<![CDATA[Background: The global prevalence of type 2 diabetes mellitus (T2DM) among young adults has been increasing rapidly, including in Indonesia, due to urbanization, changes in dietary patterns, and sedentary lifestyles. Lifestyle factors, such as physical inactivity and unhealthy eating habits, play a significant role in raising T2DM risk, while family history remains a strong genetic factor. Objectives: This study compared preventive behaviors, diabetes-related knowledge, and risk levels among college students with and without a family history of type 2 diabetes mellitus. Methods: A cross-sectional study was conducted on 300 college students aged 18-21 years. Participants were categorized according to the presence or absence of a family history of T2DM. Data collection included anthropometric measurements, a 3-day food diary, a physical activity questionnaire (IPAQ-SF), a diabetes knowledge test (MDKT), and a risk assessment (AUSDRISK). Data were analyzed using chi-square, Mann-Whitney, and logistic regression. Results: Students with a family history of T2DM demonstrated significantly higher knowledge scores (p-value=0.005) and diabetes risk levels (p-value<0.001), but lower walking activity (p-value=0.002). They also reported lower supermarket food consumption (p-value=0.008). Multivariate analysis showed that higher knowledge and supermarket food consumption were associated with a lower likelihood of having a family history of T2DM, while diabetes risk was the strongest predictor. Conclusions: Although students with a family history of T2DM exhibited better knowledge, they showed a higher diabetes risk and a suboptimal lifestyle. These findings emphasize the importance of behavior-oriented prevention strategies on campus, especially for individuals with a genetic predisposition.]]>
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