One thing that drives me a little nuts is when people look at me, based on my current weight and eating and exercise habits and ask, “How could you possibly have type 2 diabetes?”
Part of this is a stereotype that people believe: only overweight or obese people who live a sedentary lifestyle and eat a “bad” diet get type 2 diabetes.
But while those factors may contribute to getting diabetes—or for that matter prediabetes—the overwhelming risk factor is a family history of type 2 diabetes.
In my case, my father had type 2 diabetes. He found out when he passed out after drinking two beers when he was about 30 years old. He was put on insulin, and except for a short period of time when he was on oral drugs, stayed on insulin for most of his life.
My first inkling arrived even earlier, when I was graduating from college.
Under the stress of wondering what came next, I had gained a few pounds and hadn’t been feeling well. My uncle, a doctor at Johns Hopkins, took a look at me and recommended that I get a fasting glucose tolerance test.
My results showed a sugar that soared to 400 and didn’t come back down.
Luckily, rather than put me on medication, he suggested cleaning up my diet—I was eating pretty much what I wanted (goodbye pizza and full-fat ice cream)—and adding some exercise to my routine.
I did both. Within a year I was ten pounds skinnier and running 6 miles a day. My fasting blood sugars taken at the doctor’s office (this was before glucose monitors were available for home use) were good.
But neither running nor weight loss stopped me from getting gestational diabetes when I had my first pregnancy in 1985 or again in 1992. And despite my best efforts to stave off the chronic disease, several years later I was diagnosed as a true type 2.
How much is nature and how much is nurture? It’s tough to say. It’s clear from research however that the causes of type 2 diabetes are usually multifactorial—meaning more than one diabetes cause is involved.
But often, the most overwhelming factor is a family history of type 2 diabetes. Other risk factors can include obesity, living a sedentary lifestyle, increasing age or a poor diet.
Other causes such as pregnancy or illness can also be type 2 diabetes risk factors.
Of course, I don’t blame my dad. It was in his genes, as it is in mine. Among my sisters and brother, one other sister was diagnosed with type 2, but she has struggled with weight for most of her life.
So what to do if you have a family history of diabetes? My best advice is to stay vigilant. To avoid complications of diabetes, have a regular physical. Keep relatively slim. Exercise regularly. Cut down on the carbs and processed foods. Avoid stress. All the good things that anyone—a person living with diabetes or not—should do to maintain good health.
You may not have a say in whether you get diabetes, but you do have a choice in how you deal with it.