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Why is type 2 diabetes on the rise?

Type 2 diabetes was officially declared an epidemic in 2013 and yet its showing no signs of slowing down. Here, we explore the global changes, lifestyle factors, and physiological processes that contribute to this epidemic.
Napala Pratini
2/11/2022
9
min read
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Quick summary

  • Type 2 diabetes is a complex disease, from the variety of risk factors that play a role in development of the disease through to the varying ways it can be treated, or even reversed.
  • Rates of type 2 diabetes continue rising across the globe, making it an important priority for patients and healthcare systems alike.
  • Obesity is the main risk factor contributing to rising rates of type 2 diabetes, but it's not the only one.
  • There is now evidence that type 2 diabetes can be put into remission, making diabetes reversal—not management—the new gold standard of care.

In 2013, there were 382 million people in the world diagnosed with diabetes, and the World Health Organisation officially declared it an epidemic.[1]

Despite the awareness of and initiatives to combat type 2 diabetes since then, cases have been steadily rising. In 2021, around 422 million people live with a diabetes diagnosis.[2] The actual number of people afflicted is likely much higher, as many people are undiagnosed.

Whether you have type 2 diabetes yourself, you’re worried about developing the disease, or you’re reading this on behalf of a loved one, understanding why type 2 diabetes is on the rise is a key piece in the diabetes treatment and management puzzle. 

What is diabetes?

Diabetes mellitus, or diabetes, is a disease that affects the whole body. It occurs when there is an issue with how your body produces or interacts with a hormone called insulin.

Insulin is responsible for taking glucose (sugar) from foods and converting it into energy. However, those with type 2 diabetes do not make enough insulin or cannot utilise insulin properly, which means that glucose cannot be transformed into energy. Instead, it stays in the blood, resulting in high blood glucose levels.

Untreated type 2 diabetes results in high blood sugar, also called hyperglycaemia. Symptoms include dizziness, fatigue, increased thirst, and increased hunger. Sustained hyperglycaemia can eventually have serious impacts on the heart, blood vessels, eyes, kidneys, and nervous system. [2]

What causes type 2 diabetes?

Type 2 diabetes is caused by two biological processes that, in parallel, result in dysregulated blood glucose: 

  • Insulin resistance: When the body’s muscle, fat, and liver cells are unable to interact normally with insulin, they aren’t able to convert glucose into energy. This leaves extra glucose in the bloodstream, leading to hyperglycaemia.
  • Poor insulin production: The pancreas is responsible for producing insulin, but issues such as internal fat deposits can prevent it from doing this job correctly. When the body lacks sufficient insulin, blood glucose remains elevated.

It’s well-documented that excess body weight leads to an increased risk of developing type 2 diabetes, however the exact mechanism linking the two has been under debate for quite some time.

One of the most promising theories comes from the Diabetes Remission Clinical Trial (DiRECT). This 2018 study suggests that type 2 diabetes results from fat deposits building up in the liver. These fat deposits stop cells from being able to interact with insulin as they should, in turn increasing blood sugar levels.[3]

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Why is type 2 diabetes on the rise?

In the UK, around one in 14 people have diabetes, and someone is diagnosed with diabetes every two minutes. Type 2 diabetes is by far the most common variety. Of these one in 14 people, approximately 90% have type 2 diabetes.[4]

Obesity is generally accepted as the main risk factor contributing to rising rates of type 2 diabetes, but it isn’t always that simple. Other factors include:[1]

  • Age: Type 2 diabetes becomes more common with age. The average age of onset for type 2 diabetes is 45.
  • Ethnicity: Research indicates that groups such as those of African, South American, and South Asian descent are more likely to develop diabetes than other ethnic groups.
  • Poor diet: A diet high in fat, sugar, and cholesterol (essentially the holy trio of processed foods) is one of the most common causes of diabetes. This is not only due to the weight gain, but also the negative impacts that these highly processed foods have on the body.
  • Sedentary lifestyle: Regular exercise regulates blood glucose and contributes to weight loss. A non-active lifestyle is a key risk factor for diabetes.
  • Global changes: Recent studies suggest that environmental pollution, rapid urbanisation, and a society that makes it difficult to access healthy choices are likely affecting rates of diabetes.
  • Detection: Evidence indicates that 90% of people with prediabetes are living undiagnosed. However, as awareness around diabetes grows, diagnosis rates are increasing: More regular testing can lead to more diagnoses.
  • Family history: A family history of diabetes is considered to be a strong risk factor for many types of metabolic abnormalities, including type 2 diabetes.

In many cases, several of these factors will combine to result in type 2 diabetes. For instance, people of an at-risk ethnic or age group who work a sedentary job and have a close relative with type 2 diabetes are at very high risk.

How can you safeguard against type 2 diabetes?

The best thing you can do for your health is to make sure you exercise regularly and commit to a healthy diet. Make sure you allow enough time in your daily routine to prioritise your fitness and nutrition.

If you’re part of one or more at-risk groups for developing diabetes, it’s also vital that you visit your healthcare provider regularly. If your doctor catches signs of the disease early, they will be able to take action or refer you to a specialist when you need it.[5]

If you’ve already been diagnosed with type 2 diabetes, you don’t need to panic! With the right treatment and lifestyle changes, its side effects can be prevented and delayed. In fact, recent evidence indicates that type 2 diabetes can even be reversed.[3]

Remission of type 2 diabetes

Until recently, type 2 diabetes was perceived as a long-term, chronic, and irreversible condition. It was thought that those diagnosed would simply have to manage the disease for the rest of their lives, and 50% would have to go onto injectable insulin at some point.

The Diabetes Remission Clinical Trial (DiRECT), published in 2017, has proved otherwise. This study investigated whether an intensive programme for weight loss and weight loss maintenance could effectively reverse type 2 diabetes.

With intensive weight loss and behaviour change, it is possible to put type 2 diabetes into remission.

Lean et al, The Lancer

The results were positive. In the study’s discussion, the researchers state that, ‘Weight loss sufficient to achieve remission can be attained in many individuals by use of an evidence-based structured weight management programme’.[3]

In fact, it was the results of the DiRECT trial that inspired us to start Habitual. We were inspired to bring these amazing results to many more people by offering a digital version of the programme that saw such incredible results in the research.

While type 2 diabetes is serious, it’s no longer considered the lifelong condition it once was thought to be. Through hard work and changes to nutritional and physical habits, it is entirely possible to reverse the effects of this common disease and, in many cases, enter remission.

References

[1] Thibault, V., Bélanger, M., LeBlanc, E., Babin, L., Halpine, S., Greene, B. & Mancuso, M. (2016) 'Factors that could explain the increasing prevalence of type 2 diabetes among adults in a Canadian province: a critical review and analysis', Diabetology & Metabolic Syndrome, 8(71), pp. [Online]. Available at: https://doi.org/10.1186/s13098-016-0186-9 (Accessed: 27th April 2021).

[2] World Health Organisation (2021) Diabetes, Available at: https://www.who.int/health-topics/diabetes#tab=tab_1 (Accessed: 27th April 2021).

[3] Lean, M. E. J., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., et al. (2017) 'Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial', The Lancet, 391(10120), pp. 541-551 [Online]. Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext#seccestitle70 (Accessed: 27th April 2021).

[4] Diabetes UK (2020) Diabetes statistics, Available at: https://www.diabetes.org.uk/professionals/position-statements-reports/statistics# (Accessed: 27th April 2021).

[5] Santos-Longhurst, A. (2020) Type 2 diabetes statistics and facts, Available at: https://www.healthline.com/health/type-2-diabetes/statistics (Accessed: 27th April 2021).

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