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Who's at risk and why?

Adults :: Diabetes :: Who's at risk and why?

Diabetes is becoming more common in all age groups including children and young people. Type 1 diabetes is not preventable, but Type 2 diabetes is linked with behavioural factors such as being overweight and physically inactive.

The small but increasing number of children developing Type 2 diabetes at a very early age is linked to their weight and physical inactivity. The maps below show the findings from the National Child Measurement Programme 2009/10. Areas in red indicate places in Kent and Medway, where children are above the South East Coast average for being overweight or obese.

Figure 1: Proportion of pupils in reception year classified as 'Obese or Overweight'
Figure 1: Proportion of pupils in reception year classified as ‘Obese or Overweight’ in National Child Measurement Programme 2009/10 by electoral ward in Kent and Medway compared with south east region average
Figure 2: Proportion of pupils in year 6 classified as 'Obese or Overweight'
Figure 2: Proportion of pupils in year 6 classified as ‘Obese or Overweight’ in National Child Measurement Programme 2009/10 by electoral ward in Kent and Medway compared with south east region average

It is estimated that 31.4% of adults living in NHS Medway were obese in 2006–08. This is statistically significantly higher than the whole of England (25%).[1] People living in more deprived neighbourhoods in England are 56% more likely to have diabetes than those in the least deprived areas.

There is good evidence that lifestyle changes can reduce the risk of progression to Type 2 diabetes in overweight people with impaired glucose tolerance.[2] Once diabetes is present, good management of blood sugar levels and blood pressure can reduce the risk of complications. The main risk factors for developing Type 2 diabetes are:

Age

The risk of developing Type 2 diabetes increases with age; most cases of Type 2 diabetes develop in people aged over 40. Currently 47% of the population of Medway are aged 40 or over; this is projected to increase to around 51% by 2030. The proportion of the population aged over 65 is predicted to increase from 13.6% to 20.3% by 2030. This means that a greater proportion of the population of Medway will be at risk of developing diabetes.

Ethnicity

Type 2 diabetes is up to six times more common in people of South Asian descent and up to three times more common in those of African and African-Caribbean descent, compared with the white population. These groups are likely to develop the condition at a younger age. It is also more common in people of Chinese descent and other non-white groups.[3]

Weight

Over 80% of people diagnosed with Type 2 diabetes are overweight. The more overweight and the more inactive a person is, the greater their risk of developing diabetes. Information on the prevalence of obesity in Medway and levels of physical activity are presented in the healthy weight section (Appendices —> Background papers: Lifestyle and wider determinants —> Healthy weight).

Waist Circumference

The greater the waist circumference, the higher the risk of developing diabetes. For women, a waist measurement of 80cm (31.5in) or more confers an increased risk. Amongst men, a waist circumference of 94cm (37in) or more gives an increased risk of developing diabetes; this figure is lower for Asian men where a measurement of 90cm (35in) or more confers increased risk.[4]


References

[1]   Association of Public Health Observatories. Health Profile for Medway 2011; Association of Public Health Observatories. http://www.apho.org.uk/resource/view.aspx?RID=50215&SEARCH=medway&SPEAR= .
[2]   J Tuemilehto and J Lindstrom et al. Prevention of type 2 Diabetes Mellitus by changes in lifestyle amongst subjects with impaired glucose intolerance New England Journal of Medicine 2001; 344: 1343-1350.
[3]   Department of Health. The National Service Framework for Diabetes: Standards 2002; Department of Health. http://bit.ly/ICJaSC .
[4]   Diabetes UK. What factors increase the risk of prediabetes? 2009; http://www.diabetes.org.uk/Guide-to-diabetes/Introduction-to-diabetes/What_is_diabetes/Prediabetes/Risk-factors-of-prediabetes/