TYPE 2, or adult onset diabetes as it is commonly called, is one of a group of three diseases that occurs as a result of the body's inability to make or store glucose, and this further affects how the body uses glucose for energy. Type 2 diabetes, which is the most common of the three forms of the disease, according to medical internist Dr Samantha Nicholson, usually develops as a result of one or a combination of risk factors. However, she notes that many of them are preventable.
“In the case of Type 2 diabetes, the body can still make some insulin, but is unable to utilise it as effectively as it should. What happens is that insulin usually allows cells to absorb glucose. However, in this case, the cells can become less sensitive to insulin, leaving more sugar in the blood. If the blood sugar remains high, this is how the person develops Type 2 diabetes,” Dr Nicholson explained.
Dr Nicholson said that while many physicians associate this type of diabetes with lifestyle choices, your chance of developing the condition may be dependent on several other factors. She shares 10 leading risk factors below.
1. Consistent high levels of sugar intake
Heavy sugar consumption, especially simple carbohydrates that cause surges in blood glucose, can lead to diabetes.
“The theory behind that is that if you have a heavy sugar intake consistently it causes your body to have to respond by producing more insulin. The repeated overworking of the pancreas to produce insulin to control those blood sugars can lead to pancreatic dysfunction and therefore predisposes you to diabetes. Many of this subset of patients can respond to pancreatic therapy, which basically gives the pancreas a reset and so you can recover pancreatic function and can stop using insulin, and then only be on one or two pills or nothing at all.”
2. Ethnic background
Some ethnic groups tend to have higher populations of people with the condition. Research shows that diabetes is more common in people of Hispanic/Latino origin, blacks, Native Americans, Asians, Pacific Islanders, and Alaska natives.
3. Excessive steroid use
Steroid use can predispose you to diabetes. In Jamaica, there aren't many people who take a lot of steroids by mouth like is seen with athletes or bodybuilders; however, what we do have in our local setting is a higher use of topical steroids — those applied to the skin.
“In Jamaica's current bleaching 'culture', a lot of the concoctions that are being applied to the skin have a very high concentration of steroids which are applied over time and in high doses. Topical steroids also take the form of medications for many patients with chronic inflammatory diseases such as rheumatoid arthritis, those who are chronic asthmatics, and patients with lupus,” Dr Nicholson said.
She explained that consistent use over time in high doses also predisposes a person to diabetes because steroids interfere with the metabolism of glucose and leads to hyperglycaemia.
4. Gestational diabetes
One of the complications that can affect women during pregnancy is gestational diabetes. However, while the condition usually resolves after childbirth, some women will be at a higher risk of developing Type 2 diabetes. Dr Nicholson said that women who get gestational diabetes and especially those who go on to have children born weighing nine pounds or above, face later risks of developing the condition, as do their children.
Obesity is a major risk factor for diabetes.
“The fat tissue, which is called adipose tissue, was once thought to be just fat and just sitting there, but now we know that it is active and is involved in storing oestrogen that can interact with sugar metabolisms in the body and predisposes you to diabetes,” Dr Nicholson said.
This is a major risk factor, so regardless of your size, age, and sometimes even lifestyle, once there is a strong family history then you are at an increased risk of developing the condition. Your risk increases, especially if both parents have the disease.
7. Little or no exercise
If you lead a sedentary lifestyle, this increases your chances of pre-diabetes, which may further develop into Type 2 diabetes since you are likely to gain excessive amounts of weight practising this lifestyle. When you stay active, however, Dr Nicholson said that this decreases insulin resistance and helps bodily insulin to be more effective.
8. Heavy alcohol consumption
Consuming moderate amounts of alcohol, according to some studies, might reduce your risk of developing diabetes. When you abuse the substance, however, it of course results in the reverse —your chances are increased.
“When you drink too much alcohol, much like with extreme levels of sugar consumption, it causes inflammation of the pancreas, which can impair the ability of the pancreas to secrete insulin, which can potentially lead to diabetes,” Dr Nicholson explained.
Research shows that as the population ages, the number of patients reported with diabetes globally also soars. This, scientists say, occurs because of two age-related life events — one being that the pancreas produce insulin less effectively as we age, and secondly that bodily resistance to insulin increases with age.
10. Pre-existing medical conditions
Persons with pre-existing conditions such as hypertension, abnormal cholesterol and triglyceride levels, have had a stroke, or polycystic ovary syndrome, are all at an increased risk of developing diabetes.