Chapter 3 Risk Factors

Introduction

The Canadian Diabetes Strategy has adopted a population health approach to prevent diabetes and improve its control. This strategy will help to reduce the risk of diabetes developing in individuals without the disease and the risk of complications among those living with it. This chapter presents data, derived from the NPHS, on the prevalence of risk factors for diabetes and its complications.

Type 1 Diabetes

No known modifiable risk factors exist for acquiring type 1 diabetes (children and youth)¹ , a characteristic that limits the possibility of prevention. Non-modifiable risk factors include the following:

• Race and ethnic background: in the United States, the prevalence is higher among whites than among black or Hispanic people; as well, Scandinavian countries report higher rates.
• Age: incidence increases with age throughout childhood and adolescence.
• Genetic susceptibility: a family history of type 1 diabetes is associated with a slightly increased risk of developing type 1 diabetes.

Type 2 Diabetes

Weight and exercise are modifiable risk factors that can decrease the risk of developing type 2 diabetes among those at increased risk². The prevalence of diabetes increases by 5% to 10% among adults for every 1 kg increase in population-measured body weight^3,4.

Complications of Diabetes

Diabetes has many complications for which there are a number of risk factors, such as cigarette smoking, dyslipidemia, and high blood pressure. Therefore, the control of these risk factors for diabetes complications forms an essential part of a comprehensive diabetes control program. Since high blood pressure is associated with obesity and physical inactivity, maintaining a healthy weight and remaining physically active will protect against the complications of diabetes.

Socio-Economic Determinants of Health

Socio-economic factors (education and income) heavily influence the adoption of healthy behaviours. Individuals with lower income and less formal education are more likely to smoke and to be physically inactive and overweight⁵. Therefore, programs and policies must address these underlying determinants of health in a comprehensive program to prevent diabetes. In the 1998/99 NPHS, 21.4% of individuals with diabetes reported low income, and 42.7% had not completed secondary school. In the general population, the proportions were 12.8% and 22.5% respectively.

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