Ask an Expert: What Are the Risk Factors for Type 2 Diabetes?

From verywellhealth.com

This article is part of Health Divide: Type 2 Diabetes in People of Colour, a destination in our Health Divide series.

Zoe Hansen / Verywell

Meet the Expert

Do-Eun Lee, MD, has been practicing medicine for more than 20 years and specialises in diabetes, thyroid issues, and general endocrinology. She currently operates a private practice in Lafayette, CA, which opened in 2009. She has authored several publications and is the recipient of various professional awards and honours, including the Young Investigator Travel Award from Seoul National University College of Medicine Alumni Association of North America, Las Vegas.

Type 2 diabetes is common in the United States, and many people who are not diagnosed may be at risk.

According to the Centres for Disease Control and Prevention (CDC), more than a third of people in the United States are obese, and more than two-thirds of people in the United States are either obese or overweight. In addition, the ongoing pandemic has resulted in many people decreasing their exercise habits and increasing their sugar or alcohol intake, which can increase the chances they gain weight or develop a condition like diabetes. 

Environmental blockers like living in food deserts, which are home to more than 13.5 million people in the United States, likewise deplete people’s access to healthy food and increase risks for diabetes. What’s more, these barriers can disproportionately impact people of colour or who are financially vulnerable.

Below, Do-Eun Lee, MD, an endocrinologist who specializes in diabetes treatment, discusses how different lifestyles and living environments can impact risk levels for type 2 diabetes.

Verywell Health: How do food deserts impact risks of developing type 2 diabetes?

Dr. Lee: Food deserts, or limited access to food, can have a huge impact on someone’s type 2 diabetes risk.

If someone is too busy to shop, they might stock up on a lot of prepared foods, which will contribute to the development of diabetes, even at a young age. If people keep eating unhealthy food or are the offspring of people with diabetes, chances are they will also develop diabetes.

Also, people with lower socioeconomic status often have limited access to fresh fruits and vegetables.

Verywell Health: What advice do you have for people who live in food deserts?

Dr. Lee: People may be able to overcome unhealthy eating by shopping properly and smartly. Some people just do not know a good strategy or assume that all healthy food is expensive. It doesn’t have to be. Sometimes, there are some missed opportunities.

If social workers or case managers get involved in educating people on how they can shop for fresh food inexpensively, people’s risk may be reduced. When I shop, I go to a supermarket and buy fresh fruits and vegetables to make a salad with homemade dressing; my meal can be only a few dollars. There’s a misconception that eating healthy is always overpriced, and we need to teach grocery shopping as a life skill to some people.

Verywell Health: How have the last two years of the COVID-19 pandemic impacted type 2 diabetes treatment and risks?

Dr. Lee: In terms of treatment, it hasn’t been that bad. The introduction of telemedicine was very helpful, as we could do almost everything virtually except a detailed physical examination and possibly things like placing a sensor on their arm. We’ve been able to write prescriptions and don’t require authorization approval requests, which has increased accessibility. Generally, too, telemedicine reduced no-show rates and also increased compliance.

In terms of risks, however, people’s lifestyles changed. Most people stopped working out, most people ate a lot more sweets, most people drank more alcohol, and most people didn’t exercise. This wasn’t true for everyone, as tons of people also increased their exercise duration and intensity, but for the most part, people went the opposite—like a hibernating bear—and put on a lot of weight.

Verywell Health: Sweets and lack of exercise are often talked about as diabetes risks, but we sometimes hear less about alcohol consumption. Can you explain this risk?

Dr. Lee: The risks of alcohol on diabetes are multifold. When you drink alcohol, you gain weight, and you mess up your liver. The liver is a vital organ for glucose metabolism, so when your liver is diseased, your glucose is not going to be metabolised properly. Likewise, wine can raise sugar levels. This isn’t always the case, as some wine is sugar neutral or low sugar, so pure alcohol, like whiskey or hard liquor, will suppress glucose levels in the blood, meaning that your blood sugar could drop.

https://www.verywellhealth.com/ask-an-expert-risk-factors-type-2-diabetes-5521615