What are risk factors for diabetes

Type 2 Diabetes: Causes & Risk Factors


In type 2 diabetics, the pancreas usually still produces enough insulin at the beginning of the disease. However, muscle, liver and fat cells are becoming increasingly insensitive to this (insulin resistance). The pancreas tries to compensate for this by producing even more insulin. Therefore, the insulin values ​​in the blood of type 2 diabetics can be normal or even increased, but there is still too little insulin in relation to the blood sugar values ​​(relative insulin deficiency). If the body cells become more and more insensitive over time, the pancreas can no longer compensate for this.

Insensitivity to insulin can be triggered by hereditary factors as well as overweight, obesity and lack of exercise. As the sugar (glucose) cannot be transferred from the bloodstream to the body cells in sufficient quantities, the blood sugar levels rise. In addition, the lack of glucose in the body's cells causes the body to produce more glucagon. This hormone also increases blood sugar levels.

Insulin-insensitivity of the fatty tissue of the abdominal cavity (abdominal fat) is particularly critical, because fatty tissue is a hormone tissue whose cells use signal substances such as B. free fatty acids or adiponectin and other messenger substances, communicate with the liver or muscles. If a thick layer of fat reduces the effect of insulin, this affects the heart, liver, muscles and arteries and promotes the development of lipid metabolism disorders, high blood pressure and vascular damage. This clinical picture is also known as metabolic syndrome.

Later, especially with increasing obesity, the pancreas' ability to produce insulin can be exhausted. The consequence can be an actual insulin shortage (absolute insulin deficiency), which the patient then has to compensate for with insulin therapy.

Risk factors for type 2 diabetes

Type 2 diabetes typically occurs in middle age, but it also increasingly occurs in younger years and in children and adolescents. The risk factors that promote the onset of type 2 diabetes include:

Hereditary factors

There are now almost a hundred genetic factors known to increase the risk of developing type 2 diabetes. Hereditary (identical) twins almost always both develop type 2 diabetes. In the case of daughters of mothers with type 2 diabetes, the diabetes risk is 50%, whereas otherwise it is on average 30-35% with an assumed life expectancy of 80 years. In children whose parents are both type 2 diabetic, the risk of developing the disease is about 60%.

Obesity and physical inactivity

Not everyone who bears the hereditary risk will also develop diabetes. Because external factors such as overweight, obesity and lack of exercise play a decisive role in the onset of type 2 diabetes. With increasing body weight, the risk of diabetes increases 5 to 10 times. An increased waist circumference has a particularly negative effect, as the fatty tissue in the abdominal cavity increases the free fatty acids in the blood particularly strongly.


Medication can also contribute to the onset of diabetes or to worsening existing diabetes. The following drugs can negatively affect blood sugar:

  • Cortisone and its derivatives; Topically applied preparations such as ointments, however, do not affect the blood sugar level
  • diuretic drugs, e.g. B. thiazides
  • antihypertensive drugs, e.g. B. Beta blockers
  • Ovulation inhibitors ("birth control pills")
  • Antidepressants

In addition, pregnancy (gestational diabetes), liver diseases, stress factors (infections, trauma, operations, etc.) and other hormonal disorders can also promote the onset of type 2 diabetes.