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How did I acquire Diabetes?

Posted on June 20, 2019 | No Comments on How did I acquire Diabetes?

Question: “No one in my family has diabetes, so how did i get it?”

While diabetes does tend to run in families, there are also many patients with this disease with no known relatives who have it.

There are 2 major types of diabetes. Type 1 usually manifests in the young and is characterized by destruction of beta cells in the pancreas which produce insulin, leading to absence of insulin. Type 1 diabetes mellitus has a genetic predisposition but will only develop if exposed to environmental triggers like viruses or chemical toxins. Thus, in type 1 diabetes, “genetics loads the gun but the environment pulls the trigger”, so to speak. However, despite these, the risk of inheritance for type 1 diabetes is not as high as that in the more common type 2 diabetes mellitus.

Type 2 diabetes mellitus develops due to insufficient insulin and/or an inability of the body to effectively use insulin (called insulin resistance) leading to elevations in blood sugar. Heredity presents as a major risk factor for type 2 diabetes, but it is NOT the ONLY major risk factor. You may not have the genetics for diabetes but you might have the other risk factors for its development. Here’s the checklist:

Obesity is the most prominent environmental risk factor for diabetes. In fact, studies show that the single best predictor of type 2 diabetes mellitus is obesity. With increased body fat, insulin, even in sufficient amounts is unable to act effectively on the cells and renders the body insensitive to insulin (insulin resistance). The more overweight you are, the greater your risk for the disease, regardless of bloodline. Obesity is fast becoming a worldwide epidemic. The most used measurement to determine if you are obese or overweight is the body mass index (BMI), calculated as follows:

A BMI of 25 classifies you as overweight while obese starts with a BMI of 30. However, because Asians tend to get the complications of obesity at a smaller body frame than the Caucasian counterparts, the BMI cutoffs are lower at 23 for the overweight and 25 for the obese Asian.

An important concept in obesity is the abdominal fat content or the fat in your belly. The amount of intra-abdominal fat in the body correlates well with insulin resistance because the fat present inside the abdomen is not just a stored form of energy, it is also considered an active organ that produces substances which counteract the action of insulin. This abdominal fat is indirectly measured by the waist circumference. Place the tape measure on top of your umbilicus and measure on inhalation. Feel for your lowest rib and the highest point of your hip and put the tape measure circumferentially at their midpoint. Men with a waistline of >90 cm and women with a waistline of >80 cm are most at risk for developing diabetes.

A sedentary lifestyle, defined as exercise8 pounds for Filipinos) puts you and your baby at risk of having diabetes later in life. Statistics show that as high as 40% of gestational diabetic mothers may develop diabetes in the next 10 years. Some studies also show that underweight newborns of women with or without sugar problems also have a risk for diabetes in adult life. This occurs when the proper lifestyle changes are not observed.

Any kind of severe stress, severe illness or certain medications like steroids can trigger diabetes. This is known as secondary diabetes mellitus.

Other conditions such as polycystic ovary syndrome in women particularly those who are overweight may also have diabetes.

Thus, genetics is actually only one of the factors influencing diabetes development. Diabetes is also a lifestyle disease. The triad of obesity, lack of exercise, and poor eating habits can give anyone diabetes. You don’t have to have a family history of diabetes to get it yourself. However, having a family history does give you a greater risk for it. Needless to say, the more risk factors that apply to you, the more chances that you will have diabetes.

But then again, you may just not be aware that any family member has diabetes. Your relative may have not been diagnosed yet because there are no symptoms.

Type 2 diabetes mellitus frequently goes undiagnosed for many years because the high sugar level develops gradually and is generally initially asymptomatic. In fact, 1 out of 3 people with diabetes is unaware that he has this chronic condition. Thus, people frequently get diagnosed with diabetes because of an incidental finding on an annual medical check up. So, you might actually have a genetic history of diabetes and just not know it.

Having diabetes in your family tree does not mean that you will automatically get it. Likewise, not having it in the family does not mean that you won’t get it either. The bottom line is, a healthy lifestyle is strongly advocated for every person across all ages, regardless of diabetes status or family lines.

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