Nutrition Articles

What Really Causes Type 2 Diabetes

Learn Which Risk Factors Are Preventable

Contrary to popular belief, type 2 diabetes (a chronic disease) isn’t caused by eating lots of sweets. Actually, the cause is still unknown, but there are certain factors that are known to increase a person’s risk of developing this metabolic disorder. There are two main categories of risks that are associated with the development of type 2 diabetes—those that you can't change (uncontrollable), and those that you can (controllable).  The more risk factors you have, the higher your risk for developing type 2 diabetes.

Uncontrollable Risk Factors
Although these factors are out of your control, it is important to know whether you fall into any of these higher-risk categories.
  • Your age. Your risk of developing type 2 diabetes increases as you get older. Diabetes most often affects people over age 40, and people over 65 are at even higher risk. It is recommended that people aged 45 and older be tested for diabetes every three years.
  • Your family history. There is some evidence that diabetes runs in families. If your parent or sibling has type 2 diabetes, for example, your risk of developing diabetes increases.
  • Your race. Certain ethnicities—African Americans, Hispanic/Latino Americans, American Indians, Asian Americans, and Pacific Islander Americans—are at high risk for developing type 2 diabetes.
  • Your health history. Women who had gestational diabetes during pregnancy are 50% more likely to develop type 2 diabetes within 10 years. Giving birth to a baby over nine pounds also increases a woman's risk. Other illnesses and conditions that are risk factors for type 2 diabetes include pre-diabetes and any condition that affects the ability of the pancreas to produce insulin, such as pancreatitis, PCOS (polycystic ovarian syndrome), high blood pressure, unhealthy cholesterol levels, metabolic syndrome, impaired glucose tolerance (IGT), and vascular disease (such as heart attack or stroke).
You may fall into many of the above categories, or none of them. In either case, pay close attention to the controllable risk factors below, as there are several lifestyle habits that you CAN change to help reduce your chance of developing type 2 diabetes.

Controllable Risk Factors
Factors within your control are related to your lifestyle—the choices you make each day about what to eat and whether or not to exercise. Even if you have a high risk for diabetes, you can take control of these factors to reduce your risk.
  • Your weight. More than 80% of people with type 2 diabetes are overweight or obese. Carrying excess weight around your abdomen and waistline (known as the "apple" shape), greatly increases your risk of diabetes. While you can't change where your body stores fat (that's genetic), you can lose weight, no matter what your body shape. Calculate your waist-to-hip ratio to find out more about your body shape and how to improve it. You can decrease your risk with each pound you lose. In fact, dropping just 10% of your body weight (25 pounds for someone who weighs 250 pounds) can have major benefits. Use your free SparkPeople nutrition plan to reach your weight-loss goals.
  • Your activity level. Physically inactive people are more likely to develop type 2 diabetes. If you don't exercise consistently, or if you take part in planned exercises fewer than three times per week, you could be at risk. To get started, read exercising with diabetes.
  • Your medications. Several types of medications, including antidepressants and antipsychotic drugs, can dramatically increase your risk. If you are already at high-risk for developing diabetes, talk to your doctor about finding an alternative medication for your condition that doesn't have this negative side effect.
  • Your diet. Though the types of food you eat do not actually cause diabetes, what you choose to eat is directly related to your health and  your weight. If your diet is high in calories and unhealthy foods (sugar, saturated fat, cholesterol, trans fats), your diet could be contributing to your diabetes risk. Use the Nutrition Resource Center as a guide for healthy eating habits.
  • Your drinking habits. Heavy alcohol use can permanently damage the pancreas and impair its ability to secrete insulin, which can result in type 2 diabetes. Limit alcohol consumption to no more than one drink daily for women or two drinks daily for men.
  • Your smoking habits. Smokers are 50% to 90% more likely to develop diabetes than nonsmokers. Smoking can harm the pancreas, increase blood sugar levels, impair your body's ability to use insulin, and cause a host of other health problems. If you smoke, taking steps to quit today can reduce your risk of serious health problems, including type 2 diabetes.
The good thing is that you can work on changing the risk factors that you can control. Studies show that maintaining a healthy weight and regularly engaging in physical activity can reduce the risk of type 2 diabetes nearly 60 percent. You should work closely with your doctor to develop a diabetes risk-reduction plan that is safe and effective for you.
For more specific information or help, talk to your health care provider. The American Diabetes Association's National Call Center also offers live advice from 8:30 a.m. to 8 p.m. EST, Monday through Friday at 1-800-DIABETES or 1-800-342-2383.

This article has been reviewed and approved by Amy Poetker, Registered Dietitian and Certified Diabetes Educator.

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Member Comments

  • I was glad you mentioned about diabetes and sugar consumption- my aunt had type 1 for years and even thought she was a good church going Catholic lady she used to say that it was B******T that sugar caused diabetes.
  • Good information. Thanks
    those uncontrollable risk factors do not mean that we should resign and accept that as we age, we naturally get diabetes. we cannot control these factors, but nonetheless we can avoid getting the diabetes. getting the diabetes at later age mostly means that something was not right with other factors earlier in the life, whether controllable or not. this was just a theoretical input in the article.
    while it is true, that diabetes does not develop only after eating sweets, later on it was correctly mentioned that sugars can also contribute to this condition, especially in the liquid form, including sweetened juice drinks. it is the imbalance of several factors at once and everybody has a different blend of these factors present.
    the main point is that with controlling these factors one does not have to develop diabetes type 2 at all, regardless of those uncontrollable factors, too.
  • This article is very old and needs updating that is based on more current science.
  • Keepyourpower- don't worry, whoever told you that about the health insurance reforms ("Obamacare") was ignorant or lying to scare you. You won't go to jail and you won't be paying 30K for insurance with a 30K deductible. It's the current system that is really the problem because the private companies are for-profit and maximize profit by trying to push us out of the pool when we get sick, injured, or older. I struggled to pay increasing premiums in my fifties, rising 30-35% every year. A simple UTI mismanaged by a local doctor put me in the hospital and ran up expenses for expensive unnecessary tests. I was in big debt for 6 years, since my insurance company cherry picked its way through the bills instead of paying everything above the deductible (as my policy was supposed to do) and I was out of work for several months thanks to the incompetent doctor and hospital. Soon after the hospitalization, they pushed me into double the deductible and of course raised the premium another 35%. Finally they wanted 53% of my income, which would not even have left enough for the deductible after taxes and business expenses. I had to cancel. There were few choices in my state and all were equally bad, so I've been uninsured for several years. But I couldn't afford a doctor even with insurance and couldn't rely on a policy to actually pay. So like many Americans, with or without insurance I would be just one injury or serious illness away from bankruptcy and losing everything anyway. And yet I was just out of range for eligibility for a state insurance program, which would have a reasonable premium strictly tied to income (as other developed countries do it).

    But I ran my income figures through the health insurance reform calculators (just google for them), and if the politicians don't destroy the program before it gets started - I will be able to get good insurance again for a very reasonable percentage of my income (9-10%). The plan will still have us paying more than other countries (Australians pay just a few percent and have access to good medic...
    With a strong family history of diabetes, and a job that requires some hours at the computer mixed with opportunities for movement, this article was very helpful. Also, I did not realize that my Prozac can actually contribute to my weight loss (looked it up online). And, as I study depression (also a strong family history), I find that a healthy diet and regular exercise are also helpful with this disorder. What I did not realize was that my two beers a night are actually contributing to the depression. Thanks for making me think, look things up for myself and for giving straight information that we can rely on.
  • JT1234
    I really love some of the contributors here, they really know their stuff!
  • I really think that in a lot of cases the "family connection" or heredity are taken for granted! I know that in 1994 when I was diagnosed with type 2 diabetes I was told, “Well, your mother and both her sisters had diabetes so you will be on pills the rest of your life. It is a heredity disease”
    As for the cause of diabetes, it remains elusive to the main stream medical professionals yet in case after case diabetes has been curedb y alternative medicine practitioners. I know that the drug industry will not sponsor any study to prove or disprove some of these cures as natural cures or natural medicines don’t make them billions of dollars each year but it needs to be done.
    I started reading on a diet to help cure my wife’s inoperable lung cancer and supported her by learning and implementing this diet. To my amazement it helped my diabetes. In Nov of last year I was on the max dosage of metformin (2000mg@day) and max dosage of Lantus and did not have control of my diabetes even though for years I watched my carbs, lost weight, and joined the gym. My A1C was 7+ at it’s best.
    I started this alternative medicine diet and one year later I am off all meds,(including Blood pressure and 2 cholesterol drugs). I am at my high school weight, and my healthy blood profile astounds my doctor. I am not yet cured as it took years to build my insulin resistance. I still must watch my acid level until my body heals itself as the authors said it would. I will never go back to eating like I used to.
    The authors of 3 of the 4 books I have studied on this diet claim that many diseases if not all are caused by an acidic diet resulting in your body and immune system being compromised in order to keep your body from being too acidic and untimely death. This acidic condition causes immune system problems, vitamin and mineral deficiencies and inflammation of organs and the cardio systems as it tries to rid your body of this acidic condition.
    I do not count carbs as such but just check my balance of 50% carbs, 30% GOOD fats, and 20% protein by logging my...
  • Got cut off is the rest
    nflamed left would really be appreciated!

    Money is tight for us all. But the government says I am not eligible for disability payments because I have not worked 5 of the last 10 years ..putting money into SS. Hey how can I? I have tried to work. I just cannot..outside the home. The porphyria was the big factor back then. I cannot be in the sun for very long. I do not have a college education..but am self learned. My alimony will run out soon, and I will be homeless then. So I truly need to get this body in the best shape I can. I also cannot take many drugs. Especially the newer ones. So medication is out. It all must be natural.

    Oh! And with Obamacare coming soon...I will be one of those put in jail for not paying the huge taxes, and not able to find insurance. least I will have 3 hots and cot! And I won't have to pay $30k a year in insurance, with a $30k deductible.... and taxes. So I guess there is an upside to being put in the penitentiary. Let's just hope the inmates do not find out I was once a police officer!

    Sad isn't it? A person cannot help what they have inherited...yet they are imprisoned for it!!! I am a good person, I do not smoke, drink alcohol, (can't with porphyria anyway) and do not do drugs. I just stay home mostly, and try to take care of myself. I am a people person and this is just killing me.

  • I just had a 12 hour fasting glucose test. It was 137. They said the normal was only as high as 99. So ..since my doctor never got back to me...I am guessing I have Type 2. I also had other tests done. Seems I am hypothyroid too. Because of those symptoms...losing hair, not being able to sleep, dry, brittle, splitting nails...I went to see the doc, and paid the exorbitant price to walk in the door. I do not have health insurance. I have to save money to see the doc. I still need to see a dentist.

    I also have Acute Intermittent Porphyria. And Guess what the natural thing to do is..when you feel an attack coming on? Eat Carbs and Sugars. Because of the porphryia, I now weigh 230. I did weigh 240, but since I got the results of the test I have lost 10 pounds. But I live in a vicious circle. Do not eat carbs and sugars..because I probably have diabetes...or eat carbs and sugars to keep the Porph monster at bay? And then the thyroid? And possible kidney problems according to the blood tests. There do not seem to be doctors who care enough to sit down with me, to figure this out. So I am going to try a naturopath. She is my last chance.

    I have many other disabilities that keep me from doing strenuous I do my best by stretching and light exercises on the bed, and using the wall, and doorway. I KNOW I need to do strength training. I do not have the money to go to a gym. I have a TOTAL GYM at home, but it is gathering dust. Why? Because almost all the exercises I have seen on the tapes are using your knees. I broke one badly years ago as a police officer and now can hardly walk. I surely cannot put my body weight on it or do squats. I have tried contacting the people at Total Gym, but cannot get through to anyone who cares.

    If anyone has some ideas on what I can do to lose this weight..I can not lose over 10% at time, due to the porphyria...alrea
    dy had the beginnings of an attack...but thwarted that one off....and also how to exercise when you have severe arthritis, scoliosis of the lower spine, a bad right knee, and an inf...
  • I found the title of this article just a bit deceptive. What really causes Diabetes 2? Right in the first paragraph all it does is state sugar doesn't (which I'm certainly proof of) and that "Actually, the cause is still unknown ..." Risk factors =/= causation. Avoiding all risk factors that can be changed in one's lifestyle is not a guarantee of becoming immune to or getting rid of diabetes.

    Also, I would throw in a comment on sugar. Personal anecdote-wise, I'm proof that eating tremendous amounts of sugar does NOT give someone diabetes. BUT, given the silent nature of many of diabetes symptoms, there is a huge danger that someone not yet diagnosed could be exacerbating the hidden damage - hastening along things like damage to the eyes and damage to the extremities (leading to amputation), and making it considerably more difficult for them to adjust after a diagnosis.

    We don't have to become frothing at the mouth health nuts and avoid sugar like poison, perhaps even extending that to anything like white bread that converts rapidly. We do need to rein in dietary excesses and make sure we're properly nourishing our body with a variety of nutrients. A sugary treat can be a small portion of our planned nutritional allotment, but shouldn't be the main feature at multiple meals.
  • I am flabbergasted that there is not a single mention of insulin resistance in this article. Try this one then:

    "High plasma levels of insulin and glucose due to insulin resistance are a major component of the metabolic syndrome. If insulin resistance exists, more insulin needs to be secreted by the pancreas. If this compensatory increase does not occur, blood glucose concentrations increase and type 2 diabetes occurs."

    That's a summary based on information that's readily available at this site:


    What causes your blood glucose levels (and therefore your insulin levels) to rise? Sugar and starch. Cut them and watch your blood glucose levels normalize. You may have inherited a genetic TENDENCY to develop Type 2 but it's more than likely your LIFESTYLE that has triggered its onset. Change the lifestyle and you quite likely will change the outcome.

    Did I mention that insulin is also the hormone that's most responsible for causing fat to be stored rather than burned? Yup. It's indisputable, a fact found in every Biochemistry text. It's what allows you to become fat, particularly in the midsection.
    I'm currently reading a book "Start with Food" that suggests diabetes is attributed to chronic inflammation in the body caused by our nutritional choices. I'm a believer. I have a friend that came of their diabetes medication by adhering to to the recommendations in the book.
    I had learned recently that Type II Diabetes is also caused by autoimmune disease, especially Polyendocrine Autoimmune disease. I wish I had know this earlier. It is never written in the "causes" or in the risk factors. So much for seeking information. I had to get into medical journals to find this out. :(
    Just remember every-body its almost always about your carbs. It takes me a long time to buy my groceries, for reading about how many carbs in certain foods!! I think the SparksPeople' will help qiute a bit!! A big Thanks so far!!

About The Author

Nicole Nichols Nicole Nichols
A certified personal trainer and fitness instructor with a bachelor's degree in health education, Nicole loves living a healthy and fit lifestyle and helping others do the same. Nicole was formerly SparkPeople's fitness expert and editor-in-chief, known on the site as "Coach Nicole." Make sure to explore more of her articles and blog posts.

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