2.1 Identify risk factors associated with the development of type 2 diabetes

This guide will help you answer 2.1 Identify risk factors associated with the development of type 2 diabetes.

Type 2 diabetes affects millions of people in the UK. It often develops over many years. Many people do not realise they have it until they are tested. Early identification and understanding of risk factors can help workers support individuals more effectively.

What is Type 2 Diabetes?

Type 2 diabetes is a long-term condition. The pancreas does not produce enough insulin, or the body becomes resistant to insulin. Insulin is a hormone that helps the body use glucose for energy. Without enough insulin, too much glucose remains in the blood. Over time, high blood glucose can cause serious health problems such as heart disease, kidney failure, blindness, and nerve damage.

Type 2 diabetes is different from type 1 diabetes. Type 1 is usually diagnosed in children or young adults. It happens when the body stops producing insulin. Type 2 usually develops in adults, but more children and teenagers are being diagnosed because of rising obesity rates.

Non-Modifiable Risk Factors

You cannot change some risk factors for type 2 diabetes. These are called non-modifiable risk factors. Understanding them helps you identify who may be at higher risk.

Age

The risk increases with age. People over 40 have a higher chance of developing type 2 diabetes. For South Asian and Black African or Caribbean people, the risk starts to rise from around age 25. The body becomes less able to control blood sugar as it ages.

Family History

If a close family member such as a parent, brother, or sister has type 2 diabetes, the risk is higher. There is a genetic link, although lifestyle factors within families might also play a role. The more relatives with diabetes, the higher the risk.

Ethnic Background

People from certain backgrounds are more likely to develop type 2 diabetes. This includes people with Black African, African-Caribbean, and South Asian heritage. The reasons are not entirely clear, but genetics and body composition contribute.

Previous Gestational Diabetes

Women who have developed gestational diabetes during pregnancy have a higher risk later in life. Gestational diabetes is a temporary form of diabetes that can happen in pregnancy. After the baby is born, it often goes away. However, these women need to be screened in the future.

Modifiable Risk Factors

Most risk factors are linked to lifestyle. Making healthier choices can lower risk, although some people will still develop the condition.

Being Overweight or Obese

Excess body fat is the strongest risk factor for type 2 diabetes. Extra weight around the tummy (abdomen) especially increases risk. Fat in this area affects how insulin works in the body.

The more overweight a person is, the greater their risk. Losing weight reduces the risk, even if the loss is only small. The amount of risk linked to weight depends on other factors, such as age and family history.

Physical Inactivity

People who move less are more likely to develop type 2 diabetes. Physical activity helps the body use insulin more effectively. It also helps control body weight. Regular exercise – such as brisk walking, cycling, or swimming – can prevent or delay diabetes.

Even light activity such as housework or gardening can help lower risk if done regularly. Breaks from sitting during the day are important.

Unhealthy Diet

Eating a diet high in fat, sugar, and calories increases diabetes risk. Diets rich in processed foods, red meat, and sugary drinks are linked to higher blood glucose and weight gain.

A healthier diet includes:

• Plenty of fruit and vegetables
• Whole grains
• Lean proteins
• Low-fat dairy
• Small amounts of healthy fats

People who eat lots of fibre and avoid sugary drinks tend to have lower risk.

Smoking

Smoking increases the risk of type 2 diabetes. It damages the body’s cells and makes it harder for insulin to work. Smokers often have higher blood sugar levels compared to non-smokers. The risk rises with the number of cigarettes smoked.

Quitting smoking brings health benefits quickly and reduces the chance of developing diabetes.

High Blood Pressure

People with high blood pressure are more likely to develop type 2 diabetes. High blood pressure can damage blood vessels and reduce the effectiveness of insulin.

Managing blood pressure through lifestyle changes or medicines can help lower risk.

High Cholesterol

High levels of cholesterol in the blood are linked to increased diabetes risk. Cholesterol is a fatty substance found in blood. Too much can build up in blood vessels and raise the chance of heart disease and diabetes.

A healthy diet and regular activity help control cholesterol levels.

Other Risk Factors

Other risk factors sometimes affect an individual’s chance of developing type 2 diabetes.

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a condition where women have irregular periods, extra hair growth, and sometimes cysts on the ovaries. Women with PCOS have higher risk because their bodies may be more resistant to insulin.

Sleep Problems

Long-term lack of sleep or poor-quality sleep can raise blood sugar levels and appetite. People with conditions like sleep apnoea are at higher risk. Sleep apnoea causes a person to stop breathing for short periods during sleep.

Long-Term Stress

Chronic stress leads to higher levels of the hormone cortisol. This can raise blood glucose and affect eating habits.

Mental Health

People with severe mental ill health, such as schizophrenia and bipolar disorder, have higher risk levels. This may be linked to medications, inactivity, or lifestyle factors.

Medications That Increase Risk

Some medicines can increase blood glucose levels. Long-term use of steroids is one example. Some medicines for mental health, such as antipsychotics, raise the risk too.

Healthcare professionals should monitor people on these medications for signs of diabetes.

Socio-Economic Factors

Where a person lives, how much money they have, and their education level can influence risk. People with lower income often have fewer opportunities to eat healthy food or be active. Some may not have access to outdoor spaces or safe areas to exercise. Poorer communities often show higher rates of obesity and type 2 diabetes.

Recognising At-Risk Individuals

Understanding risk factors helps you spot people who might develop diabetes. Tools like the Diabetes UK Know Your Risk tool can help estimate risk.

Start by looking for:

• Family history
• Background
• Age
• Weight and waist size
• Lifestyle factors such as smoking, inactivity, poor diet, or high blood pressure

If you work in health and social care, you can encourage people to talk to their GP. Early intervention makes a huge difference.

What Does ‘Waist Size’ Mean?

Waist size is a key sign of risk, more than body mass index (BMI) for some people. For men, a waist larger than 94cm (about 37 inches) is concerning. For South Asian men, the risk starts at 90cm (35 inches). For women, a waist larger than 80cm (about 31.5 inches) increases risk.

Measuring waist size is easy and gives useful information for health workers.

Why Are Risks Important?

The risk factors for type 2 diabetes often link together. For example, poor diet and inactivity can cause weight gain and higher cholesterol, which raises blood pressure. Being aware of risks lets you support clients with information and signposting to services.

Acting early helps prevent health issues before they become severe.

Supporting People to Reduce Risk

People can lower their risk by:

• Losing excess weight
• Eating a healthy, balanced diet
• Being more active
• Stopping smoking
• Managing stress and sleeping well
• Seeing their GP for regular health checks

Small changes can have a large impact over time. Point people to services such as weight management courses, stop smoking support, cooking classes, or community exercise sessions.

Working With Different Groups

Some communities may not realise they are at higher risk, or they may be less likely to access healthcare. You can tailor information by:

• Using different languages if needed
• Giving examples that fit with their culture
• Making information accessible for people with learning disabilities

Use clear, simple messages. Avoid medical jargon.

Barriers to Reducing Risk

Some people find it difficult to make changes. They might not have the money, time, support, or motivation. Understanding these barriers helps you suggest realistic ideas.

For example, encourage short walks at home if outdoor exercise is not possible. Share easy and cheap meal ideas. Suggest group activities for support.

Final Thoughts

Recognising risk factors for type 2 diabetes is a vital part of frontline care. Each factor links to how people live and their background. Understanding who is most at risk helps you provide better support and information.

Type 2 diabetes can often be prevented or delayed by early action. By talking to people about their risks, encouraging small changes, and supporting them to overcome barriers, you make a real difference. Most people respond well to information that is clear, practical, and suitable to their life.

Always approach people with empathy and patience. Many risk factors are linked to poverty, ill health, or difficult personal situations. Your role is not to judge, but to offer support and ways forward. This approach builds trust and helps people take control of their own health.