Diabetes Risk Factors

Diabetes is a chronic health condition in which your body is unable to process and utilise glucose from the food you consume. There are three major types of diabetes, each with distinct causes and risk factors: type 1, type 2 and gestational diabetes. There are some other rarer types of this disease as well, including monogenic diabetes and cystic fibrosis-related diabetes. However, all forms of diabetes cause people to have high glucose levels in their bloodstream, leading to other health conditions, such as heart disease, stroke, and nephropathy. As there is currently no cure for diabetes, it is essential to identify if you are at risk as early as possible to adopt management strategies that may assist in preventing some types of diabetes.

What is diabetes?

Diabetes mellitus, simply referred to as diabetes, is a lifelong metabolic disorder that involves elevated levels of glucose in the bloodstream. Generally, our body cells need glucose as a source of energy. Once we consume food, dietary carbohydrates are converted to glucose, which is then regulated by insulin and glucagon hormones to maintain set sugar levels in the blood and cells.

Glucagon and insulin are the key hormones produced by clusters of cells (islets of Langerhans) in the pancreas. Insulin reduces blood sugar levels by acting as a “key to unlock the door” and transporting glucose from the bloodstream to the cell. Meanwhile, glucagon is the counter-regulator of insulin. It controls glucose levels in the blood, ensuring blood sugar levels do not drop too low (hypoglycaemia).

In people with diabetes, the body finds it hard to transport glucose from the blood into the cells due to inadequate or no insulin production. This causes extra sugar build-up in the blood (hyperglycaemia), leading cells to starve for glucose despite having them within the blood circulation. Long-term elevated glucose levels can severely damage body organs and tissues, including the heart, eyes, kidneys, blood vessels and nerves. 

The International Diabetes Federation (IDF) statistics report stated that in 2021 537 million adults worldwide were diabetic. This figure is expected to increase to around 643 million by 2030. According to IDF global findings, nearly one person dies every 5 seconds due to diabetes – 6.7 million deaths in 2021.

Type 1

Type 1 Diabetes, or juvenile diabetes, is when the body cannot produce enough insulin. This type of diabetes is due to type 4 hypersensitivity or a cell-mediated response in which a person’s immune system (T-cells) attacks insulin-secreting pancreatic cells. In type 1, a genetic abnormality generates a loss of self-tolerance among immune cells, which coordinates to harm pancreatic cells and limit their insulin production. Approximately 5–10% of diabetic individuals have a type 1 condition, and they require insulin injections to maintain blood sugar daily. For this reason, it is also known as insulin-dependent diabetes.

Type 2

In type 2 diabetes, or adult-onset diabetes, the pancreatic cells do not produce enough insulin or produce enough, but the body does not respond to it. The exact reason is still not fully understood, but due to certain factors, the glucose transporters within cells do not react normally to insulin, which is an essential step needed for glucose to enter the cell. Consequently, this results in insulin resistance. Type 2 is one of the most prevalent types of diabetes, affecting up to 90% of the population.

Gestational diabetes mellitus 

Gestational diabetes mellitus is characterised by elevated blood glucose levels during pregnancy and is linked to a number of serious complications affecting both mother and child. Gestational diabetes usually goes away after childbirth. However, the affected mother and her child are at great risk of developing type 2 diabetes.

Diabetes type 1 risk factors

The risk factors for type 1 are still unclear compared to type 2 and prediabetic conditions. Type 1 diabetes is not caused by diet or lifestyle; instead, it is caused by an autoimmune response. The presence of a genetic marker called human leukocyte antigen (HLA complex) makes one susceptible to type 1 diabetes. Many scientists and researchers have been probing to find the right answers for the cause of type 1 diabetes.

Some studies have suggested that viral infections might act as a potential trigger for the disease, which can turn the immune system to fight against the body.1  It is also thought that a few autoimmune conditions that share the same genetic marker, HLA complex, like Grave’s disease, pernicious anaemia and multiple sclerosis, may potentially raise the risk of developing type 1 diabetes.2

Family history

Type 1 is most common among people with a family history of diabetes. One is especially at risk if their first-degree family relative (parent, sibling or child) was diagnosed with type 1 diabetes. If a person has a close family member with type 1 diabetes, it is advised that the person get tested for diabetes.

Diabetes type 2 risk factors

Several risk factors can increase the chances of developing type 2 diabetes.

Obesity

Obesity is the most common modifiable risk factor in the development of type 2 diabetes. Lack of exercise and fat distribution aggravate insulin resistance. Obese adults have a five-fold higher prevalence of type 2 diabetes. In the UK, almost 90% of adults have type 2 diabetes.3

Age

Although type 2 diabetes can occur in all age groups, it is more common in older people (45 years or older).

Family history

Having a parent, sibling or child with diabetes can increase your risk of developing type 2 diabetes.

History of gestational diabetes

Having a history of gestational diabetes can significantly impact the likelihood of developing insulin resistance.5 Therefore, there is a substantial likelihood that glucose intolerance would progress and result in type 2. More than half of all women with gestational diabetes develop type 2 diabetes later in life.

Gestational diabetes risk factors

Gestational diabetes risk factors include:

PCOS

Polycystic ovarian syndrome (PCOS) is a condition that affects a female’s reproductive system, specifically the ovaries. 6 PCOS can lead to impaired glucose tolerance and induce insulin resistance. Hence, this increases the chance of acquiring gestational diabetes.

Obesity

Maternal weight gain can seriously interfere with the body's metabolic processes and elevate the risks of gestational diabetes. If not managed properly, women can develop gestational diabetes, which may also have long-term consequences for developing type 2 diabetes in the future.

Family history

Studies have shown that a family history of diabetes has been recognised as a major risk factor for developing gestational diabetes. The risk factor is 1.5 folds higher due to hereditary factors than in women without a family history of diabetes.4

Conclusion

Diabetes is a group of severe, complicated and long-lasting metabolic conditions. The disease has no known cure, but living a healthy lifestyle, learning about the different forms of diabetes, and identifying risk factors may help to diagnose the condition earlier and improve diabetic management.

References

  1. Coppieters KT, Boettler T, von Herrath M. Virus Infections in Type 1 Diabetes. Cold Spring Harb Perspect Med [Internet]. 2012 Jan [cited 2022 Sep 2];2(1):a007682. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253029/
  2. Type 1 diabetes risk factors [Internet]. [cited 2022 Sep 2]. Available from: https://www.endocrineweb.com/conditions/type-1-diabetes/type-1-diabetes-risk-factors
  3. Public Health England. Obesity and Type 2 Diabetes. Practical Diabetes International [Internet]. 2014
  4. Larrabure-Torrealva GT, Martinez S, et al. Prevalence and risk factors of gestational diabetes mellitus: findings from a universal screening feasibility program in Lima, Peru. BMC Pregnancy and Childbirth [Internet]. 2018 Jul 18 [cited 2022 Sep 2];18(1):303. Available from: https://doi.org/10.1186/s12884-018-1904-0
  5. What is gestational diabetes? Diabetes UK [Internet]. [cited 2022 Oct 12]. Available from: https://www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes.
  6. Polycystic ovary syndrome (PCOS) - Symptoms and causes. Mayo Clinic [Internet]. [cited 2022 Oct 12]. Available from: https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Sadaf Ahmed

Master of Science - MSc, Physiology, Clinical & Molecular Hematology, Karachi University, Pakistan

Sadaf is an experienced writer who creates a quality and well-researched scripts particularly related to Health Sciences.

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