CAUSES & RISK FACTORS
The cause of Type II Diabetes is unknown. Medical experts believe that Type II Diabetes has a genetic component, but that other factors also put people at risk for the disease. These factors include:

● Sedentary lifestyle
● Obesity (Weight chart in figure 2)
● Advanced age
● Unhealthy diet
● Family history of Diabetes
● Improper functioning of the pancreas
● Minority race (higher risk in Black, Hispanic, American Indian,     esternized Asian & native Hawaiian populations)
● Medication (cortisone & some high blood pressure drugs) q     Women given birth to a baby weighing more than 9 lbs
● Previously diagnosed gestational Diabetes
● Previously diagnosed IGT

RISK FACTORS FOR DEVELOPING DIABETES IN BANGLADESHI POPULATION

Several epidemiological investigation in migrant population observed that diabetes and coronary risk factors are more prevalent in Bangladeshis compared with other South Asian migrants (Indian, Pakistani) settled in United Kingdom and with the native population. It has also been reported that Bangladeshis among the entire South Asians immigrant had highest mortality and attack rate from diabetes and coronary heart disease. These findings favor the hypothesis that Bangladeshi population is genetically more prone to develop diabetes and its complications than other SEAR population.

As regards the environmental risk factors obesity, physical inactivity, food habit, life-style are known risk factors related to diabetes. Obesity, diabetes, hypertension and dyslipidemia - popularly known as "Metabolic syndrome" are the major risk for developing Atherosclerosis that eventually leads to coronary heart disease (CHD), stroke and peripheral vascular disease (PVD). It is well known that CHD is the cause ofhighest mortality in the world. Likewise, PVD is the leading cause of lower limb amputation.

Features distinguishing Type 1 from Type 2

LABORATORY INVESTIGATIONS
Besides a complete history and physical examination, the doctors will perform a battery of laboratory tests. There are numerous tests available to diagnose Diabetes, such as a urine test, blood test, glucose-tolerance test, fasting blood sugar and the glycated hemoglobin (HbA1c) test. Other conditions associated with Diabetes require several tests at diagnosis and at later review.

Urine glucose
●   A positive urine glucose test suggests but is not diagnostic for type       Diabetes.
● Test urine of ambulatory patients for ketones at the time of       diagnosis.

Urine ketones
●   Ketones in the urine confirm lipolysis and gluconeogenesis, which      are normal during periods of starvation.
●  With hyperglycemia and heavy glycosuria, ketonuria is a marker of     insulin deficiency and potential Ketoacidosis.

Blood glucose
● Apart from transient illness or stress-induced hyperglycemia, a random whole-blood glucose concentration more than 200 mg/dL (11 mmol/L) is diagnostic for Diabetes, as is a fasting whole-blood glucose concentration exceeding 120 mg/dL (7 mmol/L). In the absence of symptoms, the physician must confirm these results on a different day.

Glycated hemoglobin
● Glycosylated hemoglobin derivatives (HbA1a, HbA1b and HbA1c)     are the result of a non-enzymatic reaction between glucose and     hemoglobin. A strong correlation exists between average     blood-  glucose concentrations over an 8 to 10 week period and the     proportion of glycated hemoglobin.
● Measurement of HbA1c levels is the best method fo medium to long    term diabetic control monitoring. The patients with HbA1c levels    around 7% had the best outcomes relative to long-term    complications. Check HbA1c levels every 3 months. Values less    than 7% are associated with an increased risk of hypoglycemia;    values more than 9% carry an increased risk of long term    complications.