Why do I have type 2 diabetes?

When we think about health conditions, we tend to talk about risk factors, causes, and symptoms. We stay a little bit detached, knowing that yes, we could be healthier—but there are just so many other things to do. It’s often not until we receive a medical diagnosis of our own that reality sets in and you can’t help wondering... why me?

A type 2 diabetes diagnosis is an emotional time, and one of the most common questions we hear from our patients is: why do I have type 2 diabetes? The first part of your personal treatment plan is coming to terms with your diagnosis, and a huge part of that is not only accepting that it's happening, but understanding why.

So, if you or someone you know has just been diagnosed and is at a loss, stick with us—we’re going to help you understand your diagnosis, debunk some of the common associations (we’re looking at you, obesity), and help you find peace, positivity, and power in this life-changing moment.

Being diagnosed with type 2 diabetes is not your fault!

Before we go any further, we want to pause for a second and tell you that receiving a type 2 diabetes diagnosis isn’t your fault. Thanks to the link between weight (and therefore diet) and type 2 diabetes, people with a new diagnosis often blame themselves and sadly hear similar narratives in the media and from friends, family, and even healthcare professionals. 

“A type 2 diabetes diagnosis is not a judgment, it is an opportunity,” says Dr Silja Voolma, our in-house health psychologist. “It is an opportunity to listen differently, find new ways of working together, and explore infinite opportunities for self-discovery. If you've been newly diagnosed, make sure to take some space for rest and relaxation so you can embark on a new conversation with your body with confidence and courage.”

To be sure, there are links between type 2 diabetes and weight, but there are also many other factors involved. So, continue reading safe in the knowledge that there is no single reason for someone to develop type 2 diabetes. If you have been diagnosed, you are not to blame.

What causes diabetes?

Age, family history, ethnicity, blood pressure, weight, and smoking are some of the risk factors for type 2 diabetes.[1] We’ve talked about these risk factors before, so we won’t go into too much detail here except to say that none of the risk factors are predictive of the condition. In other words, it's impossible to say that any one of these factors causes type 2 diabetes. Everyone’s diagnosis is personal, which is why some people with no family history of type 2 diabetes will develop it, or why there are some people of a healthy weight who are diagnosed and others with a high BMI who don't develop it.

“But...I’m not overweight!”

The list above mentions weight as just one of a number of risk factors, and yet that’s the one we’re most fixated on. Is it the most visible? The one we feel like we can change? Regardless of why, the link between weight and type 2 diabetes is so assumed that people of a healthy weight who develop the condition are often surprised.

When we think of fat, we think of the visible kind, the fat that exists under the skin. What we don’t think of is the fat around our organs. People with type 2 diabetes tend to have more fat stored inside their liver and pancreas, and it's this internal fat that impacts the organs’ ability to produce insulin and regulate blood sugar.[2]

Why and how this fat builds up inside the liver and pancreas can be due to a number of factors that aren’t necessarily directly linked to weight, such as genetics. Some researchers even talk about a “personal fat threshold”, which is the amount of fat a person can gain before it starts to cause a problem in the organs.[3] Some thinner people may not be able to put down fat under their skin as well as others, so instead their bodies lay down fat inside of their organs—including the pancreas and liver. So while you might not know by looking at them, their fat stores could still be causing damage. It’s a popular idea that is still in discussion, but it would help explain why people develop type 2 diabetes at all body weights.

So, what next?

While it might seem our knowledge of what causes type 2 diabetes and how it develops is riddled with holes, we do know that there are plenty of ways to keep it in check. From diet to exercise, making changes can help reduce the risk of complications of diabetes, and you may even be able to put your diabetes into remission!

If you’re newly diagnosed with type 2 diabetes, the next thing to do is arm yourself with as much knowledge as you can find. We'd recommend having a look round our Journal, where you will find plenty of helpful resources, such as:

You and your body are beginning a new chapter, so be kind to yourself and take each day as it comes. While developing type 2 diabetes may have been out of your hands, you can take the appropriate action to keep it under control.

References

[1] Diabetes risk factors. Diabetes UK. Retrieved 29 September 2021. Accessible here

[2] Taylor, R. Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause. (2008). Diabetologia 51:1781-1789. Accessible here

[3] Taylor R., Holman R.R. Normal weight individuals who develop type 2 diabetes: the personal fat threshold. (2015). Clin Sci (Lond) 128(7):405-10. Accessible here.

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