What Causes Insulin Resistance
Researchers dont understand exactly what causes cells to become insulin resistant. But its possible that carrying excess weight and being physically inactive contribute:
- Belly fat can increase inflammation in the body, which may lead to insulin resistance.
- Exercise causes changes in your body that help keep blood sugar levels in balance. Lack of activity makes it difficult to maintain that balance.
Symptoms Of Type 2 Diabetes
Symptoms of type 2 diabetes may include feeling tired, increased hunger or thirst, losing weight without trying, urinating often, or having trouble with blurred vision. You may also get skin infections or heal slowly from cuts and bruises. Some people with type 2 diabetes may not realize they have it because symptoms often develop slowly and go unnoticed. Sometimes older adults dismiss these symptoms as getting old, but they can be signs of a serious problem. Talk with your doctor if you have any of these symptoms.
Obesity Is One Risk Factor For Diabetes But Some Thin People Can Also Develop The Disease
A 21-year-old football player ended up in the office of Chloe Paddison, RDN, LD, a registered dietitian and education specialist at St. Josephs/Candler, after suffering from excessive thirst.
He was fit, but drinking a gallon of sweet tea a day, Paddison recalls. The culprit was type 1 diabetes, in which the body cant make the insulin needed to keep a persons blood sugar at a healthy level.
Type 1 diabetes is an auto-immune disorder and is independent of weight, Paddison says. But recent studies have shown that 1 in 5 normal-weight adults can be at risk for prediabetes, which if not managed can develop into type 2 diabetes within five years.
The popular perception of a person with diabetes is that they are overweight or obese, or that they were when the disease developed. Though obesity is a major risk factor for type 2, that fact doesnt tell the whole story.
Rather than take the perspective of the condition our body is in, I want patients to look at the conditions we subject our bodies to, Paddison explains. Genetics are one of the biggest players in weight, so someone with great weight-related genetics could be living a very unhealthy lifestyle.
The lifestyle that puts thin people are risk for diabetes includes:
- Little or no physical activity
- Eating too many carbohydrates, especially from simple sources like sugary drinks
- Not managing stress
- Disrupted sleep patterns and grazing/snacking late into the night
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In Pregnancy And Parenting
CDC , 4.6 to 9.2 percent of pregnancies may be affected by gestational diabetes. In up to 10 percent of them, the mother is diagnosed with type 2 diabetes just after the pregnancy. The rest of these women have a 35 to 60 percent chance of developing type 2 diabetes within 10 to 20 years. This risk decreases if the woman leads an active lifestyle and maintains an ideal weight.
A child has a 1 in 7 chance of developing diabetes if one parent was diagnosed before age 50. If the parent was diagnosed after age 50, the child has a 1 in 13 chance. The childs risk may be greater if the mother has diabetes. If both parents have diabetes, the childs risk is about 50 percent.
Measuring Glucose In The Blood
Measuring the amount of glucose in the blood can help healthcare providers tell if a person has diabetes or prediabetes. Blood glucose can be measured after a person has fasted for 8 hours. It can also be measured 2 hours after drinking a special sweet liquid . Another way to tell if a person has diabetes or prediabetes is to measure hemoglobin A1c in the blood. HbA1c levels show your average glucose levels during the past 2 or 3 months. The American Diabetes Association recommends that testing for prediabetes and diabetes should be considered for people who are overweight and have other risk factors for diabetes.2 For people without these risk factors, ADA recommends that testing for diabetes begins at age 45. 2
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Whos At Risk For Prediabetes
If you have risk factors for prediabetes, talk to your healthcare provider about getting your blood sugar checked regularly. These prediabetes checks are essential because prediabetes often has no symptoms. You can have it for years and not know it.
You may also be at higher risk of prediabetes due to:
- Parent or sibling with Type 2 diabetes.
- Ethnicity. Being African-American, Hispanic, Native American, Asian-American race or a Pacific Islander.
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You Have A Parent Or Sibling With Diabetes
Having a first-degree relative such as a parent or sibling with diabetes doubles, maybe even triples, your own risk of developing the disease. But having whats considered a family history of diabetes is about more than just shared genes. Some proportion of family history is due to the environment that a family shares, says Carnethon. That shared environment can include family meals and other behaviors that predispose to diabetes. If, for instance, you grew up in a physically inactive family that sat down to large meals on a daily basis, youre likely to do so into adulthood.
Although you cant do anything about your genetic makeup, you can alter your lifestyle. Your genes dont have to define your destiny, since genes interact with the environment to promote, or prevent, disease, Carnethon says. Knowing that a family member has diabetes should encourage other members of the family to adhere to healthy behaviors to prevent the onset of diabetes. Those behaviors will include regular exercise and a healthy diet.
Youve Had Gestational Diabetes
Up to 10 percent of women in the U.S. are affected by gestational diabetes, a type of diabetes that can occur during pregnancy. Even if a womans blood sugar levels go down after giving birth, shes still at higher risk for type 2 diabetes later in life.
The hormonal changes during pregnancy serve as a stress test to the cells making insulin, Hamaty says. The demands for insulin increase significantly, and if they arent met, gestational diabetes develops. About 50 percent of women with gestational diabetes go on to develop type 2, according to the CDC.
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Who Is At Risk For Type 2 Diabetes
Many Americans are at risk for type 2 diabetes. Your chances of getting it depend on a combination of risk factors such as your genes and lifestyle. The risk factors include:
- Having prediabetes, which means you have blood sugar levels that are higher than normal but not high enough to be called diabetes
- Being overweight or having obesity
- Being age 45 or older
- A family history of diabetes
- Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander
- Having acanthosis nigricans, a skin condition in which your skin becomes dark and thick, especially around your neck or armpits
Tips For Aging Well With Type 2 Diabetes
- Lean on your medical team, which may consist of an endocrinologist, a podiatrist, an RDN and a CDCES, and other specialty health professionals such as a therapist for mental healthcare. In many cases, your primary care physician will be your main healthcare provider for diabetes care.
- Stick to your medication regimen, and be open to potential medication adjustments.
- Take insulin if your doctor says you need it.
- Dont smoke, or quit the habit.
- Eat diabetes-friendly foods and practice portion control.
- Exercise regularly.
- Regularly check your blood sugar.
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Type 2 Diabetes And Covid
The CDC points out that having type 2 diabetes can make it more likely that you will experience complications from COVID-19, the disease caused by the novel coronavirus. Nonetheless, proper blood sugar management can help lessen this risk.
Everyday Health editors attend the ADCES annual meeting to connect with certified diabetes care and education specialists, registered dietitian nutritionists, and people like you, who are looking for ways to better manage blood sugar, diet, medication, and more. Check out information on the next meeting here.
The ADA is considered the leading nonprofit for type 1 and type 2 diabetes education. The ADA’s free yearlong program Living With Diabetes offers top-of-the-line resources for anyone new to living with diabetes. Youll get access to their newsletter, expert Q& A session, and online support system, among other perks.
One of our favorite features from the AHA is a go-to resource for preventing heart disease: Know Diabetes by Heart. The ADA-supported initiative lays out a step-by-step guide for keeping your heart healthy while living with diabetes.
Prediabetes Flies Under The Radar
You can have prediabetes for years without symptoms. This means you likely wont know you have prediabetes until serious health problems show up. Talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, including:
- Being overweight
- Being 45 years or older
- Having a parent, brother, or sister with type 2 diabetes
- Being physically active less than 3 times a week
- Ever having gestational diabetes or giving birth to a baby who weighed more than 9 pounds
Race and ethnicity are also a factor. African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.
Ready to find out your risk? Take the 1-minute prediabetes risk test and be sure to share the results with your doctor.
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Health Problems Linked To Type 2 Diabetes
If your blood sugar is frequently imbalanced, you may be at a greater risk for the following type 2 diabetes complications.
Cardiovascular disease
Diabetic retinopathy In diabetic retinopathy, high blood sugar weakens the capillaries that supply the retina, the light-sensitive layer of tissue at the back of the inner eye.
The capillaries then swell, become blocked, or leak blood into the center of the eye, blurring vision. In advanced stages, abnormal new blood vessels grow.
Diabetic neuropathy Neuropathy, or nerve damage, can affect any nerve in your body. Most commonly, it affects the nerves in the feet, legs, hands, and arms this condition is called peripheral neuropathy.
Peripheral neuropathy can cause tingling, burning, pain, or numbness in the affected areas.
The pain of peripheral neuropathy is difficult to control, though some find topical products that contain capsaicin to be helpful.
Diabetic nephropathy In diabetic nephropathy, the nephrons in the kidneys become damaged from chronic high blood sugar.
High blood pressure compounds the problem, and high cholesterol appears to contribute to it as well.
In the early stages of diabetic nephropathy, you may not notice any symptoms, but standard blood and urine tests can detect early signs of dysfunction, and early treatment can stop or slow its progression.
Diabetic ulcer People with diabetes have an increased risk of developing foot ulcers .
Statins And Diabetes: How Big Is The Risk
Studies linking statins to diabetes receive media attention but should not distract clinicians from the goal of reducing cardiovascular risk.
At a Glance
- Media reports on the risks of statins including for developing diabetes can cause patients to be anxious and even stop taking a statin.
- Statins have been shown to reduce cardiovascular events and mortality, so the risk of diabetes should not interfere with patients taking them.
- Cardiovascular disease and diabetes risk can both be reduced by lifestyle changes, so when discussing patient concerns, clinicians can emphasize the need to intensify efforts to lose weight, improve diet, and increase exercise.
Almost eight years after the Food and Drug Administration added a warning to statin labels about the drugs increasing fasting blood sugar and hemoglobin A1C levels and by inference raising the risk of new-onset diabetes a new observational study on the diabetes risk received a great deal of media attention in 2019.
The study was picked up by Prevention magazine and National Public Radios Peoples Pharmacy and led to eye-catching headlines: Statins may double the risk of diabetes, proclaimed medicalnewstoday.com. But the findings did not differ much from those of previous studies and should not affect statin use, experts tell Endocrine News.
That New Study
Effect on Patient Perception
If somebody needs a statin, it is always a discussion with the patient, says Subramanian.
Diabetes Prevention
Resource
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How The Laboratory Can Help
Quest Diagnostics offers tests to find out if you are likely to develop diabetes. Test results can also tell if you have prediabetes or diabetes. Quest also offers tests to check if treatments are working, if you have diabetes. Tests are also available to check your risk for other health problems, such as heart and kidney disease. For more information visit the Quest Diagnostics .
Diet Exercise And Obesity
The number one risk factor for type 2 diabetes is being overweight or obese. A person is considered overweight when their body mass index is over 25 and obese when their BMI is over 30. Today, over 140 million adults and over 14 million children in the United States have obesity.
The main symptom of obesity is excessive body fat, which increases the level of fatty acids in the blood. As these fats accumulate in the liver, the function of the liver becomes increasingly impaired. And, one of its main functions is the production and storage of glucose.
Obesity triggers the onset of insulin resistance which, in turn, contributes to the onset of type 2 diabetes.
Risk factors for obesity and being overweight include:
- Excessive caloric intake
- Lack of exercise
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Drink Water As Your Primary Beverage
Sticking with water as your drink of choice will help you limit beverages that are high in sugar.
Sugary beverages like soda and sweetened fruit juice have been linked to an increased risk of both type 2 diabetes and latent autoimmune diabetes of adults .
One large observational study in 2,800 people found that those who drank more than 2 servings of sugary beverages per day had a 99% and 20% increased risk of LADA and type 2 diabetes, respectively .
In addition, one review found that 1 serving of sugar-sweetened drinks per day may increase the incidence of type 2 diabetes by 18% (
25 ).
One large study in more than 53,000 Japanese adults found that diabetes risk in those who smoke decreases over time after quitting. Smoking cessation for 10 or more years may even decrease this risk to about the same level as those who never smoked .
SUMMARY
Smoking, especially heavy smoking, is strongly linked to diabetes risk. Quitting has been shown to reduce this risk over time.
Family Health History And Diabetes
If you have a mother, father, sister, or brother with diabetes, you are more likely to get diabetes yourself. You are also more likely to have prediabetes. Talk to your doctor about your family health history of diabetes. Your doctor can help you take steps to prevent or delay diabetes, and reverse prediabetes if you have it.
Over 37 million people in the United States have diabetes. People with diabetes have levels of blood sugar that are too high. The different types of diabetes include type 1 diabetes, type 2 diabetes, and gestational diabetes. Diabetes can cause serious health problems, including heart disease, kidney problems, stroke, blindness, and the need for lower leg amputations.
People with prediabetes have levels of blood sugar that are higher than normal, but not high enough for them to be diagnosed with diabetes. People with prediabetes are more likely to get type 2 diabetes. About 96 million people in the United States have prediabetes, but most of them dont know they have it. If you have prediabetes, you can take steps to reverse it and prevent or delay diabetesbut not if you dont know that you have it. Could you have prediabetes? Take this test to find out.
Even if you have a family health history of diabetes, you can prevent or delay type 2 diabetes by eating healthier, being physically active, and maintaining or reaching a healthy weight. This is especially important if you have prediabetes, and taking these steps can reverse prediabetes.
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Can Prediabetes Put My Vision At Risk
Diabetes and prediabetes can increase your risk of vision loss. Prediabetes can cause retinopathy. This change to your eyes structure can lead to vision loss. See your eye doctor if you notice blurry vision, which can be a sign of retinopathy or another condition.
Even if you have no prediabetes symptoms, get a dilated eye exam every year. And talk to your healthcare provider about getting tested for prediabetes if you are older than 45 and have excess weight.