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Kylie Ninow
Professor B. Cason
HLTH-1020-001
November 27, 2016
Risk Factors for Type 2 Diabetes Mellitus
In the United States type 2 diabetes mellitus is becoming very common, about 10 percent
of the American population in 2015 have type 2 diabetes mellitus. Type 2 diabetes mellitus is
when the body becomes insulin resistant and is often associated with obesity, insulin therapy can
be used but is not usually required but is treated with pills. There are many factors that go in to
developing type 2 DM such as obesity, diet and lifestyle. Each of these factors play a huge part in
the risk of developing type 2 diabetes mellitus.
The first risk factor is obesity, in America around 31 percent of overweight and obese
people have type 2 diabetes mellitus. Which could have been avoided by taking better care of
their weight, diet and physical activity levels. With obesity, especially those with an android
shape, it decreases the number of available insulin receptor sites in cells of skeletal muscles
and adipose tissueobesity impairs the ability of the beta cells to release insulin in response to
increasing glucose levels (Arnoldussen, et al., pg. 743). Which only gives you a higher risk of
developing type 2 DM. With this patients should be achieving a healthy weight that will help
with the treatment plan and reduce the risk of complications from happening.
There are two different types of complications, one is acute complications and the other is
chronic complications. Some examples of acute complications are Diabetic Ketoacidosis, which
is when the insulin deficit causes fat stores to break down, and can be brought on when energy
requirements are increased by physical and emotional stress. Another is Hyperosmolar

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Hyperglycemic State (HHS) is when their blood glucose levels are at an extremely elevated state,
it is life threatening and has a high mortality rate. Chronic complications include hypertension,
which is high blood pressure and is very common among people with type 2 DM, about 20%60% have it. Peripheral Neuropathies, is also a chronic complication, it will start in the toes and
then move in an upward process to the fingers and hands. It involves the nerve fibers and the
patient will start to lose feeling in toes.
With obesity being one of the main factors, so is genetics. Genetics can increase the risk
of becoming obese, which increase your diabetes risk. What shape our body takes, like being tall,
thin, pear shape, apple shape or hourglass. There is also non-genetic trait that are passed down by
family, like if both of your parents are obese the chances of becoming obese and developing type
2 DM is doubled then someone else who has one or none. Also, eating habits are passed down by
parents.
Another risk factor is diet, the dietary intake can either help you avoid type 2 DM or only
make the chances of getting the disease even greater. A pre-diabetic or newly diagnosed, by
improving your diet with lowering calorie intake, and following dietary guidelines like MyPlate,
this can help wean them off of the type 2 diabetic treatments that they are on. Nurses Health
Studys (NHS) has found that diets with more plant-based oils over animal fats were at a much
lower risk in developing type 2 DM as well as n-6 polyunsaturated fatty acids, where those with
high trans fatty acids had higher risks in developing other diseases like heart disease (Ley, pg.
1625).
Everyone has the same basic nutrient needs but those who have type 2 DM need to eat on
a more planned out diet to help avoid hyperglycemia. To help achieve a well balanced diet for
those with type 2 DM can follow the American Diabetes Association (ADA) guidelines: 1)

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maintain a normal blood glucose levels by balancing food intake with insulin or oral glucose 2)
achieve optimal serum lipid levels 3) provide adequate calories to maintain or attain reasonable
weight, and to recover from catabolic illness 4) prevent and treat acute complications of insulintreated DM, short-term illnesses and exercise related problems or long term complications 5)
improve overall health through nutrition, using Dietary Guidelines for Americans or MyPlate
(Arnoldussen, pg. 757).
The ADA also, recommends people to adjust their diets to what they need to achieve a
healthy weight and what to focus on, they have some recommendations for the food groups.
Carbohydrates have 4 kcal/g and should be 45%-65% of daily diet but also be limited to 130
g/day. ADA also recommends, that the protein in the diet should be 15%-20% of total calorie
intake, which is also 4 kcal/g. The protein should be low in fat, saturated fats and cholesterol.
The dietary fats should be low in saturated fats and cholesterol, and should not go over 7% of
calorie intake in a day, fats have 9 kcal/g. Fiber will help people with type 2 DM by reducing
constipation, it also helps with the feeling of being full, to avoid over eating. With adding large
amounts of fiber, it can be beneficial with by eating soluble fiber with serum lipids. They dont
have any set amounts but it should be 20%-35% of total grams in a day.
Lifestyle can involve many different things like sleeping habits, exercise habits, smoking
or drinking and many other life choices. Those who have type 2 DM tend not to have strong
stable lifestyle choices like, that arent sleeping well or are sleep too much, do not exercise, and
also are known as couch potatoes. Scientists have found that the lack of exercise or physical
activity has become a risk factor in developing type 2 DM. It is recommended that Americans
have 150 minutes of moderate-intensity or 75 minutes of vigorous intensity in a week (Wardlaw,
p.713). Having a regular exercise program benefits those with and without diabetes by improving

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balance, cognitive development, balance of hormones, weight control, and concentrations level.
In the textbook, Nursing A Concept-Based Approach to Learning, discusses how people with
type 2 DM need to have a well-balanced exercise program because, exercise increases the uptake
of glucose by muscle cells therefore, can possibly reduce the use of insulin treatments.
Exercising can also help with lowering cholesterol and triglycerides, which can also decrease the
chance of developing cardiovascular diseases on top of the high chance of developing type 2
DM.
Those with type 2 DM that do have a regular exercise programs, a good diet and is
controlling their weight, is help them decrease the amount of medications they need like,
hypoglycemic agents. Those who are pre-diabetic and diabetic should follow the ADAs
guidelines to physical activity: 1) before beginning the program, have a medical screening for
previously undiagnosed hypertension, neuropathy, retinopathy, and nephropathy 2) beginning
with mild exercises and gradually increase the intensity and duration 3) monitor your blood
glucose before and after exercise 4) and exercise at least 150 minutes of moderate-intensity
activity per week (Arnoldussen, pg. 759). In an article by Sylvia H. Ley, she founds that brisk
walking, speeding walking, light toning, yoga and resistance training are associated with low
chances of developing type 2 DM, whereas secondary behavior like watching TV increasing the
chance (pg. 1626).
Sleeping also goes along with lifestyle, it is well known that those who are obese have
harder times getting a full night of sleep due to their bodies working harder than normal to digest
the fatty foods and to slow down to relax. The NHS found that sleep quality were associated
with type 2 diabetes risk as well, including regular snoring and difficulty falling or staying
asleep. (pg. 1626). Although, difficulty sleeping which is about five hours or less and too much

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sleep is nine or more hours. The NHS also found, increases in sleep duration were associated
with increased weight gain and type 2 diabetes risk, and extended periods of rotation night shift
work were associated with a higher type 2 diabetes risk. (pg. 1626).
With type 2 diabetes mellitus becoming so common among the American population,
researchers find more risk factors but, at the same time we are also finding ways to help decrease
our chances of developing type 2 diabetes. Some of the risk were obesity, diet, and lifestyle
which involved, our sleeping habits and physical activity. We are decreasing our chances by
having a healthy appetite with our food choices, being physically activity for at least 150 minutes
a week, and watching our weight.

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Work Cited
Arnoldussen, Barbara H., at al. Nursing A Concept-Based Approach to Learning,
Sec. Edition, Vol. 1 Julie Alexander by Pearson Education Inc. (2015)
742-759.Book. 25 Nov 2016.
Ley, Sylvia H., et al. "Contribution of The Nurses' Health Studies to Uncovering
Risk Factors for Type 2 Diabetes: Diet, Lifestyle, Biomarkers, And
Genetics." American Journal of Public Health 106.9 (2016): 1624.
MasterFILE Complete. Web. 25 Nov. 2016.
Wardlaw Gordon M., et al. Contemporary Nutrition: Salt Lake Community
College, 4th Edition. McGraw Hill Education. (2015): 150, 713
715.Book. 25 Nov 2016