What causes diabetes?

You have probably wondered how you developed diabetes or if your kids will develop it, too. Diabetes has various causes, but two factors are essential in both. You inherit a predisposition to the disorder, then something in your surroundings triggers it. Genes alone aren't enough of a factor to cause diabetes. One evidence of this is identical twins. Identical twins have identical genes. But if one twin has type 1 diabetes, the other gets the disease just half the time. If one of the twins has type 2 diabetes, the other's danger is three in four at most.

Diabetes is a medical condition characterized by abnormally high glucose levels. In this kind of diabetes, the body stops making and using insulin properly. What is insulin? Insulin is a hormone that can help regulate glucose levels produced in the pancreas. Primarily, insulin controls how much sugar is passed from the blood into cells, where it's used as an energy resource. Pancreas release insulin to move extra sugar into cells, which decreases the amount of sugar in the bloodstream.

Most who develop type 2 diabetes have insulin resistance, a condition where the body's cells use insulin significantly less efficiently than normal. When insulin resistance develops, more and more insulin is required to keep glucose levels normal. To keep up with the rising need, insulin-producing cells in the pancreas (called beta cells) make larger insulin quantities. With time, the beta cells become less able to react to blood glucose changes, resulting in an insulin deficit that prevents the body from reducing blood sugar levels effectively. Many people have some insulin resistance as they age, but insufficient exercise and excessive weight reduction make it worse, significantly increasing the probability of developing type 2 diabetes.

Type 2 diabetes most commonly begins in middle age or later but can develop at any age. Signs and symptoms gradually develop over the years. They include excessive thirst (polydipsia), frequent urination (polyuria), fatigue, blurred vision,  sores that don't heal well, tingling in the hands and feet (diabetic neuropathy), and weight loss. If blood sugar levels aren't controlled through medication or diet, type 2 diabetes can cause long-term health problems like heart disease and stroke, nerve damage, and damage to the kidneys, eyes, and other body areas.

See: Ayurveda treatments to prevent and reverse Diabetes Mellitus

Diabetes frequency

90-95 percent of diabetes cases are of Type 2 diabetes. In 2015, over 23 million people in the USA had diagnosed with diabetes, and another 7 million people probably had undiagnosed diabetes. Diabetes incidence increases with age, and the disease now affects more than 20 percent of Americans over age 65. 

The risk of diabetes varies by cultural and geographic background. In the USA, the disease is most common in Native Americans and Alaska Natives. Additionally, it has a higher incidence among African American or Hispanic ancestry individuals than those of non-Hispanic white or Asian ancestry. Geographically, diabetes is the most widespread in the southern and Appalachian regions of the USA. The incidence of diabetes is rapidly increasing worldwide. The disease's frequency has increased dramatically over the last three decades because of an increase in inactive (sedentary) lifestyles, obesity, and other risk factors.

See: Best Foods For Diabetics & Shopping List

Is type 1 diabetes genetic?

For most type 1 diabetes cases, people inherit risk factors from both parents.  Because most people that are at risk don't get diabetes, researchers want to learn what the environmental triggers are. One trigger may be associated with cold weather, while another cause might be viruses. A virus that has only moderate effects on many people may trigger type 1 diabetes in others. Early diet may also play a role. For instance, type 1 diabetes is lower in breastfed people who ate solid foods at later ages.

In a lot of individuals, the development of type 1 diabetes appears to take many decades. In experiments that followed relatives of individuals with type 1 diabetes, researchers have discovered that most of those who afterward got diabetes had specific autoantibodies or proteins that destroy viruses or bacteria in their blood for decades until they're diagnosed.

Your child's risk: For a woman with type 1 diabetes with her child born before 25 years, the child's risk is one at 25. If her child is born after 25years, the child's risk is one at 100. However, for a man with type 1 diabetes, the likelihood of the child developing diabetes is one at 17. That risk is doubled for the child if you developed diabetes before age 11. If both parents have type 1 diabetes, that risk is between 1 in 10 and 1 in 4. The risk of developing type 1 diabetes increases to 1 in 2 if there are additional conditions like thyroid disease and immune system disorders. Researchers are learning how to predict an individual's odds of having diabetes. For instance, many white people with type 1 diabetes have genes known as HLA-DR3 or HLA-DR4, which can be linked to autoimmune disease. If you and your child are white and have these genes, your child's risk is greater.

Scientists consider that the HLA-DR7 gene could put African Americans at risk, and the HLA-DR9 receptor may place Japanese people in danger.

An embryo evaluation can be performed for children who have siblings with type 1 diabetes. High levels of antibodies to insulin can indicate a child has a higher chance of developing type 1 diabetes.

If you believe your child might have type 1 diabetes, contact your physician. If a part of your household has type 1 diabetes, you may be entitled to a risk screening offered via the TrialNet Pathway to Prevention Study. TrialNet hazard screening is free to relatives of individuals with type 1 and uses a simple blood test that could detect your risk of type 1 diabetes years before symptoms arise. If you're in the early stages of type 1 diabetes, you may also be entitled to a prevention study.

See: Functional Medicine for Type 2 Diabetes

Is Type 2 diabetes genetic?

Type 2 diabetes causes are complicated. It results from a mix of genetic and lifestyle factors, some of which have yet to be identified. Studies have identified at least 150 DNA variants related to the risk of developing type 2 diabetes. The majority of these changes are common and are present both in people with diabetes and in those without. Each individual has some variations that increase risk and others that reduce risk. It's the combination of those changes which can help determine an individual's likelihood of developing the illness.

Nearly all genetic variations associated with type 2 diabetes are believed to act by subtly altering the amount, timing, and chemical action location (expression). These expression changes affect genes involved in several aspects of type 2 diabetes, for example, the processing and release of insulin cells and cells' sensitivity to the effects of insulin. However, for lots of variations, the mechanism by which they contribute to the condition risk is unknown.

Genetic variations probably act, and health and lifestyle factors affect an individual's overall risk of type 2 diabetes. All these variables are directly or indirectly related to how the body produces and responds to insulin. Health conditions that increase disease risk include insulin resistance, prediabetes, overweight or obesity, and gestational diabetes during pregnancy. Lifestyle factors, including smoking, a poor diet, and physical inactivity, also increase the risk of type 2 diabetes.

Type 2 diabetes includes a stronger connection to family history, and studies of twins have shown that genetics plays a compelling part in developing type 2 diabetes. The race may also play a role. Yet it also depends upon environmental factors. Lifestyle also affects the development of type 2 diabetes. Obesity tends to run in families, and households frequently have similar eating and exercise habits.

Type 2 diabetes doesn't have a clear inheritance pattern, although many affected individuals have at least one close relative, like a sibling or parent, with the illness. The chance of developing type 2 diabetes increases with the number of affected family members. The greater risk is likely due in part to shared genetic factors, but it's also linked to lifestyle influences (for example, eating and exercise habits), which can be shared by household members.

In case you've got a family history of type 2 diabetes, it could be tricky to work out if your diabetes is because of lifestyle factors or genetics. Most likely, it's due to both. Studies reveal it is likely to delay or prevent type 2 diabetes by exercising and losing weight. 

A family history of diabetes: If you have been diagnosed with type 2 diabetes, there is a reasonable probability that you aren't the first person with diabetes in your family. You are more likely to develop the condition if a parent or sibling has it. Several gene mutations have been connected to the development of type 2 diabetes. These gene mutations can also interact with the environment and with each other to increase your risk even more.

Researchers have linked several gene mutations to higher diabetes risk. However, not everyone who carries a mutation will get diabetes. But many people with diabetes do have at least one of these mutations. It can be tricky to separate genetic risk from environmental danger. The latter is often influenced by your relatives. For instance, parents with healthy eating habits are most likely to pass them on to another generation. On the other hand, genetics plays a significant role in determining weight. Sometimes behaviors can not take all of the blame. Generally speaking, mutations in any gene involved in controlling glucose levels can increase your risk of type 2 diabetes. These include genes that control:

- the production of sugar

- the production and regulation of insulin

- how glucose levels are felt in the body

A few genes related to type 2 diabetes risk include:

TCF7L2 affects insulin secretion and glucose production

ABCC8  helps regulate insulin

GLUT2 helps move glucose into the pancreas

Your child's risk: Type 2 diabetes runs in families. In part, this is because of children learning bad habits: eating a poor diet, not exercising from their parents. But there's also a hereditary basis. 

See: Ayurvedic medicine to lower blood sugar

Genetics & lifestyle choices In diabetes

Genetics Role in Diabetes

Type 2 diabetes could be hereditary. That does not mean that if your mother or father has (or had) type 2 diabetes, you are sure to develop it. Rather, it means that you have a better probability of developing type 2. Researchers know you could inherit a risk for type 2 diabetes, but it is tough to pinpoint which genes take the risk. 

Lifestyle Role in Diabetes

Lifestyle choices are also significant. As an instance, you can have a genetic mutation that can make you vulnerable to type 2, but if you have a healthy lifestyle, you might not develop diabetes. Lifestyle choices that impact the development of type 2 diabetes include:

- Lack of exercise: Physical activity has many benefits--among those being that it can help you avoid type 2 diabetes, even if you are vulnerable.

- Unhealthy meals: A meal program full of high-fat meals and lacking in fiber raises the probability of type 2 diabetes.

- Obesity: Lack of exercise and unhealthy meal preparation choices may cause obesity or make it worse. Being overweight makes it more probable you'll become insulin resistant and may also cause many other health conditions.

- Insulin Resistance: The combination of factors-genetics and lifestyle choices-contributes to insulin resistance. Your system may produce enough insulin to transport the glucose to the cells, but the body accomplishes that insulin. Glucose builds up in the bloodstream when you're insulin resistant, resulting in the symptoms associated with type 2 diabetes.

Type 2 Diabetes Is not always brought on by insulin resistance. Insulin resistance is the most frequent cause of type 2 diabetes, but it's likely to have type 2 and not be insulin resistant. You can have a kind of type 2 where your body just does not produce enough insulin; that is not quite as common. Researchers aren't sure what prevents some people from producing enough insulin, but that is another thing they are working hard to find out.

- Genetic testing for diabetes

Gene mutations tests are available that are associated with type 2 diabetes.  But other factors are far much better predictors of whether you will develop type 2 diabetes, for example:

- your family history

- high blood pressure

- body mass index (BMI)

- high cholesterol levels

- having particular ancestries

- gestational diabetes history

See: Beets and Diabetes Benefits

Diabetes prevention & reversal

The connections between genetics and the environment make it difficult to recognize a specific type 2 diabetes cause. However, that does not mean you can not reduce your risk by altering your lifestyle. The DPPOS or Diabetes Prevention Program Outcomes Study research of individuals at high risk for diabetes indicates that weight loss and improved physical activity can prevent or delay type 2 diabetes. Blood sugar levels returned to normal levels sometimes. Other reviews of numerous studies have reported similar results. You can lower type 2 diabetes risk by:

- Exercise: Gradually add physical activity into your everyday routine. Take the stairs vs. the elevator or go for a walk during lunch. You can add some weight training and other cardiovascular activities to your routine.  

- Healthy diet: It can be tough to avoid additional carbohydrates and calories when you are dining out. Cooking your meals is the simplest way to make healthful decisions.

Create a weekly meal plan that includes dishes for each meal. Stock up on all the groceries you will want, and do some of the prep work beforehand. You can ease yourself into it, also. Begin by planning your lunches for the week. As soon as you're familiar with this, you can plan out extra meals. Early identification and treatment can have a beneficial effect on your outlook. Your physician might also need to regularly check your sugar levels. Testing can help early detection of blood glucose abnormalities or identification of type 2 diabetes warning signs. 

See: Signs of diabetes in men

References


1. Andersen MK, Pedersen CE, Moltke I, Hansen T, Albrechtsen A, Grarup N. Genetics of Type 2 Diabetes: the Power of Isolated Populations. Curr Diab Rep. 2016 Jul;16(7):65. doi: 10.1007/s11892-016-0757-z. Review. Citation on PubMed

2. Centers for Disease Control and Prevention: National Diabetes Statistics Report, 2017

3. Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet. 2017 Jun 3;389(10085):2239-2251. doi: 10.1016/S0140-6736(17)30058-2. Epub 2017 Feb 10. Review. Erratum in: Lancet. 2017 Jun 3;389(10085):2192. Citation on PubMed

4. Flannick J, Florez JC. Type 2 diabetes: genetic data sharing to advance complex disease research. Nat Rev Genet. 2016 Sep;17(9):535-49. doi: 10.1038/nrg.2016.56. Epub 2016 Jul 11. Review. Citation on PubMed

5. McCarthy MI. Genomics, type 2 diabetes, and obesity. N Engl J Med. 2010 Dec 9;363(24):2339-50. doi: 10.1056/NEJMra0906948. Review. Citation on PubMed

6. Mohlke KL, Boehnke M. Recent advances in understanding the genetic architecture of type 2 diabetes. Hum Mol Genet. 2015 Oct 15;24(R1):R85-92. doi: 10.1093/hmg/ddv264. Epub 2015 Jul 9. Review. Citation on PubMed or Free article on PubMed Central

7. Pal A, McCarthy MI. The genetics of type 2 diabetes and its clinical relevance. Clin Genet. 2013 Apr;83(4):297-306. doi: 10.1111/cge.12055. Epub 2012 Dec 4. Review. Citation on PubMed

8. What Is Diabetes? National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

9. Hyperglycemia (High Blood Glucose). American Diabetes Association. September 16, 2014.

10. Type 1 Diabetes. American Diabetes Association.

11. Genetics of Diabetes. American Diabetes Association. January 27, 2017.

12. Smith-March DE. Type 1 Diabetes Risk Factors. EndocrineWeb.

13. Type 2. American Diabetes Association.

14. Risk Factors for Type 2 Diabetes. NIDDK. November 2016.

15. Cardwell CR, Stene LC, Ludvigsson J, et al. Breast-Feeding and Childhood-Onset Type 1 Diabetes. Diabetes Care. November 2012.

16. Krzewska A, Ben-Skowronek I. Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents. BioMed Research International. July 20, 2016.

17. Type 1 Diabetes. NIH Genetics Home Reference. U.S. National Library of Medicine. July 31, 2018.

18. Gestational Diabetes. NIH Genetics Home Reference. July 31, 2018.

19. Lavery J, Friedman AM, Keyes KM. Gestational Diabetes in the United States: Temporal Changes in Prevalence Rates between 1979 and 2010. BJOG. August 11, 2016.

20. Gestational Diabetes. Centers for Disease Control and Prevention. July 25, 2017.

See: Foods To Avoid With Diabetes

Get a Consultation
(650) 539-4545
Get more information via email