In Type 2 diabetes while there is no single cause there are well-known risk factors. Some of these can be modified and some cannot. But what you must remember is you cannot have diabetes without some form of insulin deficiency.
In type 2 diabetes we don’t have enough insulin to keep the blood glucose level in range, or the insulin we do have is not working properly or is being resisted by the cells of the body. It has long been thought that “Insulin resistance causes type 2 diabetes”. The argument against this is that not all insulin resistant people develop diabetes. Over 80% will. But what about the other 20%? This means that something other than insulin resistance contributes to the development of diabetes.
Insulin resistance is important, but it’s the beta cells of the pancreas that control whether you develop diabetes or not – either progressive failure of function or loss of beta cell numbers will lead to insulin deficiency causing the blood glucose level to rise.
Even in the presence of insulin resistance (through fatty infiltrate of the liver) or beta cell failure causing reduced insulin you still need to have the genetic predisposition to develop diabetes.
Unmodifiable Risk Factors
The following is a list of unmodifiable risk factors for the development of diabetes. You may have some of these and unfortunately, you cannot change these. They did not cause you to develop diabetes but placed you at increased risk. With these risk factors a modifiable environmental trigger as seen in the list of modifiable risk factors potentially can trigger the development of type 2 diabetes.
A family history of diabetes
If a parent was diagnosed with diabetes before 50 years of age
If a person is an Aborigine or Torres Strait Islander
If a person is from an ethnic background more likely to have type 2 diabetes such as Melanesian, Polynesian, Chinese or people from the Indian sub-continent
If a pregnancy has resulted in the birth of a child over 4.5kgs (9lbs) or gestational diabetes was present during pregnancy
If there is a diagnosis of Polycystic Ovarian Syndrome
Modifiable Risk Factors
These modifiable risk factors act as environmental triggers when unmodifiable risk factors are present. These triggers are within your abilities to control and in turn prevent the development of type 2 diabetes. These are where your choices determine your outcomes.
Being overweight (a body mass index greater than 25)
Having Pre-diabetes (having impaired glucose tolerance or impaired fasting glucose)
Having high triglycerides and low HDL cholesterol
High blood pressure (Hypertension)
Having a history of vascular disease
Type 2 Diabetes is a lifestyle disorder. It is a result of too much energy in (from food, alcohol and beverages) and not enough energy out through inactivity in susceptible individuals. Addressing this imbalance can reverse the process.