers are increasingly offering weight management services tailored to different cultural backgrounds and life stages.

The government and NHS also recommend routine screening for obesity and associated conditions.

Many GPs and local health services can refer people to weight management programs, including structured education, dietitian support and digital tools.

What is the cost of obesity?

Obesity costs the NHS an estimated £6.5 billion each year — and this figure is expected to rise to over £9.7 billion per year by 2050 if trends continue.

Much of this cost is related to treating obesity-related diseases, including:

• Type 2 diabetes
• Kidney disease
• Amputations
• Heart disease
• Cancers linked to obesity

Preventing obesity, or treating it early, can dramatically reduce the burden on the NHS and improve quality of life for millions.

Research highlights and new findings

Recent studies have shown that habits like late-night snacking, poor sleep during adolescence and maternal obesity during pregnancy can increase the risk of obesity in children and teens.

Sleep, in particular, plays a vital role in regulating hunger hormones and metabolism.

Studies also suggest that reducing screen time — even by just a few hours a week — can have a measurable effect on children’s waistlines.

• Preadolescent obesity risk in offspring reduced by breastfeeding
• Whole milk associated with reduced risk of obesity
• Countries with highest obesity levels revealed

Obesity is complex but it’s not inevitable.

The more we understand the contributing factors, the better equipped we are to support individuals and families on their journey toward healthier living.

Key to the development of type 2 diabetes is the body’s inability to properly respond to

insulin.

Researchers from around the globe have studied data and carried out experiments to try to understand what may cause insulin resistance and

type 2 diabetes
to develop.

Risk factors for type 2 diabetes

There are a number risk factors that are closely linked to type 2 diabetes, but research is yet to provide clear answers as to how much these factors may be a cause or otherwise an association.

Type 2 diabetes risk factors include:

• Carrying too much excess body fat
• 
  Having high blood pressure or cholesterol
• Having a close family member with type 2 diabetes
• Having previously had
  
  gestational diabetes
• Read more about
  
  risk factors
  for type 2 diabetes

Diet

Dietary factors are often viewed as a prominent cause of diabetes and often incorrect assumptions that it is the only factor linked to a cause are made.

Research indicates that

diet
can play a part in type 2 diabetes but it is still one factor amongst many others that can apply and generalisations should not be drawn without the consideration of other contributing factors.

Genetic

Research has uncovered a number of genes which are associated with an increased risk of diabetes. There are a number of factors which can influence our

blood sugar levels, including where we distribute fat on our body and how well our muscles take up glucose from the blood.

Our genes help to control each process in the body and a variation in just one gene which plays a part in

metabolism
can increase the risk of having difficulty with controlling blood sugar later in life. To date researchers have identified over 60 genes associated with type 2 diabetes.

• Read more about
  
  genetic research and type 2 diabetes

Medication

A number of

medications
have been linked with increased risks of type 2 diabetes. Some of these medications include the following:

• 
  Corticosteroids
• Thiazides
• Beta-blockers
• 
  Statins

It may sometimes be difficult to distinguish how much medications may raise the risk of type 2 diabetes in people that are already at risk and how much medications may have been the primary causal factor.

In cases where medication is thought to be the primary cause of diabetes, this may be termed as

drug induced diabetes

Stress

Stress
causes a response from the body to release hormones including the natural steroid hormone cortisol. The stress hormones prepare the body for action by raising

blood pressure, blood sugar levels and stiffening muscles but also temporarily suppress the immune system and the digestive process.

Persistently being stressed is referred to as chronic stress and this can have negative effects on health. Research indicates that there is a significant link between chronic stress and insulin resistance.

Pollution, chemicals and plastics

Type 2 diabetes has been one of the fastest growing conditions over the course of the last century and researchers have been looking at what other factors could be contributing to the steep rise in incidence.

In recent years, research has been published which indicates that pollution and other chemicals which we commonly face in our daily lives might increase the risks of type 2 diabetes.

Amongst the chemicals and pollutants that have been linked with diabetes are traffic pollution and a type of chemical, found in plastics and some make up products, called phthalates.

Read news on chemicals, pollutants and diabetes risk:

• Children are ‘particularly susceptible’ to air pollution which can alter the structure of their brain, study shows
• ‘Evidence is mounting’ that soil pollution can lead to cardiovascular disease
• Higher levels of air pollution can affect children’s academic skills, research shows

BMI stands for body mass index. It is a convenient way to see whether someone is likely to be either over or under weight.

The way BMI is calculated for South Asians is different to the way in which it is calculated for people with a European background.

The reason for this is that South Asians have been found to be more at risk of the problems of being overweight such as type 2 diabetes and heart disease.

Read more about the

risk factors of diabetes

When you have your BMI number refer to the table below and determine whether you are underweight, in the normal range or overweight.

Limitations of BMI measurements

For certain people, the BMI measurement may not be the best measure as the calculation assumes that people will have more or less a similar amount of muscle.

Therefore those who have a high level of muscle mass may incorrectly fall into the overweight bracket.

Asians have a particularly high susceptibility to type 2 diabetes and a healthy diet is one of the main ways in which diabetes can be controlled.

Type 2 diabetes

is generally associated with carrying too much body weight, over 85% of people with type 2 are overweight.

Guidelines for a healthy diet

• Cut down on simple, refined carbohydrates
• Cut down on eating high calorie and fried foods
• Choose unsaturated fats over saturated fats
• Choose less or smaller portions of fatty or carbohydrate heavy foods
• Include plenty of fresh vegetables and also fruit
• Reduce the amount of processed foods in your diet
• Watch the salt content

Cutting down on simple, refined carbohydrates

Refined carbohydrates include carbohydrates such as bread, rice and dough based foods with little fibre.

Typically, these will be white bread, white rice and foods made out of white flour.

If you wish to have bread and rice, choose varieties with a much higher amount of fibre as these will be absorbed by the body more slowly and therefore have less impact on blood sugar levels.

Look for ‘

whole grain

’ varieties as these tend to have higher quantities of fibre.

Foods which get turned into blood sugar more slowly are said to have a

lower glycaemic index

(lower GI).

Sweet foods are always going to problematic for people with diabetes. You may find your

blood sugar levels

can tolerate the occasional sweet treat but it’s best not to let sweet foods become a regular part of your diet.

Cutting down on high calorie foods

Some of the highest calorie foods are those which combine relatively high amounts of carbohydrate and saturated fat.

Fried foods such as the below tend to be highly calorific:

• Fried rice
• Samosas
• Onion bhajis
• Masala curries

Dishes using ghee, makhan or cream will also add calories. Naan bread is quite bulky so can also push up the calories.

You may ask yourself what you can eat? Look for lighter foods such as popadoms instead of naan. Curries such as bhuna or tandoori may be slightly better options for curry.

Choose unsaturated fats over saturated fats

Unsaturated fats are found in foods such as nuts, avocados, oily fish and olive oil. Saturated fats are found in butter, cream, yoghurt and meats.

Find ways to choose more of the foods that contain unsaturated fats and less of those containing saturated fat.

Unsaturated fats help to balance your cholesterol levels which is an important part of staying healthy and avoiding heart trouble.

Using olive oil in cooking rather than butter or ghee, for example, can help to reduce the calories as well as being better for your cholesterol.

Having smaller portions

Particularly with foods high in carbohydrate or sugar, having large portions of these can be detrimental to your blood glucose levels. Having smaller portions will help to reduce the number of calories and will give your body more chance to cope with the

carbohydrate content

If you’re having food with more fibre (lower GI foods) then this can help your blood sugar levels to cope too.

Smaller portions are also recommended for any of the more fatty or fried food.

Getting plenty of fresh vegetables and fruit

A truly balanced and healthy diet should contain plenty of fresh vegetables.

Not all vegetables are as good for diabetes as each other, and the same goes for fruit. Root vegetables such as potatoes are notorious for pushing blood sugar levels too high for people with diabetes, so if you have potatoes and similar root vegetables, it’s best to keep portions relatively small.

However, many other vegetables are excellent for maintaining good blood glucose levels such as cauliflower, spinach, curry leaves, cabbage, aubergine and bell peppers.

Ditching the processed foods

Processed foods are increasingly being looked at as a source of blame for the rise in chronic health conditions such as diabetes. One area of concern is over the quality of fats used in processed products. The use of hydrogenated fats, known as trans fats, is starting to be phased out or banned in a number of countries.

Processed foods have also come under criticism for being too easy to digest, meaning they hit our blood sugar more severely, and the amounts of additives they tend to contain.

Try to limit the amount of ready made meals in your diet and check the ingredients list of tins and packaging to avoid the products with the most additives.

• Read more on
  
  processed foods
  

Watch the salt

Salt levels are another factor that have had a particular focus lately with salt being believed to be a factor in high blood pressure.

The daily recommendation is to have no more than 6g of salt. One way to reduce the amount of salt you’re eating is to cut down on the amount of salt you may add to cooking, or by not adding any salt at the table.

Again, processed foods tend to be some of the worst offenders for high salt content, so cutting down on processed foods is recommended for this reason too.

Many of us would like to keep or waists relatively trim for aesthetic reasons and there are also a number of important health reasons for doing so.

Larger waists are closely associated with certain health problems and thus waist size has become an important tool in assessing the risk of

type 2 diabetes

What waist measurement puts me at higher risk of diabetes?

If your waist measurement is above the measurements listed in the table for your gender and ethnic background, then you may be at an increased risk of developing type 2 diabetes.

How do I measure my waistline?

When measuring your waist to assess your

diabetes risk, you should take a tape measure and measure around your belly at the mid point between the top of your hips and the bottom of your ribs.

The tape measure will usually pass within an inch or so of your tummy button.

Why is the waistline measurement important?

Research has shown that waistline measurements are a good indicator of diabetes risk and is generally more accurate than a

BMI reading

One reason for this is that high BMI values can result from people with higher muscle mass, which is not associated with increased diabetes risk.

Another reason is that fat deposited around the waist has been shown to increase diabetes risk more significantly than fat deposited at other parts of the

body, such as around the hips.

Measuring the waistline therefore provides a more reliable risk assessment.

Harvard University estimates that around 10% of the fat on our body is stored within our abdominal cavity around our organs.

This type of fat is known as visceral fat and is known to significantly raise the risk of health conditions including type 2 diabetes, heart disease and cancers.

• Read more about the dangers of
  
  visceral fat

How can I reduce my waistline?

The greatest health benefits of reducing your waistline come from reducing the amount of visceral fat.

A healthy diet and exercise have both been shown to be significantly beneficial for reducing this dangerous form of fat.

Other ways to improve your health, as well as your waistline, include limiting your intake of

alcohol
and also reducing stress levels.

• Read more about
  
  healthy lifestyle changes

Global studies on ethnic groups and minorities and the rising incidence of diabetes have revealed one factor in particular; ethnicity can increase or decrease one’s risk of developing diabetes.

Whilst in some cases this can be explained
by access to healthcare and other socio-economic factors, studies have
proved that even with equal access prevalence of diabetes differs between
people of different ethnicity.

Ethnicity facts

• Type 2 diabetes is up to 6 times more likely in people of
  
  South Asian
  descent
  
  
  ^[1]
  
• Type 2 diabetes is up to three times more likely in African and Africa-Caribbean people
  
  
  ^[1]
  

Furthermore, diabetes affects different
ethnic groups in different ways.

Diabetes in India and China

Although India and China are currently regarded as being the diabetes capitals
of the world, to gain an appreciation of the variation of diabetes prevalence
between different ethnic groups, the USA provides a valid model for study.

The USA houses an enormously diverse ethnic mix.

The National Health Interview
Survey is one of the most comprehensive studies to date.

In the USA, according to results from the study, it appears that black
and Hispanic people are more likely to have diabetes than non-Hispanic
whites.

Furthermore, American Indians and Natives of Alaska are apparently
more likely than any other minority to develop diabetes. Asian Americans
and Pacific Islanders have also been found to be significantly more at
risk of developing diabetes than non-Hispanic whites.

Prevalence in ethnic minorities

The prevalence of diabetes amongst ethnic minorities can also cause problems
in terms of treatment and healthcare.

The problems can stem from language
barriers and non-ethnically sensitive prevention and treatment policies.

Prevention through education

Studies have repeatedly shown that the key to stemming the flow of global
diabetes is early prevention, education and awareness.

It is the responsibility
of every nation’s healthcare system to recognise the ethnic minorities
most at risk and develop culturally appropriate treatment programs for
them.

Diabetes, particularly cases of type 2 diabetes, is a growing health problem for people of South Asian descent.

The likelihood of developing type 2 diabetes is reported to be as much as 6 times higher in South Asians than in Europeans, with a number of factors –

mostly linked with lifestyle
– believed to be behind this increased risk.

In fact, South Asian people make up just 4% of the total UK population,  but account for an estimated 8% of all diagnosed cases of diabetes.

What is defined as South Asian?

People of South Asian origin refers to individuals whose ethnicity is from one or more of the following countries:

• Afghanistan
• Bangladesh
• Bhutan
• India
• Maldives
• Myanmar (Burma)
• Nepal
• Pakistan
• Sri Lanka

However, when referring to the South Asian community in the UK, this is generally limited to people of India, Pakistani and Bangladeshi descent, who combined make up the largest ethnic minority in the country.

What are the statistics?

People from South Asian communities are known to be

up to 6 times more likely to have type 2 diabetes

than the general population. In addition, South Asians tend to have poorer diabetes management, putting them at higher risk of serious health complications.

South Asians without diabetes are also 3 times more likely to

develop cardiovascular disease, but combined with type 2 diabetes, this risk rises even further, particularly for adults with type 2 diabetes aged 20 to 60.

Furthermore, the survival rates in these young patients are also significantly lower compared to the caucasian population.

Risk indicators

In the UK, the National Institute for Health and Care Excellence (NICE) states that adults of South Asian origin are at risk of developing type 2 diabetes if they have:

• 
  A body mass index
  
  (BMI) of 23 or more, indicating they are overweight, and/or
• 
  A waist size
  
  of 35 inches or more for males, and 31.5 inches or more for females.

Why are South Asians at higher risk?

It is not entirely known why this is the case, but many experts believe diet, lifestyle and different ways of storing fat in the body all play a major part in upping the risk for this ethnic group.

Diet and obesity

In terms of diet, traditional foods high in sugar and fat combined with western “fast foods” are thought to be a major factor behind the high rates of obesity amongst South Asian communities in western countries, and could therefore also play a role in the development of diabetes.

Obesity, particularly central or abdominal obesity, is strongly associated with type 2 diabetes and people of South Asian origin are known to be more likely to have excess fat stored around the abdomen.

Genetics

Genes are thought to play a big part in South Asians’ diabetes risk.

In one large-scale international study, published in the August 2011 edition of journal Nature Genetics,

six separate genes were identified that make this group of people susceptible to type 2 diabetes

Muscles and fat metabolism

In 2010, a study published in the journal PLOS One suggested the way in which people of South Asian origin burn fat through their muscles could make them more prone to type 2 diabetes.

The team from Glasgow University found that

South Asians have skeletal muscles which do not burn fat as well as Europeans

This impaired fat metabolism may increase the likelihood of insulin resistance, which is often a precursor to full-blown type 2 diabetes.

What is type 2 diabetes?

Type 2 diabetes
is a long term health condition that is characterised by high levels of glucose in the blood. Common symptoms of diabetes include continual tiredness, increased need to go to the toilet to urinate, thirst, blurred vision and dry eyes.

Type 2 diabetes is often, but not always, associated with being overweight, and can take a number of years to develop and can damage the body, particularly if it is not diagnosed early enough.

Type 2 diabetes is a long term health condition that is characterised by high levels of glucose in the blood.

Common symptoms of diabetes
include continual tiredness, increased need to go to the toilet to urinate, thirst, blurred vision and dry eyes.

Type 2 diabetes can take a number of years to develop and can damage the body, particularly if it is not diagnosed early enough.