Perceptions of risk in adults with a low or high risk profile of developing type 2 diabetes; a cross-sectional population-based study

Objective: To compare the perceived seriousness and risk of type 2 diabetes among low risk with high risk profile non-diabetic subjects and examine the relationship of perceived risk with multiple self-reported risk indicators. Methods: A cross-sectional population-based study among 4435 low risk profile and 2607 high risk profile non-diabetic residents of the Hoorn region, participating in a stepwise type 2 diabetes screening study. Main outcome measures were perceived seriousness and risk of diabetes in subjects categorized (low vs. high risk profile) using the Symptom Risk Questionnaire. Results: 85.0% of the low risk and 81.2% of the high risk profile subjects perceived diabetes as a moderate to very serious disease. About half(43.0%) of all 7042 Subjects reported that they do not know their risk of having diabetes. The mean perceived risk of having diabetes was slightly lower for the low risk compared with the high risk profile subjects (difference = 2.8%: 95% confidence interval [CI] = 1.8% to 3.8%; P < 0.001). This difference was mostly explained by having a parent or sibling with diabetes, frequent thirst and claudication (difference = 0.6%; 95% CI = -0.7% to 1.9%). Interestingly, perceived risk decreased with increasing age within both groups (P for trend < 0.001). Conclusions: Both low risk and high risk profile subjects perceive diabetes as a serious disease. Even among those at high risk profile for type 2 diabetes, almost half appeared not to know their risk. Perceived risk of having diabetes was slightly lower for the low risk compared with the high risk profile subjects. Furthermore, perceived risk decreases with increasing age. Practice implications: This study points to a greater need to effectively address people's (mis)perceptions, and how to raise the awareness and understanding of type 2 diabetes and its risk factors in the general population in order to influence early detection and healthy lifestyle changes. (C) 2008 Elsevier Ireland Ltd. All rights reserved.