Type 2 Diabetes Causes and Risk Factors

Type 2 Diabetes Causes and Risk Factors

There are no known, specific causes for Type 2 diabetes. However, those most at risk for Type 2 diabetes are adults 45 years and older and those of any age who are sedentary and overweight.

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    Here are some things you can do to lower your risk for type 2 diabetes:
    • Lose weight. Are you more than 20% over your ideal body weight? Losing even a few pounds can help you prevent type 2 diabetes.
    • Make healthy food choices. Follow simple daily guidelines, like eating enough fresh vegetables and fruits, and whole grains. Limit fat to 30% or less of your daily calories, and watch your portion sizes. Healthy eating habits can go a long way in preventing diabetes and other health problems.
    • Stay active. Regular exercise can help prevent type 2 diabetes. Plus it can help you lose weight, manage stress, and feel better. Learn more about physical activity
    • Breastfeed. If you can, breastfeed your baby. Breastfeeding can provide both short- and long-term benefits to both your baby and to you.
    • Talk to your doctor. Be sure to tell your health care providers that you've had GDM.
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    You are at higher risk for developing type 2 diabetes if you are overweight, don't exercise and are over 30 or have close relatives with diabetes, especially type 2 diabetes -- where the pancreas makes insulin, but the body does not respond to it properly (insulin resistance). Higher-risk groups include blacks, Latino/Hispanic, Native American, Alaskan Native, Asian and Pacific Islander American.

    Prediabetes is now recognized as a risk factor for developing diabetes later in life. The term describes an increasingly common condition in which blood glucose (blood sugar) levels are higher than normal but are not yet diabetic. About 86 million Americans have prediabetes, in addition to the 29.1 million with diabetes.

    If you are 45 or older, you should be screened for diabetes. A normal initial test should be followed up with retesting at three-year intervals or at the frequency recommended by your healthcare professional based on your personal health history and other risk factors you may have.

    For individuals at high risk for developing diabetes, the guidelines issued by leading health professional organizations recommend that screening begin at age 30. These conditions, in addition to those described above, can raise your risk for developing diabetes.
    • having blood pressure at or above 140/90 millimeters of mercury (mm/Hg)
    • having abnormal blood fat levels, such as high-density lipoproteins (HDL) less than 40 milligrams per deciliter (mg/dL) or triglycerides greater than 200 mg/dL
    • test results showing impaired glucose tolerance or impaired fasting glucose (100-125 mg/dL after an overnight fast) and a blood glucose level of 140-199 mg/dl two hours after drinking the glucose drink provided in the oral glucose tolerance test (OGTT).
    • women who had diabetes during pregnancy or gave birth to a baby weighing more than nine pounds
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    Type 2 diabetes causes other health problems, especially if blood sugar levels are not well controlled. Type 2 diabetes can increase the risk of heart disease and stroke, vision problems and blindness, kidney disease and kidney failure, nerve damage and amputations.
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    Type 2 diabetes develops when cells start ignoring insulin. To understand why that matters, you need to understand that carbohydrates in food break down into glucose (sugar) during digestion. That glucose enters the bloodstream. Meanwhile, the pancreas produces the hormone insulin in response to the rise in blood glucose. Insulin is needed to "unlock," or open, the cells so that glucose can enter and be used for energy. When cells become insulin resistant, the pancreas struggles to make even more insulin. Eventually, the pancreas may not be able to make as much insulin as before, and blood sugar levels just get higher and higher.

    Heredity and lifestyle factors, such as being overweight and not exercising, increase your risk of developing type 2 diabetes.
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    There are many things, called risk factors, that affect your risk for type 2 diabetes and heart disease. Some of these you can change, like whether or not you smoke, and some you can't, like your age. It's important to know where you stand in your risk for diabetes and heart disease. Once you know your risk, you can take steps to lower your risk so you can lead a longer, healthier life.

    Either way, understanding and managing your risk can help you prevent diabetes and heart disease and live a longer, better life.

    Risk factors include:
    • Overweight
    • High blood glucose (sugar)
    • History of diabetes during pregnancy, called gestational diabetes (for women)
    • High blood pressure
    • Unhealthy cholesterol
    • Physical inactivity
    • Smoking
    • Unhealthy eating
    • Age, race, gender, and family history
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    There is a close link between obesity and diabetes type 2 risk. In fact, the majority of American overweight/obese adults either have type 2 diabetes or prediabetes. Therefore, weight loss is a good place to start in beating this silent killer.  When a person puts on 11 to 16 pounds of body weight they have double the risk of developing type 2 diabetes. Those who gain 17 to 24 pounds triple their risk. Losing about 10 percent of your body weight (if you’re overweight or obese) can help with insulin sensitivity and blood sugar management. It’s time to break free from old programming that says we should eat what we want, when we want in the quantities we want and instead start to nourish our bodies and move our bodies to reclaim our natural state of wellness. And since diabetes follows a progressive course, we must intervene early before it’s too late.
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    Genetics appears to play a role in how type 2 diabetes develops. Like type 1 diabetes, type 2 diabetes also appears to run in families, and it is most likely due to the inheritance of certain genes. The link to genetics seems even stronger in type 2 diabetes than in type 1 diabetes. If a person with type 1 diabetes has an identical twin, there is a 25 to 50 percent chance that the twin will develop diabetes. But if a person with type 2 diabetes has an identical twin, there is a 60 to 75 percent chance that the person will develop diabetes.

    More evidence for the role of genes in type 2 diabetes comes from studying certain ethnic groups. Compared with Caucasians, African Americans, Asian Americans, Hispanic Americans (except Cuban Americans), and Native Americans all get type 2 diabetes more often. Native Americans have the highest rate of type 2 diabetes in the world. Hispanic groups, such as Mexican Americans, that share genes with Native American groups (where there has been cultural mixing) have a higher rate of type 2 diabetes than Hispanic groups, such as Cuban Americans, where less intercultural contact has occurred.
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    Did you know that being an apple shape (more fat around your middle) rather than a pear shape (more fat around your hips) puts you at greater risk of type 2 diabetes and heart disease? Another measure you can take is of how far it is around your waist (your waist circumference).

    Take a tape measure (a flexible one is best) and place it snugly (not tight) around your waist. Compare the length around your waist to the number below. If the length of your waist is the same or bigger than the numbers below, you have too much weight around your waist.
    • Men: over 40 inches
    • Women: over 35 inches
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    Your blood glucose level is monitored by cells in your pancreas that are the lone producers of insulin, the hormone that transports glucose from the outside to the inside of your cells so your body can transform that glucose into usable energy.

    When the alarm sounds to make more insulin to help transport the extra blood glucose, the body can act like a chubby runner at the front of a marathon; it just can't keep up. It huffs and puffs and makes more insulin, but the demand is just too great.

    A person with type 2 diabetes has lost this glucose-insulin struggle. And so a vicious cycle begins: It made sense for us to store fat to survive when we were likely to have famines periodically or failed bison hunts, but today that fat causes insulin resistance, which makes us eat more, which causes more fat, which is associated with eating more, so we accumulate more fat, which causes more insulin resistance, and so on.