medwireNews: People in the general population typically believe that they have a low risk for type 2 diabetes, regardless of what their actual risk is, show the results of a German national survey focusing on diabetes-related knowledge.
Indeed, more than three-quarters of 639 people with a 5-year diabetes risk of at least 5% according to the multifactorial German Diabetes Risk Score (GDRS) “perceived their diabetes risk as almost absent or slight,” report Christin Heidemann (Robert Koch Institute, Berlin) and colleagues in BMJ Open Diabetes Research & Care.
The telephone-based survey asked 2327 adults without known diabetes whether they thought they had “almost no risk,” “slight risk,” “moderate risk,” or “high risk” for developing diabetes within the next 5 years.
The researchers then used the GDRS, which takes into account age, waist circumference, height, physical activity, smoking, history of hypertension, family history of diabetes, red meat intake, wholegrain intake, and coffee consumption, to define their actual diabetes risk.
Overall, just 2.3% of participants believed that their risk for diabetes was high, despite almost a quarter (24.5%) having an elevated (5–<10%) or high (≥10%) actual 5-year diabetes risk.
The vast majority of participants said that they had either almost no risk or slight risk, including 89.0% of those with a low (<2%) actual risk, 84.5% of those with a still low actual risk (2–<5%), 79.3% with elevated risk, and 78.9% with high actual risk.
Heidemann and team also used multivariate analyses in order to identify determinants of perceived diabetes risk among the participants with elevated or high actual risk.
They found that younger age (odds ratio [OR]=0.92 per year), a family history of diabetes (OR=2.10), and being informed about an increased diabetes risk by a physician (OR=3.27) were all significantly associated with a higher perceived diabetes risk.
This last association “illustrates the importance of strengthening the healthcare system to enable physicians to implement primary prevention in daily practice,” the authors remark.
By contrast, the team identified no other sociodemographic variables (including education level), potentially modifiable diabetes risk factors, preventive healthcare behaviors, or beliefs about health and diabetes that played a role in determining perceived diabetes risk.
The researchers therefore conclude that since high-risk individuals “did not or only barely link their prevailing modifiable risk factors with an increased perceived risk […], primary prevention approaches should include measures that increase the awareness of diabetes risk factors such as unhealthy lifestyle behaviors and ageing in the general public and improve patient education by health professionals with regard to prevailing personal risk factors.”
They add: “While the proportion of adults that acknowledged diabetes as a serious condition was relatively high in the current study (overall 65.2%), the proportions of adults that believed in general or personal control of diabetes risk (overall 23.0% or 9.7%) were surprisingly low.
“Thus, strengthening control beliefs also appears to be essential in diabetes prevention strategies.”
By Laura Cowen
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BMJ Open Diabetes Res Care 2019; 7: e000680