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Diabetes mellitus emerges from the interplay of diverse factors. The causes of diabetes can be categorized into modifiable variables, which can and should be influenced to diminish the likelihood of disease onset or even prevent it altogether, and unalterable factors.
An increase in glycemia can be caused by a decrease in insulin production or a violation of its function. In the first case, this is manifested by type 1 diabetes, and in the second - type 2.
What causes type 1 diabetes?
The main reason is the absolute lack of insulin, which occurs due to the death of pancreatic beta cells. It is a condition in which the body begins to produce antibodies (destroyers) to its own tissues, especially cells that synthesize insulin.
Without this hormone, sugar does not enter the liver cells, muscles, and adipose tissue, and there is an excess in the bloodstream.
For these tissues, glucose is a vital source of energy, so the body begins to produce more. However, sugar cannot enter the cell. It turns out that the vicious circle will result in high blood sugar and damaged organs and tissues.
To cleanse the body of sugar, in parallel with it there is excessive excretion of urine. Polyuria develops. After her thirst, the body tries to make up for the fluid loss.
Energy starvation of cells leads to increased appetite. Patients start eating hard but lose weight because carbohydrates are not fully absorbed.
However, the most significant consequence of ketone accumulation is the development of hyperglycemic coma. The only effective way to stop these pathological processes is to restore insulin deficiency, as well as to prevent the cause of this deficiency.
There is no unequivocal opinion as to why a particular patient developed type 1 diabetes. Often the disease manifests itself in the background of full health.
The most studied causes of type 1 diabetes are viruses, heredity, and new synthetic substances. However, it is impossible to accurately predict or explain the cause of the disease.
Table - Factors that provoke the development of type 1 diabetes
It is also true that no substance has been found that reliably determines the development of type 1 diabetes. "Sterile" living conditions This reason is increasingly being considered in developed countries.
The fact is that very comfortable living conditions contribute to the fact that people have turned into “greenhouse plants” and their immune system is not well developed.
At the same time, the factors that prevent the development of diabetes are being actively investigated. These include vitamin D, substance P, the use of insulin in microdoses in healthy people to protect beta cells and others.
Unfortunately, all these techniques exist only within the framework of scientific research and are not actually applied in practice.
What is type 2 diabetes?
The mechanisms of type 2 diabetes are much more understandable: impaired insulin function has been proven in combination with its relative or absolute deficiency.
Initially, liver cells no longer bind to insulin. They "won't recognize him." Therefore, insulin cannot transfer sugar to the liver cells, so they begin to synthesize glucose on their own. It happens mostly at night. This is why sugar rises in the morning.
factors of type 2 diabetes
Insulin is enough or even in excess. Therefore, normal glycemia may exist during the day.
Excessive insulin synthesis naturally depletes the pancreas. At this point, there is a steady rise in glycemia.
Why do you lose insulin sensitivity and develop type 2 diabetes?
The most significant cause of insulin resistance is excessive fat deposition, mainly in the internal organs, so-called abdominal obesity.
Table - Factors in the development of type 2 diabetes
Let’s turn more to risk factors.
On the one hand, diabetes in one parent increases the risk of the disease from 30 to 80%. When both parents have diabetes, the risk rises to 60-100%.
On the other hand, research in this area shows that children inherit eating habits and physical activities from their parents. The daughter does not have diabetes because the mother had it or had it.
But because the daughter also has obesity and leads an extremely inactive life.
After 45 years, there has been a sharp increase in people with type 2 diabetes. Thus, although diabetes before the age of 45 is rare enough, then in the period from 45 to 65 the incidence of diabetes is already about 10%. The percentage of patients increases to 20%. over the age of 65
From the point of view of racial affiliation, Hispanics are more often ill. Moreover, their diabetes occurs at a younger age and there is a rapid progression of complications.
Factors that can change
Body mass index (BMI) serves as a gauge for identifying overweight and obesity by calculating the ratio between body weight (measured in kilograms) and height (measured in meters) squared.
Obesity has now been shown to be a key factor in type 2 diabetes.
The likelihood of type 2 diabetes increases with the progression of obesity.
Risk of type 2 diabetes
In Russia, more than half of the population is obese and overweight - about 60% of women and 55% of men.
The result of human nutrition is a character who sees when he steps on the scales.
If we consider food to be an indirect risk factor for diabetes, we must first and foremost consider the fat content and its composition. These are saturated fats of animal origin that are the hardest to digest and are best stored as adipose tissue.
The myth of nutrition
It is a common belief that diabetes can be "eaten" by consuming a large number of sweets. This is an absolutely proven misconception.
Overeating leads to obesity, which is a direct cause of type 2 diabetes.
If a person consumes all the energy derived from food, the likelihood of developing diabetes is extremely small. And it doesn't matter what he eats.
This is clearly seen in athletes who consume huge amounts of food during training, including easily digestible carbohydrates, but do not have diabetes.
True, at the end of a sports career, the load is reduced, and the eating habit is often maintained. This is where rapid weight gain occurs with the development of diabetes and the rapid progression of complications.
When the patient already has prediabetes or diabetes, then the attention on the composition of food products shifts to carbohydrates. It will now be necessary to take into account the glycemic index of food because it is this factor that determines the level of glycemia.
The fat content of food must be considered to maintain normal body weight. In addition, fatty foods contribute to the development of ketosis, and hyperglycemia - ketoacidosis coma.
The situation is similar to physical activity. People who lead a sedentary lifestyle do not consume energy entirely derived from food but store it in the form of a fat reserve.
For people with diabetes, exercise is the best way to increase muscle sensitivity to insulin. Recovering glucose utilization by muscle fibers most effectively reduces insulin resistance.
Thus, overeating and sedentary life are the main causes of obesity and type 2 diabetes. Without lifestyle changes, diabetes compensation is not possible.
Stressful situations also cause the development of type 2 diabetes. It is important to remember that stress for any reason is not just an emotional experience.
For our body, stress is an acute infection, a sharp rise in blood pressure, or trauma. Even traveling or moving always has significant stress.
Often patients note that they discovered diabetes during hospital treatment for a completely different reason, which confirms the role of stress in the development of diabetes.
Numerous studies confirm the association of smoking, including second-hand smoke, with the development of diabetes. This means that the risk of diabetes increases not only among smokers but also among those around them.
A significant cause of diabetes is alcohol, which directly destroys the pancreas. There is even a separate type of diabetes - a specific type that develops on the background of alcohol abuse.
This type of diabetes is characterized by a rapid loss of insulin, which means the ineffectiveness of sugar-lowering pills.
Risk factors associated with the onset of type 2 diabetes encompass elevated blood pressure, an escalation in atherogenic lipids, polycystic ovary syndrome (PCOS), as well as a prior occurrence of myocardial infarction or stroke.
Since the main causes of type 2 diabetes are variable, it is possible to effectively prevent the development of the disease. In the case of the initial manifestations of diabetes, the change of risk factors plays a key role in the treatment and a favorable prognosis for the patient.
Why does type 1 and 2 diabetes occur
After passing many tests, receiving a disappointing diagnosis, and lifelong treatment, all diabetics inevitably wonder, “Why me? Could this have been avoided?
“The answer is disappointing: in most cases, the disease could have been prevented by knowing why diabetes occurs and taking timely action.
Type 2 disease, diagnosed in 90% of patients, is largely the result of our lifestyle. It is no wonder that for many years it was considered a disease of the rich, and now it is increasingly found in countries with a rising standard of living.
Lack of exercise, refined foods, obesity - these are all causes of diabetes that we organize ourselves. But the conditions of our lives have no effect on the development of type 1 disease, there are no proven means of prevention yet.
What causes diabetes
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Absolute insulin ceases to be synthesized in the pancreas. Relatively, iron also works well, and the level of insulin in the blood is high, and the cells refuse to recognize it and stubbornly do not release glucose.
The relative deficiency was observed at the beginning of type 2 diabetes, absolute - during the first debate of type 1 and prolonged type 2 disease. Let’s try to understand what factors lead to such consequences and provoke the development of diabetes.
Type 1 diabetes
Insulin is synthesized in cells of a special structure - beta cells, which are located in the protruding part of the pancreas - the tail. In type 1 diabetes, beta cells are destroyed, which stops the production of insulin.
Blood sugar rises when more than 80% of the cells are affected. Until this moment, the process goes unnoticed, the remaining healthy beta cells take over the functions of the destroyed ones.
In the sugar growth phase, any treatment is already useless, the only way out is insulin replacement therapy. The process of destruction can be detected at an early stage only by chance, for example, during an examination before surgery. In this case, you can slow down the development of diabetes with the help of immunomodulators.
Type 1 diabetes is divided into 2 subtypes, depending on the cause of the beta-cell damage:
- 1A is caused by an autoimmune process. Roughly speaking, this is a mistake of our immunity, which considers its own cells foreign and starts working on their destruction. At the same time, neighboring glucagon-synthesizing alpha cells and somatostatin-producing delta cells do not suffer. The speed of the process in different people is significantly different, symptoms can appear after a few months and after a week. The main symptom associated with the development of diabetes mellitus 1A is the presence of various autoantibodies in the blood. Antibodies to islet cells (80% of cases) and to insulin (50%) are most commonly found. Upon completion of the work of immunity, the autoimmune process ceases, therefore, with prolonged diabetes, antibodies are not detected.
- 1B is called idiopathic, occurring in 10% of patients. It has an atypical development: insulin synthesis stops, and blood sugar rises, despite the absence of signs of an autoimmune process. What causes diabetes 1B is still unknown.
Type 1 diabetes is a disease of young people with strong immunity, most often debuting in adolescence. After 40 years, the risk of this type of diabetes is minimal.
Infectious diseases can become infectious diseases, especially rubella, mumps, mononucleosis, and hepatitis. There is evidence that allergic reactions, stress, chronic viral and fungal diseases can trigger the autoimmune process.
Scientists have discovered a hereditary predisposition to develop type 1 disease. Having close relatives with diabetes increases the risk for order of magnitude. If one in two people with a common genotype (twins) has developed diabetes, in 25-50% of cases it will occur in the other. Despite a clear link to genetics, 2/3 of diabetics have no sick relatives.
Type 2 diabetes
There is no generally accepted theory as to why type 2 diabetes occurs. This is mainly due to the multifactorial nature of this disease. A link between genetic damage and the patient's lifestyle has been discovered.
In any case, the onset of diabetes is accompanied by:
- insulin resistance - violation of the reaction of cells to insulin;
- problems with insulin synthesis. First, there is a delay when a large volume of glucose enters the blood, which can be detected by a glucose tolerance test. Then there are changes in the production of basal insulin, which causes sugar to rise in the voice. Increased load on the pancreas leads to a decrease in the number of beta cells, all the way to the cessation of insulin synthesis. It has been established: that the better the diabetes is compensated, the longer the beta functions will function, and the later the patient will need insulin therapy.
What violations can occur:
Genotype dependence can be monitored more often than in type 1. Fact in support of this theory: if one of the twins becomes ill, the probability of avoiding diabetes in the other is less than 5%.
The disease in parents increases the risk in children by 2-6 times. Genetic defects that can cause violations have not yet been decoded. These are believed to be individual genes. The first is responsible for the tendency to insulin resistance, and the second is for the violation of insulin secretion.
The Cause Property
Occurrence of diabetes in men and women
Worldwide, diabetes mellitus is observed with equal frequency in both men and women. Dependence on the risk of the disease on the sex of the person can be monitored only in some age groups:
- at a young age, there is a risk of getting sick in men. This is due to the characteristics of fat distribution in the body. The abdominal fat type (visceral fat) is characteristic of men. In women, first of all, the hips and buttocks increase, and fat is deposited less dangerously - subcutaneously. As a result, men with a BMI of 32 and women with a BMI of 34 have an equal likelihood of diabetes;
- after 50 years, the proportion of women with type 2 diabetes is rising sharply, which is associated with the onset of menopause. This period is often accompanied by a slowdown in metabolism, weight gain, and an increase in the number of lipids in the blood. There is currently a tendency for earlier menopause, so carbohydrate disorders in women also become younger;
- Type 1 diabetes in women begins earlier than in men. Risk of children of different sexes:
As can be seen from the table, most girls get sick in preschool. In boys, the peak falls on adolescence.
- women are more likely than men to have autoimmune diseases, therefore, diabetes 1A is more common among them - symptoms of diabetes in women;
- men are more likely than women to abuse alcohol and pay less attention to health. As a result, they develop chronic pancreatitis - a permanent inflammation of the pancreas. Diabetes mellitus can occur if long-term inflammation spreads to beta cells - an article on diabetes in men;
What causes diabetes in children
The highest incidence of type 1 diabetes occurs in 2 periods: from birth to 6 years and from 10 to 14 years. It is at this point that the provoking factors that burden the pancreas and the immune system act.
It is hypothesized that in infants the cause may be artificial feeding, especially cow’s milk or sweetened. Severe infections have a significant impact on immunity.
The sudden increase in morbidity in adolescents is caused by hormonal changes and an increase in the activity of the insulin antagonist hormone. At the same time, children's ability to resist stress decreases, and natural insulin resistance appears.
For many years, type 2 childhood illness was extremely rare. Over the last 20 years, the number of sick children in Europe has increased 5 times, and there is a tendency for further growth. As in adults, the causes of diabetes are obesity, lack of exercise, and poor physical development.
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Lifestyle analysis showed that modern children have replaced active sports with sedentary computer games. The nature of young people’s diets has also changed radically.
If there is a choice, preference is given to products with high caloric but low nutritional value: snacks, fast food, and desserts.
Chocolate has become a normal bite, which was unthinkable in the last century. Often a trip to a fast-food restaurant becomes a way to reward a child for achievements, to celebrate a joyful event that influences his eating behavior in adolescence and adulthood.
Causes of disease
Type I diabetes refers to autoimmune pathologies.
Infectious diseases can cause a malfunction in the immune system, including:
- Mumps, popularly known as mumps.
- measles.
- Infectious mononucleosis.
- Acute and chronic viral hepatitis.
Sometimes an inadequate immune response is the result of intoxication of the body with drugs, pesticides, nitrosamines, and other substances. Severe pancreatic injuries may contribute to the development of pathology.
Often, type I diabetes is accompanied by diseases such as:
- thyrotoxicosis.
- Diffuse toxic goiter.
- Itsenko-Cushing syndrome.
- Pheochromocytoma, etc.
Hereditary predisposition to the disease should not be ruled out. Moreover, this reason applies to type I and type II diabetes. It has been proven that the risk of its occurrence in children is 30% if one parent in the family is ill.
The probability of developing pathology increases to 60% when diagnosed in both mother and father.
Risk factors leading to type II diabetes:
- Obesity. A large amount of adipose tissue in the body causes the cells to become insensitive to insulin. In this regard, the danger is the abdominal type of obesity, when lipid deposits are concentrated in the abdomen.
- Eating Disorders. An unhealthy diet with a predominance of simple carbohydrates and a lack of fiber on the menu.
- Diseases of the cardiovascular system: coronary heart disease, hypertension, atherosclerosis.
- Endocrine diseases: pancreatitis, pancreatic tumors, pituitary insufficiency, etc ..
- Stay in a state of chronic stress.
- Taking certain medications, namely synthetic steroids, cytostatics, diuretics, etc ..
- Chronic adrenal insufficiency.
- The person is over 45 years old. As the body ages, its cells lose their ability to absorb insulin.
- High blood cholesterol.
All of these factors are exacerbated by a sedentary lifestyle. Lack of motor activity causes disturbances in the work of most internal organs, muscles consume little glucose, which is why it accumulates in the blood.
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