Diabetes is more than just watching your sugar intake – it’s a complex metabolic condition influenced by a variety of factors including genetics, lifestyle choices, and environmental triggers. By understanding what contributes to, and is associated with this widespread condition, you’ll be better equipped to safeguard your health against it.

What is diabetes?

To better understand the risk factors of diabetes, let’s first understand what diabetes is. Diabetes is a chronic health condition that is characterized by elevated glucose levels in the bloodstream. This elevation in blood sugar arises because either our body does not produce sufficient amounts of insulin or fails to respond to it. Insulin is an example of a hormone that lowers blood glucose levels by directing glucose to leave our blood and enter our cells.

Now, there happen to be two forms of diabetes, type 1 and type 2. The former arises when our immune system erroneously targets and destroys body cells that produce insulin. Type 2 diabetes, on the other hand, arises when body cells fail to produce sufficient amounts of insulin. It can also arise when our body fails to respond to the insulin released by cells. This form of diabetes arises due to factors including obesity, sedentary habits, and poor dietary choices. Check out more details on diabetes and its subtypes in our blog: Everything you need to know about Diabetes and Pre-diabetes.

Risk factors for diabetes

Obesity: One key risk factor for diabetes – particularly type 2 diabetes – is obesity. This is because being obese (defined as having a Body Mass Index or BMI of 30 or higher), worsens insulin resistance in muscle and tissue cells. Insulin resistance occurs when the body fails to respond to the usual effect of insulin. Typically, insulin ushers glucose from the blood into cells. This keeps blood glucose levels in check. However, in individuals experiencing insulin resistance, blood glucose struggles to enter the cells, leaving blood sugar levels high. Over 90% of individuals affected by diabetes tend to be overweight or obese. But for Asian populations, patients with pre-diabetes/diabetes have a mean BMI significantly lower than the defined at-risk BMI levels established by the CDC and may not even meet the criteria for being overweight. So BMI is not the best indicator of diabetes risk for all. To learn more, check out our blog on lifestyle interventions to manage diabetes.

Cardiovascular disease (CVD): Another risk factor for diabetes is CVD. CVD refers to a group of conditions that affect the heart and blood vessels. One type of CVD is known as atherosclerosis. This is a chronic condition characterized by the buildup of fatty plaque inside our arteries. The plaque arises because of cholesterol and fat. Its buildup over time can block the blood vessels, narrowing and stiffening them. This can eventually restrict the flow of blood to the heart. The condition can elevate your risk of diabetes because it can lead to endothelial dysfunction. This is a fancy term to describe a condition where our blood vessels fail to produce and release a chemical called nitric oxide. But how is nitric oxide related to diabetes? This chemical plays an important role in regulating our insulin sensitivity. As levels of the nitric oxide decrease, insulin resistance can develop, contributing to the onset of type 2 diabetes.

Conversely, diabetes can also cause CVD. Individuals with diabetes are 2 to 4 times more likely than others to develop CVD. Given the bidirectional relationship between CVD and diabetes, it is vital to protect your heart! Quitting smoking, losing weight, eating a balanced diet, exercising, controlling your blood pressure, and optimizing your cholesterol are just some of the ways you can lower your risk of CVD. To learn more about CVD and ways by which it can be prevented, check out our blog on CVD.

Hypertension: Diabetes can also increase the risk of developing hypertension. Hypertension, commonly known as high blood pressure, is a medical condition characterized by elevated pressure in our arteries. When blood pressure remains consistently high over time, it can strain the heart and blood vessels, increasing the risk of serious health complications such as heart disease, stroke, kidney damage, and other cardiovascular problems. Diabetes can increase the risk of hypertension by promoting insulin resistance – which in turn makes it difficult for glucose to enter cells, leading to abnormal blood vessel structure and function. And these abnormalities can then contribute to hypertension. Another way by which diabetes can increase the risk of hypertension is by damaging our kidneys. Kidney damage can disrupt the body’s ability to regulate blood pressure by altering the balance of fluids and salts in the body. Fortunately, you can fight hypertension with what you put in your mouth. To find out more, check out our blog on dietary interventions for hypertension.

Diabetic Retinopathy (DR): Unfortunately, the high blood sugar levels associated with diabetes can end up damaging the blood vessels of the light-sensitive tissue at the back of the eye known as the retina. This can then cause DR which can lead to vision problems if not treated promptly. This is why diabetic individuals must have regular eye check-ups with an ophthalmologist or optometrist. Talk to your doctor about seeing a retina specialist to get tested if you have diabetes.