Type 2 diabetes is the most common form of diabetes mellitus, affecting more than 350 million people worldwide.
This form of diabetes is expanding, increasing its incidence in all countries, mainly due to poor diet and increased cases of obesity. In the past 30 years the number of cases of type 2 diabetes has increased by more than 100%. Therefore, understanding the risk factors and causes of diabetes is essential to prevent it.
Type 2 diabetes mellitus is a type of diabetes that occurs because of poor insulin action in the bloodstream. Usually there are two problems: 1) the pancreas produces less insulin than would be necessary for proper control of glucose levels; 2) the insulin produced is insufficient, it works poorly. Tissues lose the ability to recognize the presence of insulin, so that the sugar in the blood does not reach the cells. This process is known as insulin resistance.
Although it is a form of diabetes mellitus more common than type 1 diabetes, the causes of type 2 diabetes are less known. This form of diabetes is probably triggered by multiple factors, not all yet recognized. Why the pancreas produces less insulin and the reasons why it works poorly are not yet fully understood.
The development of type 2 diabetes mellitus seems to involve complex interactions between environmental and genetic factors. Presumably, the disease develops when a genetically susceptible person adopts a "diabetogenic" lifestyle, that is, with excessive caloric intake, sedentary lifestyle, obesity, smoking, etc.
90% of type 2 diabetics are obese or overweight, but not every obese individual is diabetic. This simple fact serves to show that the cause of type 2 diabetes is not restricted to a single factor. Most likely several factors are involved.
While we have not yet fully clarified the causes of type 2 diabetes mellitus, its risk factors are already well known. We will list below the main ones:
1. Family history - Individuals who have relatives with type 2 diabetes, especially if first degree, are at higher risk of developing the disease. These patients should be very careful about gaining excessive weight.
2. Ethnicity - for reasons not yet known, the incidence of type 2 diabetes varies according to the ethnic origin of the patient. In descending order of incidence, the ethnicities with the greatest risk of type 2 diabetes are: descendants of Asians, Hispanics, blacks and whites. Here is a caveat, despite the higher incidence of diabetes in Asian offspring, the population of Asia, by having healthier eating habits, end up presenting fewer cases of diabetes than the American population, mostly composed of whites.
3. Obesity - overweight is perhaps the main risk factor for the development of type 2 diabetes. The risk increases progressively from a BMI greater than 25. Obesity is such an important factor that some patients manage to stop being diabetics only by losing weight. Currently, more than 90% of type 2 diabetics are overweight.
To learn more about body mass index and BMI calculation, visit the following article: BMI.
4. Abdominal fat - in addition to being overweight, the way fat is distributed throughout the body is also a determining factor for a higher risk of insulin resistance and type 2 diabetes. The risk of diabetes is higher in individuals with central obesity, that is, those who accumulate fat in the belly. Men with a waist greater than 102 cm and women with waist greater than 88 cm are at high risk. Women who accumulate fat preferentially in the hips have fewer risks than those that accumulate fat in the abdominal region.
5. Age above 45 years - although it is an increasingly prevalent disease in young people, type 2 diabetes is more common in individuals over 45 years of age. The decrease in muscle mass and the increase in body fat that occurs with aging probably play an important role in these patients.
6. Sedentary lifestyle - a sedentary lifestyle reduces calorie expenditure, promotes weight gain and increases the risk of type 2 diabetes. Among sedentary behaviors, watching television for a long time is one of the most common, being proven to be associated with development of obesity and diabetes. Regular physical activity not only helps to control weight, but also increases tissue sensitivity to insulin, helping to control blood glucose levels. Both bodybuilding and aerobic exercise help prevent type 2 diabetes.
7. Cigarette - Individuals who smoke are 40% more likely to develop type 2 diabetes than nonsmokers. The longer the patient smokes and the larger the number of packets consumed per day, the greater the risk. The association of smoking with diabetes is so strong that it takes five years without smoking for the risk of diabetes to begin to fall. And only after 20 years of non-smoking does the patient again have the same risk of people who never smoked.
8. Altered fasting glycemia - The diagnosis of diabetes is made when the patient has glycemia (blood glucose levels) persistently above 126 mg/dl. However, normal blood glucose levels are below 100 mg/dl. Patients midway between 100 and 125 mg/dL are considered to have impaired fasting blood glucose, which is a pre-diabetes stage. The risk of progression to established diabetes is very high in this group.
9. Hypercaloric diet - The Western diet, based on excessive consumption of red meat, processed meats, calories, sweets and soft drinks, is associated with a greater risk of developing type 2 diabetes. If the patient is overweight, the risk is even greater. Regular consumption of cereals, vegetables, soy and fiber reduces the risk of diabetes.
10. Hypertension - hypertensive patients are at increased risk of having diabetes. It is not known whether hypertension has any role in the development of the disease or whether it, because it has many common risk factors, only appears alongside diabetes, with no causal relationship. Some medications used to treat hypertension, such as diuretics and beta-blockers, interfere with the action of insulin, increasing the risk of diabetes.
11. High cholesterol - Patients with high cholesterol levels are also at a higher risk for type 2 diabetes. Elevated levels of LDL (bad cholesterol) and triglycerides and/or low levels of HDL (good cholesterol) are the main factors.
12. Polycystic ovarian syndrome (PCOS) - women with PCOS often have insulin resistance and, consequently, the risk of developing type 2 diabetes.
13. Gestational diabetes - is a type of diabetes that arises during pregnancy and usually disappears after childbirth. However, even with normalization of glucose at the end of pregnancy, these patients are at high risk of developing type 2 diabetes within 10 years of pregnancy.
14. Use of corticosteroids - corticosteroids are class of medicines widely used in medical practice, mainly against diseases of immunological and/or allergic origin. One of the common side effects of prolonged use of corticosteroids is the development of diabetes.
This is a very common doubt in the population. The simple answer is: no, eating too much candy does not cause diabetes. However, it is good to point out that poor diet, with excess carbohydrates and fats, is one of the factors that lead to obesity or overweight, these are risk factors for diabetes.
As noted, numerous risk factors for type 2 diabetes have already been identified. In this article we have listed only the most common and proven. There are also studies that show a relationship between diabetes and dozens of other factors, such as high levels of uric acid, schizophrenia, depression, never breastfeeding, irregular menstrual cycle, exposure to bisphenol A, use of anabolic steroids, etc.
No one can change their ethnicity, age or family history, so the patient should always keep in mind which modifiable risk factors. If you have a family history of diabetes, try to stay active, within the weight, do not smoke, and eat a healthy diet. It is not because your father or mother had type 2 diabetes that you will necessarily have. Prevention may be within your reach.
