Diabetes is a chronic condition characterized by problems with insulin and leading to uncontrolled blood sugar levels. It is one of the top 10 health problems in the United States, and one of the top causes of death and disability. Over 38 million adults and children in the United States have diabetes, the number continually rising in recent decades and is forecasted to increase by 54% to more than 54.9 million Americans by 2030.
While some people are predisposed to diabetes, there are other factors which can contribute to the rising prevalence of the disease.
Genetic Predisposition
Studies have shown that genetics play a significant role in diabetes. Type 1 diabetes is generally considered to be an autoimmune disorder wherein the body’s immune system attacks the insulin-producing cells and the body fails to produce insulin. The risk is increased by having variants of genes which are associated with the immune system. In Type 2 diabetes, the body either stops producing or processing insulin. Gene variants in Type 2 diabetes have been related to insulin metabolism. Because of the role of genetics in diabetic risk, there have been a lot of efforts into using this information to determine those at risk and to change other factors such as diet to mitigate this risk.
Obesity
Overweight and obesity mean the accumulation of excess fat in the body. Having a body mass index or BMI of 30 and above is considered obese while a BMI 25.0 to <30 is within the overweight range. Both overweight and obesity have been linked to increased risk for type 2 diabetes because these can cause insulin resistance and cell dysfunction. Obesity also increases the risk for other medical conditions such as heart disease and strokes, all the more in diabetics. Because of this, approaches to managing diabetes include behavioral changes to help lose weight along with glucose or sugar control, as in the case of diabetes weight loss programs.
Diet and Lifestyle
Not all those who have the genes predisposing them to diabetes get diabetes. Environmental and lifestyle factors are significant especially in type 2 diabetes. A high-calorie diet of processed or refined foods, high-sugar beverages, and saturated fat contribute significantly to the type 2 diabetes epidemic. Multiple studies also showed that lack of physical activity, smoking, and alcohol use also increase the risk for diabetes. On the other hand, changing these lifestyle factors have been shown to not only lower the risk for diabetes but also make the condition manageable.
Socioeconomic Factors
It has been found that diabetes affects those with low socioeconomic status more in the United States. Socioeconomic factors include income-to-poverty ratio (IPR), education level, employment status. The differences are found to be largely due to differences in behavioral lifestyle and access to healthcare. These factors are also seen to be why diabetes disproportionally affects racial and ethnic minorities. Considering these factors then drive research and intervention efforts to achieve health equity in those populations to decrease the risk and the burden of diabetes.
Environmental Influences
Evidence shows that environmental factors may contribute to the development of type 2 diabetes. These factors include air pollution, dense population, and residential noise and crime problems. The ways through which these factors can impact diabetes seems more to be in how these can limit the lifestyle changes needed to prevent and manage diabetes such as being able to walk and avoiding stress. Factors like walkability and the presence of green spaces, open spaces, or recreational centers lower the risk for diabetes. Another factor suggested is the presence of endocrine disrupting chemicals (EDCs) which increases the risk for diabetes by affecting weight, insulin metabolism, and appetite.
In conclusion, diabetes in the United States is caused by a complex interplay of genetic, health, lifestyle, socioeconomic, and environmental factors. Addressing the diabetes epidemic then requires a comprehensive multipronged approach to prevent and manage this condition.