Written by Jeff Dai, PharmD Candidate; Tanya H. Khamis, PharmD Candidate;
David Q. Pham, PharmD, BCPS, CDE Jeff Dai and Tanya Khamis are from Western
University of Health Sciences, College of Pharmacy in Pomona, California.
Dr. David Pham is an Associate Professor of Pharmacy Practice at Western
University of Health Sciences as well as a Diabetes Pharmacist at the
Mary and Dick Allen Diabetes Center.
Diabetes is a chronic disease in which glucose in the blood is consistently
elevated. Recent data reports that 29.1 million people in the U.S. currently
have diabetes, of which 8.1 million are undiagnosed.1 Statistically it
is estimated that there will be a 165% increase in newly diagnosed patients
with diabetes from 2000 to 2050.2 By being aware of the risk factors of
the disease it may be possible to prevent or delay the onset of diabetes.
There are three major classifications of diabetes:
type 2, and
gestational diabetes (GDM). Type 1 diabetes occurs due to a lack of insulin caused by an autoimmune
process that destroys insulin producing cells in the pancreas. Unfortunately,
there is not much that can be done to prevent this type of diabetes.
Type 2 diabetes can be prevented. Type 2 diabetes occurs when the insulin
that is being made by the pancreas is resistant or less effective. There
are two categories of risk factors; those that are modifiable and those
that are not. Non-modifiable risk factors for type 2 diabetes include:
first degree relative with diabetes and high risk ethnicities such as
Native Americans, African Americans, Pacific Islanders, Hispanics, and
Asians. Modifiable risk factors include a high BMI (body mass index),
cigarette smoking, high blood pressure, and high cholesterol levels.
Achieving a healthy body weight through exercise and diet has been shown
to lower type 2 diabetes risks by up to 58% in high risk populations.3
A healthy body weight is considered to be a BMI of 18.5 – 24.9 kg/m2.
Moderate weight loss through weekly exercise and engaging in dietary strategies
revolving around reducing both caloric intake and consumption of dietary
fat can reduce the risk of developing diabetes. Physical activity has
been shown to increase insulin sensitivity and the American Diabetes Association
recommends 30 minutes of exercise 5 times a week.3
GDM is defined as glucose intolerance during the course of pregnancy.
Factors that put mothers at risk for GDM include: older than 25 years
of age, overweight (BMI > 25 kg/m2), previous GDM, previous newborn
over 9 lbs., diabetes in first-degree relatives, stillbirth in previous
pregnancy, and lastly high risk ethnicities similar to type 2 diabetes.
As with type 2 diabetes, reducing the risk of GDM may be achieved through
exercise, diet, and early detection.
Screening for diabetes, specifically with a routine blood test, is suggested
at least every 3 years in patients with any of the risk factors listed
above. Early detection can help delay the complications of diabetes. A
fasting blood glucose reading above 100 mg/dl should be discussed with
your clinician. While diabetes is generally considered a silent disease,
signs of high blood glucose such as increased thirst, hunger, or urination
should trigger people to get their sugar tested and/or see their primary
Prevention is possible with type 2 diabetes. Early detection is key to
delaying any complications. In addition, engaging in a healthy lifestyle
through diet and exercise has been shown to reduce the risk of developing
- Centers for Disease Control and Prevention. National Diabetes Statistics
Report: Estimates of Diabetes and Its Burden in the United States, 2014.
Atlanta, GA: US Department of Health and Human Services; 2014.
- Boyle, James P., et al. “Projection of Diabetes Burden Through 2050.”
Diabetes Care 24:1936–1940, 2001.
- American Diabetes Association. Standards of medical care in diabetes—2014.
Diabetes Care. 2014;37(suppl 1):S14-S80