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Blog: Managing patients at risk of diabetes

What are the risk factors for diabetes? What can we change and what has to be managed?

What are the risk factors for diabetes? What can we change and what has to be managed?

Let me remind you of a few risk factors for the condition:

  • A family history of diabetes.
  • Being overweight.
  • An unhealthy diet.
  • Physical inactivity.
  • Increasing age.
  • High blood pressure.
  • Ethnicity.
  • Impaired glucose tolerance 

It’s immediately obvious that we can’t do anything about some of these factors, such as ageing, ethnicity and family history of diabetes. So does that mean diabetes is inevitable for patients in these groups?

Diabetes UK has a risk calculator to help people to assess their risk of developing Type 2 diabetes. It is a very simple tool, which I have tried out myself, and can be found on their very informative website.

As healthcare professionals, we can encourage people at risk of developing the condition to check out their own risk by trying out this risk assessment. This may prove more motivating for them to make changes or seek further help or advice than if a nurse tells them the same kind of thing.

In their risk calculator, Diabetes UK also includes waist size and Blood Pressure (BP). The former we can work to improve, the latter we may not be able to change at all. So how should we approach these risk factors with patients? How should we advise them?

If someone presents with an impaired blood glucose – now more common than a glucose tolerance test – what is our responsibility?

We need to address factors that as individuals we can influence. Talking through someone’s diet with them can prove very informative, and may point to the reason why their sugar levels are creeping up. Do they eat late at night? Are they eating a carbohydrate heavy meal at that time? How could they improve? Could they take more in the way of physical activity?

At the DESMOND education day that I and many others run for those newly diagnosed with Type 2 diabetes, we talk about making small changes in diet. This can put change within reach of those we are talking to. Sometimes, people are just not aware that to lower their blood sugars, they need to reduce their intake of foods such as rice, pasta, potatoes or bread.

Helping people to understand simple facts about diet can help them with both weight and waist size reduction. Both of these will reduce their risk of later developing Type 2 diabetes, or, if they already have diabetes, to control their blood sugars well and reduce the risk of complications developing.

Many people take very little in the way of physical activity, so approaching this issue needs to be done sensitively. Suggestions as to how to be innovative in what they are doing may help them to discover that activity is not to be dreaded, and does not necessarily mean they have to go to the gym every day of the week.

We cannot change increasing age or ethnicity. But we can provide people with the information they need to keep themselves as healthy as possible to reduce the risks of developing the condition.

Helping people to understand their risk of developing Type 2 diabetes and then changing old, bad habits is not easy. But it surely must be better than waiting until someone is taking several medications before we broach the subject of their own responsibility for their health.

Seize the opportunity if you can, and try to stop the relentless increase in diabetes.