Risk Factors for Type 2 Diabetes

Non-Modifiable Risk Factors

The American Diabetes Association suggests that age ≥35 years is a major independent risk factor, with screening recommended to begin no later than age 35 for all individuals 1
Risk increases progressively with advancing age, making it one of the most consistent predictors 1, 2
First-degree relatives (parents or siblings) with diabetes confer strong genetic risk, more so than for type 1 diabetes 1, 3
Higher risk populations include African American, Native American, Hispanic/Latino, and Asian American individuals 1, 3

The American Heart Association recommends that BMI ≥25 kg/m² is considered a primary risk factor (≥23 kg/m² for Asian Americans) 1, 2
Central/abdominal adiposity carries particularly high risk, even in individuals without elevated BMI by traditional criteria 3
Lack of physical activity independently increases diabetes risk 1, 3
Women with prior gestational diabetes mellitus (GDM) have substantially elevated risk 1, 2, 3

The American College of Cardiology recommends that hypertension (≥140/90 mmHg) significantly increases diabetes risk 1, 3, 5, 6
Impaired fasting glucose (100-125 mg/dL) or impaired glucose tolerance (2-hour OGTT 140-199 mg/dL) markedly increase progression risk 3, 5
HbA1c 5.7-6.4% identifies individuals at high risk 3

The American Academy of Pediatrics recommends that testing should be considered in youth with overweight (≥85th percentile) or obesity (≥95th percentile) plus one additional risk factor 3
Maternal history of diabetes or GDM during the child's gestation is a major risk factor 3

The American Diabetes Association recommends that standard BMI cutoffs should not be used for Asian Americans—use ≥23 kg/m² instead of ≥25 kg/m² to avoid missing high-risk individuals 1, 2
HbA1c should not be relied on for diagnosis in individuals with HIV—it may underestimate glycemia 1