Building Competency in Diabetes Education THE ESSENTIALS

PATHOPHYSIOLOGY| 3-37

• CANRISK is a diabetes questionnaire that helps individuals assess their risk of developing type 2 diabetes (55). • There is no clear understanding of inheritance of type 2 diabetes. The estimated risk of developing type 2 diabetes is approximately 2 to 4 times higher when one or both parents have this condition. The lifetime risk of developing type 2 diabetes is 40% for individuals with one affected parent and 70% if both parents are affected (56). Although some studies have suggested excess maternal transmission of type 2 diabetes in offspring, this hereditary pattern has not been confirmed in other high risk population groups. The higher risk for next generation of a mother with type 2 diabetes than father has been based on both genetic factors (such as mitochondrial mutations), and environmental components (such as intrauterine environment). However, potential bias in reporting family history and quality of the studies have contributed to the controversy over the high maternal transmission of type 2 diabetes (57). It is likely that the risk of developing type 2 diabetes in families is mediated by lifestyle influences (eating and physical activity habits) shared between family members, but the precise factors accounting for this increase in risk are poorly understood (58). • The risk of developing type 2 diabetes in identical twins, if one twin develops type 2 diabetes: 63 to 90% (53). • The risk of developing type 2 diabetes in non-identical twins, if one twin develops type 2 diabetes: 43% (53). Mortality In 2017, it is estimated that approximately 4.0 million people age 20-79 years died from diabetes, which accounts for one death every eight seconds (48). About 46% of this number are contributed by people under the age of 60 and the negative economic impact is defined as indirect costs of diabetes (48).