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What causes type 2 diabetes?

Type 2 diabetes is not a single disease. It comprises several different conditions based on a complex combined effect of genetics, environmental factors and lifestyle.

Type 2 diabetes was previously known as adult onset diabetes or diabetes on adults. These terms are obsolete and are no longer used. Type 2 diabetes can begin at any age, even though most people get it after they have turned 40.

Type 2 diabetes is a diverse group of disorders of energy and sugar metabolism. It is triggered by external living environment and lifestyle factors in a person who has a genetic predisposition to it.

There are several hundred known genes that predispose you to type 2 diabetes. Genes regulate, e.g. your energy metabolism, the build-up and use of fat, function of pancreatic and fat cells, insulin production, intestinal hormones as well as leptin, which regulates hunger.

If your parents or siblings have type 2 diabetes, your own risk to get diabetes is also increased:

  • If one of your parents has type 2 diabetes, your risk is roughly twice as high.

    • The risk is higher from the mother’s side.

  • If both of your parents have type 2 diabetes, your risk is roughly five times as high.

  • If a sibling has type 2 diabetes, your risk of getting it is roughly three times higher compared to the rest of the population.

If a person in your immediate family has type 2 diabetes, you should try to prevent type 2 diabetes through lifestyle choices and weight control.

Environmental factors that may increase the risk of type 2 diabetes include an urban environment which leads to reduced daily activity and lack of exercise or changes in work and free time, for example. Changes in our eating environment may also increase the risk of diabetes: portion sizes have increased, ready-made meals have become more common and there is an abundance of energy-rich snacks and nibbles on offer.

Most significant of the lifestyle factors that increase the risk of type 2 diabetes are eating habits leading to weight gain and lack of exercise. Sleep deprivation, depression, stress, inflammations and other diseases can also affect the metabolism, increasing the risk of diabetes.

Type 2 diabetes can be divided into several different subgroups, which are characterised various degress of reduced insulin production or reduced effectiveness of insulin i.e. insulin resistance:

  • For some, it is caused by being overweight and the resulting increased need for insulin and insulin resistance.

  • For some, overweight i.e. extra fat builds up in the internal organs, leading to the fatty degeneration of the liver and pancreas and further into reduced effectiveness and production of insulin.

  • For some, the production of insulin is insufficient to begin with.

  • For some, the underlying factor is metabolic changes related to ageing.

  • For some, the ability of the pancreas to produce insulin declines with age, leading to insulin deficiency.

Updated 30.9.2023