Did you know that an estimated 529 million adults worldwide lived with diabetes as of 2021.1? Among these cases, type 2 diabetes (T2DM) is the most prevalent form, accounting for 90-95 percent of all diagnosed cases.2 However, despite its widespread impact, many people still struggle to understand the root causes of this chronic condition.
T2DM is a complex condition with a multitude of factors that can contribute to its development. Understanding these factors can allow you to gain a better understanding of why some individuals are more susceptible to the condition than others.
Whether you have received a diagnosis of T2DM, want to learn more about preventing it, or have a loved one whom the disease affects, this article can provide you with valuable insights. It delves into the mysteries of T2DM to shed light on those underlying causes and can empower you with the knowledge to make healthier choices. Armed with this knowledge, you can take active steps to prevent or manage the disease more effectively.
Insulin resistance
Insulin resistance is a fundamental underlying mechanism in the development of type 2 diabetes. Insulin is a hormone that the pancreas produces and plays a crucial role in regulating blood sugar levels by facilitating the uptake of glucose into cells for energy or storage.3 In insulin resistance, the body’s cells become less responsive to the effects of insulin, making it more difficult for you to absorb and use glucose.4
As a result, the pancreas must produce higher insulin levels to maintain normal blood sugar levels, leading to hyperinsulinemia.4 Over time, the pancreas may become unable to keep up with the increased demand for insulin, leading to the development of impaired glucose tolerance, and ultimately, T2DM.4
A variety of factors can influence insulin resistance, including aging, family history, genetic predisposition, dietary habits, physical inactivity, obesity, stress, and some medical conditions. Understanding the role of insulin resistance in the pathogenesis of T2DM is crucial for developing effective prevention and management strategies.
Risk factors of type 2 diabetes mellitus
Aging and Diabetes
One of the primary risk factors for developing T2DM is age. As you grow older, your risk of developing the condition increases.5 This is primarily due to the gradual decline in the body’s ability to effectively use insulin, a hormone responsible for regulating blood sugar levels.5 With age, the cells in your body become more resistant to the effects of insulin, leading to a higher risk of insulin resistance, and ultimately, T2DM.5
Does Type 2 Diabetes Run in Families
Another significant risk factor is family history. If you have a close relative, such as a parent or sibling, who has received a diagnosis of T2DM, your risk of developing the condition is significantly higher.6
Is Diabetes Genetic?
Genetic factors play a crucial role in the development of this disease because certain genetic variations can make you more susceptible to insulin resistance and the impaired production of insulin by the pancreas.7
The genetic component of T2DM is a complex and multifaceted topic. Numerous genetic variants can contribute to your risk of developing the condition. These genetic factors can influence glucose metabolism, insulin production, and the body’s response to insulin.
One of the most well-studied genetic factors associated with T2DM is the transcription factor 7-like 2 (TCF7L2) gene. The TCF7L2 gene plays a crucial role in regulating the production and secretion of insulin, and individuals with certain genetic variations in this gene are more susceptible to insulin resistance and impaired glucose tolerance.8
In addition to the TCF7L2 gene, researchers have identified other genetic variants that contribute to the development of T2DM. These include genes involved in insulin signaling, glucose metabolism, and the regulation of pancreatic beta-cell function.9-11 The interplay between these genetic factors and environmental influences, such as lifestyle and dietary habits, can further exacerbate the risk of developing T2DM.
Diet and Diabetes
One of the most prominent lifestyle factors is dietary habits. They play a significant role in the development and management of T2DM. The type and quantity of the foods you consume can have a profound impact on your body’s ability to regulate blood-sugar levels and maintain insulin sensitivity.
Consuming a diet that is rich in processed foods, lacking in fiber, and lacking in essential nutrients can lead to weight gain, inflammation, and disruptions in the body’s ability to regulate blood sugar levels. One of the primary dietary factors that can contribute to the development of T2DM is the consumption of refined carbohydrates and added sugars, such as in sugary beverages.12,13 These types of carbohydrates quickly absorb into the bloodstream, leading to rapid spikes in blood sugar levels and placing a significant burden on the pancreas to produce more insulin. Unhealthy fats can also contribute to the development of insulin resistance and the progression of T2DM.14
In contrast, a diet plentiful in whole, fiber-rich carbohydrates, such as vegetables, fruits, and whole grains, can help to regulate blood sugar levels and support insulin sensitivity.15 Additionally, a diet high in healthy fats, such as those found in nuts, avocados, and olive oil, can also help to improve insulin sensitivity and reduce the risk of T2DM.16
Does Exercise Affect Diabetes
Physical inactivity is another significant risk factor for the development of T2DM. Regular physical activity promotes weight management and plays a crucial role in maintaining overall metabolic health and reducing the risk of chronic conditions, including T2DM.17 When you engage in regular physical activity, such as aerobic exercise or strength training, you can improve your body’s insulin sensitivity.
Exercise stimulates the uptake of glucose by the muscles, reducing the demand on the pancreas to produce excessive amounts of insulin.18 Exercise enhances your body’s ability to regulate blood-sugar levels and lower your risk of developing T2DM compared to those who lead a more sedentary lifestyle.
Conversely, a sedentary lifestyle characterized by prolonged periods of inactivity and a lack of regular physical exercise can contribute to the development of insulin resistance and increase the risk of T2DM.19 Individuals who lead a more sedentary lifestyle, such as those who spend a significant amount of time sitting at a desk or in front of a screen, are more likely to develop insulin resistance and have a higher risk of developing T2DM compared to those who engage in regular physical activity.
Relationship between Obesity and Diabetes
Obesity is widely recognized as one of the most significant risk factors for the development of T2DM.20 The relationship between obesity and T2DM is complex and multifaceted, with obesity playing a central role in the progression of the condition.
Excess body weight, particularly visceral fat accumulation around the abdominal region, can lead to insulin resistance.21 Visceral fat is metabolically active and can release a variety of inflammatory substances, hormones, and free fatty acids that contribute to the development of insulin resistance.
Obesity also contributes to other risk factors, such as high blood pressure and dyslipidemia—abnormal blood lipid levels, further increasing the risk of developing T2DM and its associated complications.22
Is Stress a Reason for Diabetes
Stress can impact your body’s hormonal balance. Chronic stress can lead to the release of hormones, such as cortisol, that can contribute to insulin resistance and impaired glucose regulation.23 Stress can also influence lifestyle factors, such as diet and physical activity, further exacerbating the risk of T2DM.24
Other Medical Conditions Affecting Diabetes
Certain medical conditions, such as polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease (NAFLD), have been associated with an increased risk of developing T2DM.25 These conditions can disrupt the body’s hormonal balance, contribute to insulin resistance, and increase the likelihood of weight gain, all of which are key risk factors for T2DM.
Living Life with Diabetes
The development of T2DM is a complex and multifaceted process, influenced by a combination of genetics, lifestyle, and environmental factors. By understanding the root causes of this chronic condition, you can take active steps to prevent or manage its progression.
Whether it’s addressing genetic predispositions, adopting a healthy diet, engaging in regular physical activity, or maintaining a healthy weight, each of these factors plays a crucial role in reducing the risk of T2DM. By taking control of your health and implementing lifestyle changes, you can empower yourself to prevent or effectively manage this condition, ultimately improving your overall well-being and quality of life.
Remember, the journey to preventing or managing T2DM isn’t a one-size-fits-all approach. It requires a personalized and holistic approach that considers your unique genetic makeup, lifestyle, and health status. Work closely with your healthcare provider to develop a comprehensive plan that addresses the specific risk factors and the needs you may have. Together, you can take the necessary steps to unravel the mysteries of T2DM and take control of your health.
References:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext
https://www.cdc.gov/diabetes/communication-resources/diabetes-statistics.html
https://www.yourhormones.info/hormones/insulin/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1204764/
https://www.sciencedirect.com/science/article/abs/pii/S0083672920300583
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1327713/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911377/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952407/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083885/
https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-020-00604-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578191/
https://pubmed.ncbi.nlm.nih.gov/15113714/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762218/
https://pubmed.ncbi.nlm.nih.gov/21490391/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099360/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654180/
https://www.cdc.gov/physical-activity-basics/benefits/index.html
https://diabetes.org/health-wellness/fitness/blood-glucose-and-exercise
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364419/
https://www.ncbi.nlm.nih.gov/books/NBK592412/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038351/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096264/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561544/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767465/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093689/
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