Environmental Factors Around Type 2 Diabetes

Family History of Type 2 Diabetes May Have More to Do with Environmental Factors than Genetics

What is Preventable and Why Prevention Tactics Are Not so Accessible

iStock-873670030 overweight family iconI would love to see a statistic that shows the percentage of people with type 2 diabetes that have family members with the same condition. I would wager that this percentage is well above 50%.

Studies show that you are more likely to develop type 2 if one of your parents or siblings has it.[i] While the development of type 2 diabetes has been linked to quite a few genetic mutations (including those that determine weight gain),[ii] the influence of family members and other environmental factors may very well be the principal causes of this life-threatening condition.

You could have a genetic mutation that makes you more vulnerable to type 2, but if you are eating healthy, exercising regularly, and refraining from smoking and over-consuming alcohol, you may not develop diabetes.[iii]

Just look at how the rate of obesity has risen in direct relationship with the spike in diabetes cases from the '90s until the present day. Though science is still unclear as to what the link between obesity and diabetes is, most patients with type 2 diabetes are obese, and the global epidemic of obesity explains the sharp increase in the incidence and prevalence of type 2 diabetes during the past 20 years.[iv]

iStock-825673466 causes of diabetesIn addition to being overweight or obese, cardiovascular health issues like high blood pressure and low HDL "good" cholesterol are strong risk factors for type 2 diabetes.[v] All of these high-risk factors, for the most part, are caused by environmental issues such as poor diet, lack of exercise, stress and lifestyle choices that are not so healthy.

While I concede that there are some genetic predispositions for obesity and heart disease that have nothing to do with lifestyle choices, I would argue that these would be the exception and not the norm. Obesity, for instance, has been declared a pandemic by leading authorities like the National Institutes of Health and the World Health Organization (WHO), who released these staggering data points last February (2018):

  • Worldwide obesity has nearly tripled since 1975
  • In 2016, more than 1.9 billion adults aged 18 years and older, were overweight, with 650 million of these being obese
  • These hard numbers translate into 39% of all adults being overweight, and 13% obese.[vi]

Anyone who has been following our blogs, which generally have been an indictment of the broken Western food system and its prevalence of added sugars, bad carbs, sneaky sugars and "health halos," would agree with me that these disturbing figures are not influenced by genetics to any significant degree.

Like type 2 diabetes, the WHO contends that obesity is preventable. The American Diabetes Association (ADA), the Centers for Disease Control and Prevention (CDC) and other top health organizations advocate that heart disease and high blood pressure are also preventable. 

I emphasize these points because many type 2 patients would be quick to write off their condition as hereditary because mom or dad has it, or an older sibling has it, and so there is not much they can do about it other than staying on their medications and following doctor's orders at a minimum. 

While I think I have convinced most of you at this point that environmental factors are perhaps the major causes of type 2 diabetes, we have a long way to go before we can say let's focus on prevention, and we can curb and eventually decrease the rates of type 2 diabetes globally.

Perhaps the most troubling statistic from the WHO February 2018 fact sheet is that "most of the world’s population lives in countries where overweight and obesity kills more people than underweight."[vii]

Now the US might not be included in the WHO's list of most affected countries, but the higher prevalence of type 2 diabetes in our lower income ethnic communities leads me to assert that there are two other environmental factors at play:

  1. Lack of education on diabetes prevention and diabetes care management; AND
  2. Lack of access to healthy foods and exercise "facilities" (this includes parks and external safe places).

There is a lot to chew on here in exploring these two points – which I believe are the two most harmful environmental factors.

Start by considering the omnipresence of food swamps and food deserts that exist and the federal government’s role in manifesting the obesity and diabetes epidemics, and you can understand why type 2 is more of a family tradition and not a genetic inheritance.

Improving Weight Management

[i] https://www.healthline.com/health/type-2-diabetes/genetics#genetics-vs.-environment
[ii] http://diabetes.diabetesjournals.org/content/56/6/1737
[iii] https://www.endocrineweb.com/conditions/type-2-diabetes/type-2-diabetes-causes
[iv] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206399/
[v] https://www.everydayhealth.com/diabetes/genetics/
[vi] https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
[vii] https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Sean Browne

Sean Browne

Former Chief Revenue Officer, CCS Medical

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