THE RISK FACTOR'S OF DIABETES

BY:

OGHOJE PRECIOUS

NUO/CHS/22/13124

A SEMINAR SUBMITTED TO THE DEPARTMENT OF PUBLIC AND

COMMUNITY HEALTH, COLLEGE OF MEDICAL & HEALTH SCIENCES,

NOVENA UNIVERSITY, OGUME, DELTA STATE

JANUARY, 2025

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INTRODUCTION

Diabetes is a chronic, metabolic disease characterized by elevated levels of

blood glucose (or blood sugar), which leads over time to serious damage

to the heart, blood vessels, eyes, kidneys and nerves. The most common is

type 2 diabetes, usually in adults, which occurs when the body becomes

resistant to insulin or doesn't make enough insulin. In the past 3 decades

the prevalence of type 2 diabetes has risen dramatically in countries of all

income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-

dependent diabetes, is a chronic condition in which the pancreas produces

little or no insulin by itself. For people living with diabetes, access to

affordable treatment, including insulin, is critical to their survival. There is a

globally agreed target to halt the rise in diabetes and obesity by 2025. (Ley,

et. al., 2022)

About 830 million people worldwide have diabetes, the majority living in

low-and middle-income countries. More than half of people living with

diabetes are not receiving treatment. Both the number of people with

diabetes and the number of people with untreated diabetes have been

steadily increasing over the past decades. (WHO, 2024)

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WHAT IS DIABETES?

Diabetes is a condition that happens when your blood sugar (glucose) is

too high. It develops when your pancreas does not make enough insulin or

any at all, or when your body is not responding to the effects of insulin

properly. Diabetes affects people of all ages. Most forms of diabetes are

chronic (lifelong), and all forms are manageable with medications and/or

lifestyle changes. (CDC, 2024)

TYPES OF DIABETES

There are several types of diabetes. The most common forms include:

Type 1 diabetes: This type is an autoimmune disease in which your

immune system attacks and destroys insulin-producing cells in your

pancreas for unknown reasons. Up to 10% of people who have diabetes

have Type 1. It is usually diagnosed in children and young adults, but it can

develop at any age.

Prediabetes: This type is the stage before Type 2 diabetes. Your blood

glucose levels are higher than normal but not high enough to be officially

diagnosed with Type 2 diabetes.

Type 2 diabetes: With this type, your body does not make enough insulin

and/or your body’s cells don’t respond normally to the insulin (insulin

resistance). This is the most common type of diabetes. It mainly affects

adults, but children can have it as well.

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Gestational diabetes: This type develops in some people during pregnancy.

Gestational diabetes usually goes away after pregnancy. However, if you

have gestational diabetes, you’re at a higher risk of developing Type 2

diabetes later in life. (Xia, et. al., 2021)

Other types of diabetes include:

Type 3c diabetes: This form of diabetes happens when your pancreas

experiences damage (other than autoimmune damage), which affects its

ability to produce insulin. Pancreatitis, pancreatic cancer, cystic fibrosis

and hemochromatosis can all lead to pancreas damage that causes

diabetes. Having your pancreas removed (pancreatectomy) also results in

Type 3c.

Latent autoimmune diabetes in adults (LADA): Like Type 1 diabetes, LADA

also results from an autoimmune reaction, but it develops much more

slowly than Type 1. People diagnosed with LADA are usually over the age

of 30.

Maturity-onset diabetes of the young (MODY): MODY, also called

monogenic diabetes, happens due to an inherited genetic mutation that

affects how your body makes and uses insulin. There are currently over 10

different types of MODY. It affects up to 5% of people with diabetes and

commonly runs in families.

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Neonatal diabetes: This is a rare form of diabetes that occurs within the

first six months of life. It is also a form of monogenic diabetes. About 50%

of babies with neonatal diabetes have the lifelong form called permanent

neonatal diabetes mellitus. For the other half, the condition disappears

within a few months from onset, but it can come back later in life. This is

called transient neonatal diabetes mellitus.

Brittle diabetes: Brittle diabetes is a form of Type 1 diabetes that is marked

by frequent and severe episodes of high and low blood sugar levels. This

instability often leads to hospitalization. In rare cases, a pancreas

transplant may be necessary to permanently treat brittle diabetes. (WHO,

2016)

SYMPTOMS OF DIABETES

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CAUSES OF DIABETES

Too much glucose circulating in your bloodstream causes diabetes,

regardless of the type. However, the reason why your blood glucose levels

are high differs depending on the type of diabetes. (Al-Worafi, 2024)

Causes of diabetes include:

1. Insulin resistance: Type 2 diabetes mainly results from insulin

resistance. Insulin resistance happens when cells in your muscles,

fat and liver don’t respond as they should to insulin. Several factors

and conditions contribute to varying degrees of insulin resistance,

including obesity, lack of physical activity, diet, hormonal imbalances,

genetics and certain medications.

2. Autoimmune disease: Type 1 diabetes and LADA happen when your

immune system attacks the insulin-producing cells in your pancreas.

3. Hormonal imbalances: During pregnancy, the placenta releases

hormones that cause insulin resistance. You may develop

gestational diabetes if your pancreas cannot produce enough insulin

to overcome the insulin resistance. Other hormone-related

conditions like acromegaly and Cushing syndrome can also cause

Type 2 diabetes.

4. Pancreatic damage: Physical damage to your pancreas — from a

condition, surgery or injury — can affect its ability to make insulin,

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 resulting in Type 3c diabetes.

5. Genetic mutations: Certain genetic mutations can cause MODY and

neonatal diabetes.

COMPLICATIONS OF DIABETES

Diabetes can lead to acute (sudden and severe) and long-term

complications — mainly due to extreme or prolonged high blood sugar

levels. (Papatheodorou, et. al., 2021)

1. Acute diabetes complications

Acute diabetes complications that can be life-threatening include:

i. Hyperosmolar hyperglycemic state (HHS): This complication mainly

affects people with Type 2 diabetes. It happens when your blood

sugar levels are very high (over 600 milligrams per deciliter or mg/dL)

for a long period, leading to severe dehydration and confusion. It

requires immediate medical treatment.

ii. Diabetes-related ketoacidosis (DKA): This complication mainly

affects people with Type 1 diabetes or undiagnosed T1D. It happens

when your body does not have enough insulin. If your body does not

have insulin, it cannot use glucose for energy, so it breaks down fat

instead. This process eventually releases substances called ketones,

which turn your blood acidic. This causes labored breathing, vomiting

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 and loss of consciousness. DKA requires immediate medical

treatment.

iii. Severe low blood sugar (hypoglycemia): Hypoglycemia happens

when your blood sugar level drops below the range that is healthy for

you. Severe hypoglycemia is very low blood sugar. It mainly affects

people with diabetes who use insulin. Signs include blurred or double

vision, clumsiness, disorientation and seizures. It requires treatment

with emergency glucagon and/or medical intervention.

2. Long-term diabetes complications

Blood glucose levels that remain high for too long can damage your body’s

tissues and organs. This is mainly due to damage to your blood vessels

and nerves, which support your body’s tissues. (Butalia, et. al., 2022)

Cardiovascular (heart and blood vessel) issues are the most common type

of long-term diabetes complication. They include:

i. Coronary artery disease.

ii. Heart attack.

iii. Stroke.

iv. Atherosclerosis.

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Other diabetes complications include:

i. Nerve damage (neuropathy), which can cause numbness, tingling

and/or pain.

ii. Nephropathy, which can lead to kidney failure or the need

for dialysis or transplant.

iii. Retinopathy, which can lead to blindness.

iv. Diabetes-related foot conditions.

v. Skin infections.

vi. Amputations.

vii. Sexual dysfunction due to nerve and blood vessel damage, such
as erectile dysfunction or vaginal dryness.

viii. Gastroparesis.

ix. Hearing loss.

x. Oral health issues, such as gum (periodontal) disease.

THE RISK FACTORS OF DIABETES

1. Non-Modifiable Risk Factors:

i. Family History: A family history of diabetes significantly increases

the risk.

ii. Age: People over 45 years old are at higher risk.

iii. Ethnicity: Certain ethnic groups, such as African Americans,

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 Hispanic/Latino Americans, and Native Americans, are more prone to

diabetes.

2. Modifiable Risk Factors:

i. Obesity: Excess body weight is a major risk factor for diabetes.

ii. Physical Inactivity: A sedentary lifestyle increases the risk.

iii. Diet: A diet high in processed foods and sugars can lead to diabetes.

iv. High Blood Pressure and Cholesterol: These conditions are linked to
diabetes.

v. Smoking: Smoking contributes to the risk of developing diabetes.

vi. Sleep Disorders: Sleep conditions like obstructive sleep apnea can
raise the risk. (CDC, 2024)

PREVENTION

1. Eat a healthy diet, such as the Mediterranean diet.

2. Get physically active. Aim for 30 minutes a day at least five days a
week.

3. Work to achieve a weight that’s healthy for you.

4. Manage your stress.

5. Limit alcohol intake.

6. Get adequate sleep (typically 7 to 9 hours) and seek treatment for

sleep disorders.

7. Quit smoking.

8. Take medications as directed by your healthcare provider to manage

existing risk factors for heart disease. (CDC, 2024)
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CONCLUSION

Diabetes is significantly influenced by a combination of modifiable and non

-modifiable risk factors. While factors such as age, family history, and
ethnicity cannot be changed, adopting a healthy lifestyle can significantly
reduce the risk of developing diabetes. This includes maintaining a healthy
weight, engaging in regular physical activity, consuming a balanced diet,
managing blood pressure and cholesterol levels, quitting smoking, and
addressing sleep disorders.

Awareness of these risk factors and preventive measures is crucial in

mitigating the impact of diabetes and promoting overall health and well-
being.

RECOMMENDATIONS

1. Maintain a Healthy Weight: Achieve and sustain a balanced body weight.

2. Regular Exercise: Engage in at least 150 minutes of moderate or 75 minutes of

vigorous activity weekly.

3. Healthy Diet: Eat a variety of nutritious foods and avoid processed and sugary

items.

4. Monitor Blood Sugar: Regularly check blood sugar levels if you're at risk.

5. Manage Stress: Incorporate stress-relief practices such as meditation or yoga.

6. Regular Health Check-Ups: Monitor blood pressure, cholesterol, and overall

health.

7. Adhere to Medications: Follow prescribed treatments as directed.

8. Quit Smoking: Seek support to stop smoking.

9. Quality Sleep: Aim for 7-8 hours of sleep per night.

10. Prioritize Mental Health: Seek support for mental well-being.

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 REFERENCES

Al-Worafi, Y. M. (2024). Diabetes Mellitus: Causes and Risk Factors in

Developing Countries. SpringerLink

Butalia S, Kaplan GG, Khokhar B, Rabi DM (December 2022).

"Environmental Risk Factors and Type 1 Diabetes: Past, Present,
and Future". Canadian Journal of
Diabetes (Review). 40 (6): 586–593.

Centers for Disease Control and Prevention (CDC): "Diabetes Risk Factors |
Diabetes | CDC" Published on May 15, 2024.

Global Report on Diabetes: "GLOBAL REPORT ON DIABETES - World Health

Organization" Published in 2016

Ley, S. H., Schulze, M. B., Hivert, M.-F., Meigs, J. B., and Hu, F. B. (2022).
Chapter 13: Risk Factors for Type 2 Diabetes. National Institute of
Diabetes and Digestive and Kidney Diseases2.

Papatheodorou K, Banach M, Bekiari E, Rizzo M, Edmonds M (11 March

2021). "Complications of Diabetes 2017". Journal of Diabetes
Research. 2021: 3086167.

World Health Organization (WHO): "Diabetes - World Health Organization

(WHO)". Published on November 14, 2024.

Xia, M., Liu, K., Feng, J., Zheng, Z., & Xie, X. (2021). Prevalence and Risk
Factors of Type 2 Diabetes and Prediabetes Among 53,288 Middle-
Aged and Elderly Adults in China: A Cross-Sectional Study. Dove
Medical Press3.

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