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Diabetes Type 2

Causes and risk factors for type 2 diabetes

You are at greater risk of getting diabetes if:

  • A close member of your family has diabetes
  • You are white and over 40
  • You are black, Asian or from a minority ethnic group and over 25 years old
  • You’re overweight
  • If you have high blood pressure and if you have had a stroke or heart attack
  • A women with polycystic ovary syndrome and are overweight
  • A women and you’ve had gestational diabetes or given birth to a baby over 10 pounds
  • You have a severe mental health condition, such as depression,schizophrenia or bipolar disorder, and you're taking medication for it
  • You've been told you have impaired glucose tolerance or impaired fasting glycaemia

The more risk factors that apply to you, the greater your risk of having diabetes.
 

Mike thinks diabetes is caused by hereditary factors as well as lifestyle.

Mike thinks diabetes is caused by hereditary factors as well as lifestyle.

Age at interview: 64
Sex: Male
Age at diagnosis: 59
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I understand it is partly hereditary and partly your lifestyle. Being broad around the waist is not good. A lot more Asian people suffer from diabetes I understand so because I have always been broader round the waist and because my father had it and my grandfather, I've just assumed that it was partly due to the lifestyle that I have led and partly due to you know hereditary problems. That is why I have ended up with it.

My brother is three and a half years younger than me. I keep pulling his leg, I say, 'Have you had a check recently, because it's your turn next? Beware. Beware.' So you know, it hasn't bothered me, I've just assumed that's the reason, and if I had looked after myself a lot better, you know possibly I would have delayed the onset of it, although I probably wouldn't have enjoyed myself so much.

 

Nasir was told his diabetes was probably hereditary but he says he's also been overweight for...

Nasir was told his diabetes was probably hereditary but he says he's also been overweight for...

Age at interview: 38
Sex: Male
Age at diagnosis: 28
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No they're not sure, they said it could be linked to hereditary because, because not my father but my grandfather had diabetes, some of my aunts on my father's side of the family have had it, so they're saying it could be linked to that because type two's not common in, you know, people at that age, age group it's usually, it comes on, you know, later life.

But were you do, well what kind of weight did you have at that time?

I've always struggled with my weight but I think at that time I was probably about thirteen stone or so which is, you know, maybe two, three stone overweight. But I did have a bit of a sweet tooth, you know, I won't lie about that, I certainly enjoy my chocolates and my drinks and stuff. But they never really came up with a definitive answer why you've got it, and I think they were just more concerned with the fact right you have got it, let's try and treat it, you know, it doesn't matter how you got it really at the end of the day, if you've got it, they didn't really go into it in too much detail about, how, why, where, you know, it came from. It would be good to know but I suppose at the end of the day it's, to a certain extent it's irrelevant how it got there it's the fact is you've got it.

 

Mrs Patel and five of her siblings have diabetes which they inherited from their father.

Mrs Patel and five of her siblings have diabetes which they inherited from their father.

Age at interview: 68
Sex: Female
Age at diagnosis: 53
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So if I said to you why do you think you've got it, what would your answer be?

My answer? It must be genetic from the parents, you see. You see one thing is our lifestyle has changed by living in cities as well. One reason is maybe our lifestyle, the second is our food, what we used to eat before and what we are eating now. Lot of variation in food as well. So that maybe the reason and genetic. Because father had it so you pass on to us as well.

Are you worried that your children will get it?

Yeah we [are], I am, because we both are diabetic.

You and your Husband?

Husband.

The people we talked to had different ideas about what might have caused diabetes. Many believed that a family history of diabetes had predisposed them to the condition, others said it was caused by a combination of factors which included being overweight, being a heavy smoker or drinker, and not having done much exercise for years. Some people said that eating too much over many years hadn't affected them until they became middle-aged and had stopped being so active. Eating too much of the wrong kind of food and 'comfort' eating were said by several people to have contributed to their diabetes (see 'Food, Eating and Diet').

 

Duncan thinks that his old habits of eating lots of takeaways and heavy drinking may have caused...

Duncan thinks that his old habits of eating lots of takeaways and heavy drinking may have caused...

Age at interview: 63
Sex: Male
Age at diagnosis: 61
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I mean you get annoyed sometimes. And also I think I am probably helped by the fact that it is my fault in a way. I mean I am not saying it's entirely my fault, but one of the reasons I ate too many take-home Chinese and too many bottles of wine, was being coming home at half eight in the evening after a long day's teaching I probably felt I needed it. So I mean to that extent may be it wasn't entirely my fault.

But I knew I used to teach alcohol awareness at school, so I couldn't say I didn't know that I was drinking too much, and I couldn't say I didn't know that not taking enough exercise was bad for me. So to that extent, I may be don't feel as miserable as I would do, if I had been struck down by something that I had been responsible for.

And if I, I mean it sounds pretty bad to say that if I did sort of pop off tomorrow then, because I had eaten or drunk or whatever too much for sixty one years, then at least I had sixty one good years. So to that extent I am not too bothered.

 

Pamela attributes her diabetes to both hereditary and lifestyle factors.

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Pamela attributes her diabetes to both hereditary and lifestyle factors.

Age at interview: 54
Sex: Female
Age at diagnosis: 50
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Oh, I got it because I overate, I'm in no doubt about it. I mean I've got a genetic disposition to it. My grandmother, my father had it. But, no, I ate completely the wrong things. I mean I was reading an article earlier on today about clotted cream in, I think it was in the Sainsbury's magazine. And I thought, “My goodness, I lived in Somerset, next to a dairy farm.” We grew up on whole milk. Never heard of anything other than clotted cream in my life. You know, cheese, butter, I mean it was just in abundance. We had, you know, and that was fine. My mother made cakes and all of this sort of thing. And that was fine. The way we ate was fine when we were doing a lot of activities, children whatever. It was when the processed stuff came in. Like, you know, suddenly you could buy cakes or you, you know, you, home-made jams or ice cream, you know, things that were suddenly different. And that I think is when, and we stopped, then I stopped being so active, in my mid 20s I wasn't so active.

And I think I've had a lifetime of eating, you know comforting foods, and I think that's just what I enjoy eating, but I ate too much of them. Oh, yes, I think it's, it's definitely that, and certainly the last five or six years that I've been in London because I was tired and working hard and travelling and commuting, whatever, you know, I was grabbing whatever I could, whenever I could.

 

Isabel blames many aspects of her former lifestyle for her diabetes.

Isabel blames many aspects of her former lifestyle for her diabetes.

Age at interview: 60
Sex: Female
Age at diagnosis: 57
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Now do you have any idea what might cause diabetes generally?

Well it's the failure of the sugar to be absorbed by your insulin. You, the body to produce enough insulin to absorb the sugar and convert it into whatever it is that's supposed to then excrete it. And I know that there's a lot of research on talking about insulin-resistant cells in your body, and there's quite a breakthrough, that recently has been made about that. So if it comes up in the newspapers I am always interested in it, you know I want to read more about it.

Do you think there's anything that might pre-dispose you? Any factors?

Fair, White and 40, or in this case 60, you know I think I must be a classic case for having, for getting diabetes' I'm indolent, I don't exercise as much as other people, I'm very overweight and I eat too much. And I think that pre-disposed me towards diabetes, too much sugar in my diet, too much fat.

 

Alex thinks his drink problems played a part in causing his diabetes.

Alex thinks his drink problems played a part in causing his diabetes.

Age at interview: 54
Sex: Male
Age at diagnosis: 51
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Another problem I think it's only fair to mention as we're going into the background is that I, was going to say 'had' but probably I 'have' - I have an alcohol dependency issue. It's under control at the moment obviously I'm not drinking, so as long as I don't touch alcohol I'm fine. If I came to your house and took one drink then, I'm sorry it's 'Good night Vienna' and I'm away. And that all lasts for several months and it'll probably end up with me being hospitalised.

Well we don't need to be 'Brain of Britain' to know you shouldn't be drinking alcohol if you're diabetic, but so I've got the added problem that having the, I suppose being alcoholic and having diabetes is another concerning issue, and one I have to have a strong mental defence against, and at this moment in time it's fine, I'm glad to say. So that's another issue that goes along with the peripheral neuropathy and the diabetes. And I also had a mini-stroke back in 2002, and I don't think it's anything to do with diabetes, but it was also another problem for my' Well the ability I suppose is the best way of putting it.

Other illnesses or health conditions, particularly having high blood pressure and high cholesterol, were also seen as contributory factors in diabetes. Some people we talked to had comorbidities (other illnesses) which had made it difficult for them to take regular exercise. 

 

Andy doesn't know exactly what caused his diabetes but says that chronic pain has always made...

Andy doesn't know exactly what caused his diabetes but says that chronic pain has always made...

Age at interview: 52
Sex: Male
Age at diagnosis: 52
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Because of chronic pain I'm relatively sedentary. I don't do exercise' I'm not exactly a couch potato, but I don't go and do exercise.

Interestingly I had for four months from January through to at the end of April, I joined the gym and I was going swimming every other day. And I gave that up simply because my joints were just hurting more and more. It wasn't actually, whilst I felt my chest improving, the rest of my body felt so much worse' In hindsight I just wonder whether that was the diabetes coming on. But I didn't get any, I didn't feel any benefits from the exercise, so I gave that up as a bad idea.

It seemed like a sensible thing to do so I gave it a go, joined the gym. I can't use the gym equipment but they've got a swimming pool, so I'd go every morning before, every other morning, before work go and do sort of fifteen to twenty minutes in the pool. Didn't help - gave that up' I'm not suggesting that starting exercise triggered the diabetes at all, but it's just I had done some exercise and I felt the benefit in my chest, and breathing became easier' But, no I didn't feel the benefit anywhere else and my joints ached.

I know that I was perfectly fine December 2005. Six months later I'm diabetic - very - now, did I get a virus? I don't know. Nobody's ever tried to find out where I got it from. I'm not overweight. I'm 6'2' and fifteen and a half stone - I could do with losing about a stone but I'm not hugely overweight. I'm a little bit overweight. I don't sit down and do absolutely nothing, I just don't do a lot of exercise because of the [chronic] pain.

Others wondered if having too much stress in their lives either through life events or because of pressure at work could have triggered diabetes. Others said that having a 'sedentary' job which included working at a computer screen all day or driving for a living could be partly to blame for their diabetes. 

 

Lawrence has wondered about the causes of his diabetes and thinks that a series of stressful...

Lawrence has wondered about the causes of his diabetes and thinks that a series of stressful...

Age at interview: 38
Sex: Male
Age at diagnosis: 37
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I've no idea, I've no idea, but when I went through the web search just researching on my own in terms of trying to understand what exactly is diabetes and how you come up with it, one of the possible causes, they said that, you know, there's a myriad of causes or you just don't know. But one of the possible causes they said was, was possibly stress, so' Maybe it could've been stress I don't know, but of all the possibilities they listed, I couldn't identify with any of them except the stress element. So maybe it might've been stress but I really don't know. The doctor said officially they don't really know what causes it, they know how it occurs, the mechanism of it but, they can't really tell you what actually triggers it off, but to me, the only one I could identify was possibly stress but I couldn't say for sure.

Without wanting to pry into that, was it severe stress over a long period of time?

Well I wouldn't say over a very long period of time, but it was certainly over, you know it was a series of events over a short period of time, because you know I'd just lost my parents, and we were having problems with our visa renewals, and because of that my wife had stopped working for a while, so financially we were under severe pressure, so I'm just' Because I traced you know, my life back and that's the only period I could think of that I could have gone through stress, but other than that I've no idea, I've no idea.

 

Stuart drives a taxi for a living and feels it hasn't helped with his diabetes.

Stuart drives a taxi for a living and feels it hasn't helped with his diabetes.

Age at interview: 60
Sex: Male
Age at diagnosis: 55
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Well, taxi driving really isn't, perhaps isn't terribly compatible with somebody that's trying to eat well and sort of exercise. It's a lot of sitting around for a start. And, like I say, I take a good breakfast before I go. And then I'm very careful at lunchtime with what I eat. I usually get a sandwich, and occasionally a packet of crisps. But try not, I've always got some fruit in the car that, that I can sort of snack on if I need to snack. Or I particularly like some small raw carrots and there's usually a pack of those in as well to nibble on. So I'm not eating sort of chocolate bars and things like that in between. But the diet is absolutely okay.

But it's the exercise part that suffers in taxi driving because I can't wander too far from the car, and I can't sort of get out for a walk at a quiet period because I've got to be close to the radio. So it is difficult. So therefore exercise in an evening, going out for a walk is important. Although I don't do that very often. But I do in a morning do sit-ups and I've got some weights at home that I use, just for 20 minutes each morning. So I'll do some sit-ups and some weights just to, you know, try and exercise a little bit. But it's the cardiovascular stuff that I miss out on.

 

Helen was under stress at work and wonders if too much adrenaline pumping round her body might...

Helen was under stress at work and wonders if too much adrenaline pumping round her body might...

Age at interview: 63
Sex: Female
Age at diagnosis: 60
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So do you, I mean do you ever have any thoughts about why you got diabetes?

Yes. Not, 'Woe is me' and, 'Why me?' Because I mean that's just life. I don't know again too much about the current research and how much they feel that diabetes is maybe an auto-immune problem. I know they checked me out for auto-immune because I've had problems before with, I had hair loss, which was an auto-immune, and I also had you know, loads of allergies. And they did check me out and they said, 'No, it wasn't auto-immune.' So that's, I've put that aside. But because I've got an auto-immune problem within my own child, that had to be checked out. But that's the one thing I really would like to know really, where mine came from? What it is - did I just overload my system?

I mean there's a lot of research that I've read that said that having the adrenalin gland constantly pumping. And certainly with the kind of pressurised job, with the lifestyle I liked to lead, I was always on the go and was pumping all the time. I was aware of that.

I would have said I was on overdrive for six months, I mean really overdrive, trying to run a school in two-thirds of a building, too many people, staff stressed out their minds. Then go back into a building where they'd taken down roofs and we'd to clear up. I mean it was just, it was six months of hell. And that was only, that was in 2000/2001, so it wasn't long before. And I can look back and say, you know, I started to feel not so much energy after that. Again, you don't know. But I really, oh, that's the one thing I would like to know. Is there a family connection? They don't know. I mean one's a, that's my mother's cousin, which is kind of out there, and one's a great-aunt, which is out here. Is it to do with adrenalin stress? I don't know.

Growing up in a stressful environment had also made some women develop eating disorders including bulimia. Several women linked their current weight problems with early childhood experiences of abuse and bullying which meant that they had taken comfort in food and/or alcohol at an early age. 

 

Kay talks about her childhood, the abuse she experienced and the effect that had on her weight.

Kay talks about her childhood, the abuse she experienced and the effect that had on her weight.

Age at interview: 34
Sex: Female
Age at diagnosis: 30
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A lot of people think that Mum used to feed us a lot. But it is the same, she was big. If you saw her now, she is slim as you, she is. She works nights, well a fortnight about at the factory. We grew up, well I grew up as my Dad was a chef and' he always did large meals, but it wasn't because of that. A lot of the family are big anyway because of our glands. It is something to do with the glands. But otherwise, Mum always brought us up healthy and whatever. I was always on the go. It wasn't the fact that I sat about. I am always on the go. Or with little 'un anyway, she likes doing things. And growing up, we grew up in a chip shops, because Dad was a chef up till I was about seven, and a lot of the time I was abused anyway when I was growing up by a friend of the family. So that was hard as well. Coping with that and coping with the weight issue because kids around, around where we lived, they could be cruel sometimes, but then most kids can be can't they?
 

Initially Zoe thought that her weight loss was a sign of diabetes.

Initially Zoe thought that her weight loss was a sign of diabetes.

Age at interview: 32
Sex: Female
Age at diagnosis: 20
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For a long time as a kid I tried to lose weight and couldn't, and all of a sudden one day I just lost - well it just went on a spiral - and I lost about six or eight stone, eating the same foods I had ever eaten. And they say maybe that was when my diabetes had hit me. But we just didn't recognise it because I'd, I've always drunk a lot of fluids, and, you know, being sleepy and tired, I've always found, put a fight against it because like with being a, a big girl I never wanted people to say I told you so, you can't do this and you can't do that, so I've always had two or three jobs at a time. To overcompensate people saying, 'Oh no she's lazy, she's this, she's that.' And I've always dieted, I've always exercised. And it was just weird that nobody picked up that I was diabetic.

But I didn't know at the time I was the only, I thought I was the only one in the family, since I've found out I'm diabetic that I found out my mother, my father, my sister, everyone else is diabetic in the family, my grandma was diabetic. But it's just really strange how afterwards that we found out, that's what I've, I found myself lucky to be the first one to find out. But I started off with what they called 'old age diabetes', what they told me [laughs], and I was like well.

Was it type 2 diabetes?

Yeh [laughs].

I know that sounds really silly I just, I think as a kid I did become bulimic because of my weight. And I can remember going to see doctors and, you know, there was a time I used to have to sing when I went to the toilet and people used to have to, you know, hear me, listen to me just to make sure I wasn't being sick. And I can go a long time still to this day of eating and I could actually bring that food up the next day, of holding it... But I think it's just something that's built into me, you know, the more you eat the bigger you get. I don't, I don't know how not to be sick now. It's like a natural, every day, yeah so it doesn't bother me [laughs].

Eating too much of the 'wrong thing' such as food that was rich in sugar, salt, fats and having a habit of drinking fizzy 'pop' or fruit juice as opposed to water was also said by the people we interviewed to lead to diabetes. Eating sweets and sugar does not cause diabetes, but eating a lot of sugary and fatty foods can lead to being overweight which is a risk factor.

Not everyone was interested in what had caused their diabetes and said that what mattered more was accepting the diagnosis and getting to grips with what it would mean for them in the long-term. A few people said they had no idea why they had developed diabetes and wondered if glandular problems or an unknown virus may have been responsible. 

 

He feels resigned to having diabetes and prefers to focus on controlling it as much as possible.

He feels resigned to having diabetes and prefers to focus on controlling it as much as possible.

Age at interview: 52
Sex: Male
Age at diagnosis: 38
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Have you ever wondered why you have got diabetes?

Oh yeah. I wonder all the time, you think 'why me?' Probably it's like, it's probably like any other disease. If somebody goes to the hospital and they say you have got cancer, they say why me? But you can't answer it. There is no answer to it, it's you. It could have been your lifestyle. It could be inherited from your family. It could be through stress. It could be through anything. But you can't say how did I get it? Because you don't know. So you've just got to live with it. And that's it. You are diabetic. End of story. And there's nothing you do about it. You can worry about it as much as you like, you've got it and that is it. So you've just got to live with it, get on with it. Yes, you do. I mean when he said to me, you know, 'You have got sugar.' You think, 'Oh why me? What have I done, to deserve this?' You probably haven't done anything. It's probably like they say they jump a generation. Probably your grandparents had it. Perhaps you grandparents didn't have it. You might be the first of the family ever to have it. It could be from anything.

Last reviewed March 2016.

Last updated March 2016.

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