From Insulin Resistance to Elevated Blood Sugar: Insights into Type 2 Diabetes Development

This week marks Type 2 Diabetes Prevention Week and as a contribution we want to shed light on five important topics. You can expect insights into the origins of type 2 diabetes, its link with other conditions, as well as current testing methods and the latest developments. This is the first of a series of 5 blogs to mark Type 2 Diabetes Prevention Week. Today's post is on the development of type 2 diabetes (T2D). 

How does type 2 diabetes develop?

The development of T2D is not a sudden occurrence.  It is a gradual process influenced by various factors, from genetics and environmental factors to lifestyle. Understanding how T2D develops is crucial in preventing its onset and managing its progression.  People develop prediabetes several years before they develop T2D. Whilst T2D is well understood, a number of different terms can be used to describe prediabetes, the most common of which are dysglycaemia, impaired glucose tolerance and intermediate hyperglycaemia - these all describe a metabolic state which precedes T2D. 

At the core of T2D development lies insulin resistance, a condition where the body's cells become less responsive to insulin, the hormone responsible for regulating blood sugar levels. Initially, the pancreas compensates by producing more insulin to overcome this resistance. However, over time, the pancreas becomes less efficient at secreting insulin, leading to elevated blood sugar levels characteristic of T2D.  

What factors influence the development of type 2 diabetes? 

Genetic and ethnic factors play roles in the development of type 2 diabetes, influencing both susceptibility and progression. Genetic predisposition is marked by variations in numerous genes involved in insulin production, secretion, and glucose metabolism, making certain individuals inherently more vulnerable. Ethnically, certain populations exhibit higher prevalence rates due to a combination of genetic susceptibility and physiological factors. For instance, people of South Asian, African, Hispanic, and Native American descent tend to have higher risks. These disparities can be attributed to genetic differences in insulin sensitivity and beta-cell function among these groups.  

Lifestyle factors, such as diet and physical activity, can significantly influence T2D development. Diets high in processed foods, sugar and unhealthy fats contribute to weight gain, obesity, and insulin resistance. Sedentary lifestyles further exacerbate these effects, leading to metabolic dysfunction and an increased risk of T2D. 

Moreover, environmental factors, such as socioeconomic status and access to healthcare, also impact T2D development. Individuals from underserved communities may face barriers to accessing nutritious foods, healthcare services, and educational resources, exacerbating their risk of T2D. Health inequalities further compound these challenges, making it essential to address social determinants of health and promote health equity as crucial components of T2D prevention efforts. 

Summary

Early detection and intervention are paramount in managing T2D and mitigating its complications. Screening for prediabetes and T2D allows for timely interventions, such as lifestyle modifications and pharmacotherapy, to prevent or delay disease progression. Raising awareness about T2D risk factors and promoting healthy behaviours can empower individuals to make informed choices and take proactive steps towards better health outcomes. 

Understanding the journey of T2D development is essential in combating its prevalence and empowering individuals to take control of their health. By addressing modifiable risk factors, promoting healthy lifestyles, and ensuring equitable access to healthcare, we can work towards reducing the burden of T2D and improving the quality of life for millions affected by this condition.