Nature vs. Nurture: Genetics, Lifestyle, and Diabetes Risk (2023)

There are currently over 400 million living with diabetes mellitus worldwide, and in recent times, there have been misconceptions about the factors that could cause this condition.

For instance, some believe that only eating lots of sugar puts them at risk. Unfortunately, that’s incorrect — according to Diabetes UK, smoking, genes, and alcohol, among many others, are also risk factors.

This article breaks down all the potential risk factors of diabetes and presents some ways to protect your health if you are at risk.

Each type of diabetes comes with its risk factors. Knowing them can help you spot the signs of the condition and get the right treatment.

In type 1 diabetes, your immune system destroys the beta cells that help produce insulin. Once damaged, the body can’t make insulin.

Some of the risk factors of type 1 diabetes are:

• Age: A person could have type 1 diabetes at any age, but it’s more prominent among children (4 years - 10 years), teenagers (13 years - 19 years), and young adults (over 19 years). A report shows at least 1 in 300 children and adolescents develop type 1 diabetes by 20 years old.

• Family History: Type 1 diabetes has an inherited susceptibility to the condition. So, if there’s a family history of the condition, there’s a high risk of getting it, too. If two parents have type 1, the chances of the children developing the condition are higher than when it’s only one parent. Researchers also discovered a higher likelihood of a child developing diabetes if the father has a history.

• Viral Infections: Certain viruses can increase the risk of type 1 diabetes, such as coxsackie virus (hand, foot, and mouth disease), German measles, and mumps.

People with type 2 diabetes don’t produce enough insulin for proper functioning, which makes glucose stay in the blood. Unlike type 1, type 2 diabetes can happen due to lifestyle factors like having excess body weight or being inactive.

Many times, type 2 diabetes is diagnosed in older people. However, other genetic and environmental factors play a role apart from age. Here are some of the major factors:

• Physical Inactivity: Lack of physical activity increases the chances of type 2 diabetes and makes management difficult for those with the condition. However, exercising can help prevent its development and improve the effects of anti-diabetic drug therapy or insulin therapy.

• Polycystic Ovary Syndrome (PCOS): PCOS is a common cause of infertility in women of different age brackets. Most women with PCOS are insulin resistant — their bodies can produce insulin but can’t effectively use it. The insulin resistance in these women makes them highly prone to type 2 diabetes.

• Overweight or Obesity: When one’s body accumulates high body fat, it can lead to type 2 diabetes. According to a study published in the National Library of Medicine, an increase in body mass index linearly increases the risk of type 2 diabetes. Hence, it’s imperative to maintain a healthy weight or work on losing weight.

Health experts sometimes use the term “borderline diabetes” to describe prediabetes. It’s when a person has a high blood sugar or blood glucose level but not enough for a type 2 diabetes diagnosis.

Without early lifestyle changes, anyone with prediabetes is significantly more likely to develop type 2 diabetes.

Here are the risk factors for developing prediabetes:

• Weight and Waist Size: A high waist signifies fat build-up around organs in most cases. This could cause insulin resistance as the hormone cannot get through the fat. According to a review, it’s best to maintain a wait size of less than 80cm for women, 94cm for men, and 90cm for South Asian men.

• Diet: Drinking sugary beverages, eating red meat, and consuming other processed foods are associated with the risk of prediabetes. Avoid foods that may also lead to high blood pressure, such as salty foods.

• Sleep: People with obstructive sleep apnea are at a high risk of insulin resistance. A study by the University of Hertfordshire shows a significant relationship between poor sleep and increased hemoglobin A1c (HbA1c) levels, which indicates high blood sugar.

During pregnancy, a woman’s body produces more hormones and goes through other changes, including weight gain. Those changes make the body’s cells use insulin less effectively, causing insulin resistance.

Many women have insulin resistance late in pregnancy, but some also experience it before getting pregnant. Women with insulin resistance before pregnancy usually need significant insulin at the start of pregnancy, causing gestational diabetes.

Here are some of the major risk factors of gestational diabetes:

• Prediabetes: Women with prediabetes before pregnancy have a higher risk of developing gestational diabetes during pregnancy due to insufficient insulin.

• Ethnicity: Racial/ethnic minority populations may be at a higher risk of developing gestational diabetes mellitus (GDM). A study shows that Hispanics and other races/ethnicities had 40% - 60% greater odds of GDM than non-Hispanic Whites.

• Previously Delivering a Baby Weighing Over 9 Pounds: Fetal macrosomia is a term that describes a newborn who is over 8 – 9 pounds.

The risk of developing diabetes may depend on whether one’s parents, sibling, or family relative has the condition. It could also be a combination of genetics and environmental factors.

There’s a link between gene mutations and the development of type 2 diabetes. If a health professional diagnosed you with type 2 diabetes, there’s a high chance that you are not the first with the condition in your family.

Here’s how genetics can be a major risk factor for those with type 1 and type 2 diabetes:

For type 1 diabetes, the risk of a person developing it is increased by HLA-DQA1, HLA-DRB1, and HLA-DQB1 genes. These genes belong to a family called the human leukocyte antigen (HLA) complex. They give instructions for producing proteins that are crucial in the immune system.

There are many variations of the HLA genes, and people may have a combination of the two variations — haplotype. The presence of haplotypes increases the risk of autoimmune disorders like type 1 diabetes.

Type 2 diabetes has a stronger link to family history than type 1. In a study involving twins, it was evident that genes played a major role in developing type 2 diabetes.

Your genes can interact with the environment to either switch your genes on or off. The process is described as epigenetics, and it plays a vital role in the development of type 2 diabetes, which is influenced tremendously by your environment.

Day-to-day activities can cause an increase or drop in blood glucose, even for people with type 1 and type 2 diabetes. For this reason, it’s crucial to maintain a healthy lifestyle.

Here are some areas to focus on:

You need to eat healthy foods to prevent and manage diabetes. Avoid meals containing too many carbs, as this increases blood sugar. For instance, you should reduce your intake of white bread or white rice as they are major carbohydrate sources.

Some of the best foods to eat are those with high protein and low sugar content. You should also have a good mix of green and leafy vegetables in your meals.

A meal with whole grains will give you high levels of fibre, which is important for people with diabetes. Consuming fibre helps slow the digestion process, which will stabilize your blood sugar levels.

Try substituting whole grain options for refined white grains in your next meal. Some whole-grain foods to try out if you have type 1 or type 2 diabetes are:

• Brown rice

• Bulgur

• Whole grain pasta

• Quinoa

• Millet

• Rye

• Whole grain bread

Eating beans is an excellent source of plant protein, which will help you satisfy your appetite and reduce your intake of carbs. Beans are also low on the glycemic index (GI) scale, making them good for regulating blood sugar.

Among the various types of beans, here are some to consider:

• Pinto

• Navy

• Black

• Adzuki

• Kidney

Nuts are generally great additions to your healthy diet, whether or not you have diabetes. It contains fatty acids that contribute to a healthy heart. They also provide nutrients like protein, magnesium, iron, and vitamin B6.

A 2018 study shows a relationship between eating walnuts and a lower risk of diabetes. They can also help prevent dilation, but relaxing and dilating blood vessels.

The omega-3 in fatty fish makes it an excellent addition to any diet. Omega-3 are polyunsaturated fats that help keep the body functioning, promoting brain and heart health.

According to a report, a diet containing high polyunsaturated fat can control blood sugar levels and lipids for people with diabetes.

Fruits promote vitamins and minerals and don’t contain carbs. Citrus fruits like grapefruits and oranges benefit people with diabetes because they have a low GI. They are also good sources of vitamin C, potassium, and folate.

Probiotics are bacteria in the human gut that help improve overall digestive health. A study shows that probiotic yogurt improves cholesterol levels in people with type 2 diabetes.

When you exercise or perform a physical activity, your blood glucose levels will reduce, and insulin sensitivity increases.

Even light exercises like house chores and gardening can improve blood sugar levels. Could you ask your healthcare provider about an exercise plan, create a routine for physical activity, and continuously check blood sugar?

If you need some ideas for physical activities, here are some moderate-intensity ones to consider:

• Dancing

• Cycling

• Walking briskly

• Swimming

• Playing sports

For people with diabetes, drinking alcohol can cause low blood sugar, leading to hypoglycemia. This is especially possible when combining alcohol with medications like insulin and sulfonylureas.

Low blood sugar occurs when the liver metabolizes alcohol instead of maintaining one’s blood sugar. Generally, diabetics must abstain from these beverages to manage their condition effectively.

When stressed, the body produces hormones like epinephrine (adrenaline), glucagon, cortisol, and growth hormone, which affect blood sugar levels. You need to learn relaxation techniques, prioritize your daily tasks, and set limits to work activities to control your stress levels.

Some healthy ways to cope with stress are:

• Take breaks from watching or listening to the news, including social media

• Take good care of your body

• Talk to other people who make you feel good about yourself

• Avoid drugs and alcohol to avoid health problems

Early diagnosis of diabetes can help reduce the severity of the condition or avoid complications. Try to understand the possible risk factors for type 1 and type 2 diabetes, and if you fall into any of those categories or are prone to a risk, consult a doctor. Ensure you avoid lifestyle choices that increase the risk of diabetes or worsen the condition.

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