Under the Hood

American Diabetes Month: How Who You Are May Raise Your Type 2 Diabetes Risk

blood sugar
Estimates indicate 25.8 million Americans have type 2 diabetes; those who are at greater risk are older, Latinos or African-American women, shift workers, and sleep apnea sufferers. Dennis Skley

Estimates indicate 25.8 million Americans have type 2 diabetes, yet nearly seven million of them have never been diagnosed. While this may seem unfathomable to you, consider these common symptoms of the disease, and think about whether you yourself would notice their appearance:

  • increased thirst
  • increased hunger
  • fatigue
  • increased urination, especially at night
  • unexplained weight loss
  • blurred vision
  • numbness or tingling in the feet or hands
  • sores that do not heal

Because so many people simply don’t notice this disease, it often goes untreated, and over time it may affect and harm their eyes, kidneys, nerves, and heart. In some cases, the disease results in heart attacks, strokes, kidney disease, blindness, amputations, and even death. Though the exact causes are unknown, type 2 diabetes is believed to be caused by a combination of genetic susceptibility and behavioral factors, including high body weight, lack of exercise, and poor diet. Some people, then, are much more likely to develop this illness than others.

Middle-Aged and Older People

Type 2 diabetes is typically diagnosed in people over the age of 40, and for this reason it often appears in a prominent position on lists of illnesses of longevity or the so-called lifestyle diseases. While the risk of type 2 diabetes certainly rises with advanced age, the reason why is not crystal clear, though it may be linked to changes in how our bodies metabolize sugar. Insulin is necessary when our bodies convert glucose into energy. People with type 2 diabetes either do not produce enough insulin or their cells resist the insulin. When glucose, which our bodies make from the food we eat, builds up in the blood instead of properly aiding cell metabolism, our cells become starved for energy. The efficiency of this process, apparently, may break down over the years.

Latinos and African-American Women

Latino populations, which include all people who can trace their origins to Spanish cultures, and non-Hispanic black women have the highest lifetime risk of type 2 diabetes worldwide, according to a recent study. The risk for these two groups exceeds 50 percent, meaning each individual within these groups is more likely than not to develop type 2 diabetes. As with age, researchers do not entirely understand why this is the case, though many suspect some form of genetic tendency. Diabetes is known to be polygenic, meaning more than one gene contributes to the condition, and a number of studies have identified more than 70 distinct genome locations carrying common variants. In one particular study, scientists performed genetic tests on about 3,700 DNA samples that led to the identification of a gene mutation which resulted in a higher prevalence of type 2 diabetes — five times as high — among Mexican and U.S. Latinos compared to Americans of European descent.

Asian Americans, Native Americans, and Pacific Islanders

Less dramatic though still signficant, Asian Americans, Native Hawaiians, and Pacific Islanders are at an increased risk for type 2 diabetes when compared to white Americans. What is important to note is that members of these three groups who are overweight increase their risk of disease by more percentage points than someone of another ethnic group who is carrying the exact same number of extra pounds. Strikingly, between the years of 1994 and 2004, the incidence of diabetes in diabetes among American Indian and Alaska Native teens between 15 and 19 increased by 68 percent. This trend is worrisome, to say the least, and many researchers attribute this to unhealthy lifestyle choices in the areas of diet, weight, and exercise.

Shift Workers

A Chinese study, which focused on worker’s body mass index, family history of diabetes, level of physical activity, and work schedule and analyzed data from international studies involving more than 226,500 people, found shift workers had a nine percent greater chance of developing diabetes than 9-to-5 workers. What’s more, within this same group, men had a 37 percent higher risk of developing type 2 diabetes than women. Finally, shift workers whose schedules skipped from one part of the day to the next were also more likely to develop diabetes; they had a 42 percent chance of developing type 2 diabetes.

Sleep Apnea Sufferers

A Canadian study of more than 8,500 people demonstrated a connection between obstructive sleep apnea and diabetes. Patients with mild or moderate sleep apnea were found to have a 23 percent increased risk of developing diabetes compared to people without the condition, while those with more severe sleep apnea had a 30 percent higher risk. While the connection is not entirely understood, scientists believe shorter sleep times and higher heart rates may play a role in escalating risk levels for diabetes.

The Poor

The Department of Agriculture (USDA) discovered in one unusual study that blood sugar levels in people with type 2 diabetes rose with higher food prices. Essentially, the researchers measured glucose levels in 2,400 adults with type 2 diabetes in 35 United States markets and then analyzed the data along with grocery store prices during the previous three months. They discovered whenever consumers were priced out of healthy foods, such as lean meats, fruits, vegetables, and low-fat yogurt, their glucose levels would climb. However, when the same consumers were priced out of packaged or prepared foods, their blood sugar levels dropped. Never underestimate the health impacts of everyday decisions made within seconds in the grocery aisles.

Children Born to Moms with Gestational Diabetes

During pregnancy, nearly one in every 10 women will develop what is known as gestational diabetes, a passing condition of high blood sugar levels that will dissipate after the birth of their child. Children exposed to gestational diabetes are around six times more likely to develop diabetes or prediabetes than other children. Seemingly, after enduring an impaired glucose tolerance during their first few days of life, these babies become more prone to obesity and heart problems, and in turn, are more likely to develop diabetes. (And, by the way, the mothers themselves are also more likely to develop type 2 diabetes in the years to come.)

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