Risk factors for diabetes
What is a risk factor?
Risk factors are attributes, characteristics or exposures that increase the likelihood of a person developing a condition or health disorder. Behavioural risk factors are health-related behaviours that individuals have the most ability to modify. Behavioural risk factors for type 2 diabetes include:
- dietary risks, for example inadequate fruit and vegetable intake
- physical inactivity
- smoking.
Biomedical risk factors are bodily states that have an impact on a person’s risk of disease. Biomedical risk factors for type 2 diabetes include:
- impaired fasting glucose and impaired glucose tolerance
- high blood pressure (also known as hypertension)
- dyslipidaemia
- overweight and obesity
- waist circumference of increased risk of disease.
Some biomedical risk factors can be influenced by health behaviours. Of note, social determinants of health may directly or indirectly influence behavioural and biochemical risk factors (AIHW 2020). Socioeconomic factors such as lower education status and lower annual household income have been associated with type 2 diabetes (Zhang et al. 2020).
Fixed or non-modifiable risk factors cannot be modified. Fixed risk factors for type 2 diabetes include:
- ageing
- sex recorded at birth
- family history of diabetes (through inherited genes or through sharing an environment of risky health behaviours)
- ethnic background.
Fixed risk factors for type 1 diabetes include family history of type 1 diabetes but the exact cause is unknown at this time. There are no behavioural risk factors which increase the risk for type 1 diabetes, although maintaining a healthy lifestyle is important for managing the symptoms and long-term complications associated with the condition.
Other non-traditional risk factors such as living with a mental health condition can also increase the risk of developing all diabetes types, excluding type 1 (Lindekilde et al. 2021). In addition, Australians living with diabetes are more likely than other Australians to have poor mental health and wellbeing (AIHW 2011). These effects can arise directly, through biological pathways including the side effects of medications, and indirectly, through health behaviours.
Some factors involved in developing type 2 and gestational diabetes are not linked to behavioural risk factors. However, both conditions are associated with behavioural and biomedical factors that increase the risk of diagnosis and related complications. Clustering of biomedical risk factors with a common underlying cause, as found in metabolic syndrome, also increases the risk of developing type 2 diabetes (Harris 2013).
The Australian type 2 diabetes risk assessment tool (AUSDRISK) is a short list of questions including both behavioural and biomedical risk factors which assesses the risk of a person developing type 2 diabetes over the next 5 years. It evaluates both behavioural and biomedical risk factors for diabetes.
For most behavioural and biomedical risk factors there is no known threshold at which risk begins. The relationship between risk and disease is continuous – there is an increasing effect as exposure to the risk factor increases. Having multiple risk factors further escalates risk.
Many chronic conditions, including diabetes, share behavioural and biomedical risk factors. Modifying behavioural risk factors can reduce an individual's risk of developing type 2 diabetes prematurely and result in substantial health benefits by reducing illness and mortality rates. Evidence shows that lifestyle interventions such as intensive dietary changes and weight reduction can help people with recently diagnosed type 2 diabetes achieve remission (Zoungas and Sumithran 2024; Hocking et al. 2024).
For information about population trends for key risk factors, see the risk factors dashboard.
Risk factors among adults with and without diabetes
This section compares prevalence of 5 key biomedical risk factors among adults living with and those without diabetes.
The populations with and without diabetes were obtained from the 2022–24 National Health Measures Survey (NHMS) – which is the most recent national survey to include biomedical testing (ABS 2025a). Diabetes was identified based on measured HbA1c test results and self-reported diabetes status and medication use.
Adults who had diabetes in the 2022–24 NHMS had statistically significantly higher levels of impaired fasting glucose, dyslipidaemia (unhealthy or abnormal blood lipids), overweight or obesity and waist circumference of increased risk of disease (ABS 2025b). Although a higher proportion of people with diabetes had high blood pressure than those without diabetes, the difference was not statistically significant. These findings were similar for men. However, the prevalence of dyslipidaemia, overweight or obesity and high blood pressure was not statistically significantly different in women with and those without diabetes.
After adjusting for differences in the age structure of the populations, in 2022–24, an estimated (Figure 1):
- 81% of adults with diabetes had dyslipidaemia, 1.4 times as high as those with without diabetes
- 71% of adults with diabetes had impaired fasting glucose, 25 times as high as those without diabetes
- 92% of adults with diabetes had a waist circumference that indicates an increased or substantially increased risk of metabolic complications, 1.4 times as high as that for adults without diabetes
- 88% of adults with diabetes were living with overweight or obesity, 1.3 times as high as those without diabetes.
Figure 1: Risk factor prevalence among adults with diabetes and those without diabetes, 2022–24
The chart shows that in 2022-24, nearly 9 in 10 adults with diabetes were living with overweight or obesity and 8 in 10 adults had dyslipidaemia.
| Risk factor | With diabetes | Without diabetes |
|---|---|---|
| Waist circumference of increased risk of disease |
92.4%
(CI [84.2–100.6]) |
65.8%
(CI [64.0–67.7]) |
| Overweight or obese |
87.6%
(CI [76.8–98.4]) |
65.4%
(CI [63.3–67.5]) |
| Dyslipidaemia |
81.2%
(CI [69.0–93.3]) |
56.7%
(CI [54.4–58.9]) |
| Impaired fasting glucose |
71.2%
(CI [58.4–83.9]) |
2.8%
(CI [1.9–3.8]) |
| High blood pressure |
35.4%
(CI [19.1–51.6]) |
21.9%
(CI [20.1–23.7]) |
- Age-standardised to the 2001 Australian Standard Population.
- CI (confidence interval) is a statistical term describing a range (interval) of values within which we can be 'confident' that the true value lies, usually because it has a 95% or higher chance of doing so.
- Diabetes status is based on HbA1c test results and self-reported data.
- High blood pressure is defined as measured systolic blood pressure of 140 mmHg or more, or diastolic blood pressure of 90 mmHg or more.
- Waist circumference of increased risk of disease is defined as a measured waist circumference greater than 94 cm for men and 80 cm for women.
- Percentages are calculated using risk factor–specific denominators, as eligibility and data availability vary between measures (for example, fasting blood samples were required for dyslipidaemia estimates).
Source:
AIHW analysis of detailed Microdata, ABS 2025b.
Additionally, compared to adults without diabetes, those with diabetes were more likely to have 2 (55% compared to 41%) or 3 of the 4 risk factors (32% compared to 19%) assessed in the NHMS including high blood pressure (≥140/90 mmHg), overweight or obese (Body Mass Index ≥25 kg/m2), waist circumference of increased risk of disease (>94 cm for males and >80 cm for females), and current smoker status (ABS 2025a).
The higher prevalence and number of risk factors among adults with diabetes highlight the need for secondary prevention to limit the condition’s further development and increased severity. Secondary prevention focuses on the early detection and best practice management of a condition or disorder to reduce deterioration and long-term effects. This includes identifying people at risk of ill-health through screening programs, general health examinations, as well as the identification of complications and co-morbidities.
See further information below about these and other risk factors for diabetes.
For more information on these and other diabetes risk factors, see:
- High blood pressure
- High blood plasma glucose
- Overweight and obesity
- Waist circumference of increased risk of disease
- Dyslipidaemia
- Physical inactivity
- Dietary risks
- Smoking
- Determinants of health for First Nations people
- Burden of Disease
Visit Risk factors for more information on this topic.
ABS (Australian Bureau of Statistics) (2025a), National Health Measures Survey, 2022-24, ABS Website, accessed 23 February 2026.
ABS (2025b) Microdata: National Health Measures Survey, 2022–24, AIHW analysis of detailed microdata, accessed 1 December 2025.
AIHW (Australian Institute of Health and Welfare) (2020) Australia’s health 2020: data insights, AIHW, Australian Government, accessed 27 September 2024.
AIHW (2011) Diabetes and poor mental health and wellbeing: an exploratory analysis, AIHW Australian Government, accessed 2 March 2022.
Harris MF (2013) 'The metabolic syndrome', Australian family physician, 42(8): 524–527. PMID: 23971058.
Hocking SL, Markovic TP, Lee CMY, Picone TJ, Gudorf KE and Colagiuri S (2024) ‘Intensive Lifestyle Intervention for Remission of Early Type 2 Diabetes in Primary Care in Australia: DiRECT-Aus’, Diabetes Care 47(1):66-70, doi:10.2337/dc23-0781.
Lindekilde N, Scheuer SH, Rutters F, Knudsen L, Lasgaard M, Rubin KH, Henriksen JE, Kivimäki M, Andersen GS and Pouwer F (2021) 'Prevalence of type 2 diabetes in psychiatric disorders: an umbrella review with meta-analysis of 245 observational studies from 32 systematic reviews', Diabetologia, 65:440–456.
Zhang H, Rogers K, Sukkar L, Jun M, Kang A, Young T, Campain A, Cass A, Chow CK, Comino E, Foote C, Gallagher M, Knight J, Liu B, Lung T, McNamara M, Peiris D, Pollock C, Sullivan D, Wong G, Zoungas S, Jardine M and Hockham C, on behalf of EXTEND45 Steering Committee (2020) ‘Prevalence, incidence and risk factors of diabetes in Australian adults aged ≥45 years: A cohort study using linked routinely-collected data’, Journal of Clinical and Translational Endocrinology, 22:100240, doi:10.1016/j.jcte.2020.100240.
Zoungas S and Sumithran P (2024) ‘Remission of type 2 diabetes is achievable in primary care with intensive lifestyle intervention’, Evidence-Based Nursing, Published Online First: 08 March 2024, doi:10.1136/ebnurs-2023-103923.