Type 2 Diabetes

Polygenic risk

People with high polygenic risk scores are 2.6 to 6.9 times more likely to get type 2 diabetes than are people who aren't in the high-risk category.

This estimate is based on data about people of African, East Asian, European, and Hispanic or Latino ancestry. Information is lacking or not available for those of other ancestries.

For participants with a high polygenic risk score, recommendations include:

  • Risk factor counseling for physical activity, body mass index and diet.
  • For adults and children age 12 and older:
    • Assess for symptoms such as passing large amounts of urine and weight change.
    • Consider a biochemical screen with hemoglobin A1C or fasting glucose.
    • Consider metformin (Glumetza, Fortamet, others) and medical nutrition therapy consultation if hemoglobin A1C or fasting glucose is high.

Family history and clinical risk factors

The GIRA report identifies participants with any of these risk factors:

  • Being overweight or obese, meaning a body mass index greater than or equal to 25.
  • Being of non-European ancestry and over age 45.
  • Having a parent, full sibling or child who has type 2 diabetes.
  • Not being physically active.

Lab results that indicate clinical risk of type 2 diabetes include:

  • High-density lipoprotein cholesterol less than 35 milligrams per deciliter.
  • Triglyceride levels above than 250 milligrams per deciliter.
  • Hemoglobin A1C levels at or above 5.7%.

Diagnoses that indicate clinical risk of type 2 diabetes include:

  • High blood pressure.
  • Polycystic ovary syndrome.
  • Gestational diabetes.

The GIRA report recommends considering screening for type 2 diabetes in adults who:

  • Have one or more clinical risk factors.
  • Are overweight or obese.
  • Are 45 years old or above.