It’s a simple question, but the simple answer is that the medical community does not yet know.
The good news is that some diagnosed with diabetes mellitus can put the disease in complete remission. The even better news is that with the right diet, exercise and diabetic drugs, including insulin, metformin and many others developed in recent history, almost all of us with diabetes will not only live (that was not the case in the not too distant past), but we can live long and normal lives. The bad news is that there is no cure today. That means regardless what causes diabetes, if we stop doing what is needed to control it, the symptoms and possible complications they can cause will probably come back.
Unfortunately, none of that tells us what causes diabetes. We do, however, know quite a bit about what the risk factors are, what happens after we get it and what that can mean to us personally. So let’s start by discussing what it is, what the differences are between major types and what some risk factors or possible causes are for each. Knowing that much already helped researchers find medications and other treatments we need to survive. That’s a real plus in my book, but let’s hope a cure for diabetes is next … or better yet, that the actual causes of diabetes are soon discovered so that preventing diabetes becomes a reality before the disease strikes any more of us. Let’s begin …
As described in detail on the what is diabetes page, diabetes is a condition where sugar levels in the blood are too high. If it is diabetes mellitus, then either the pancreas no longer produces enough insulin for cells to transfer the sugar they need from the blood, or the cells themselves have become much less efficient in accepting the much needed energy supply, even though insulin may be readily available.
A form called gestational diabetes can be a temporary condition. Type 2 diabetes is persistent but easier to control, and Type 1 diabetes is considered permanent since without insulin injections there is no survival. There are others that act like Type 1 but occur due to an accident, injury, or by taking substances that are toxic to cells in the pancreas where insulin is produced. These last examples are not as common as ‘normal’ Type 1 or Type 2 diabetes, but the end effect is the same and certainly no less important.
Finally, if it is diabetes insipidus, then high blood sugar is not the problem at all. It is called diabetes because of frequent urination, but it is a problem where the kidney cannot concentrate urine due to insensitivity to, or lack of a hormone produced by the pituitary gland. Many of the symptoms of diabetes are present, but high blood sugar level is not one of them.
Type 1 diabetes is the most severe. It usually comes on very quickly, possibly in as little as a few weeks and if not treated immediately it can lead to serious problems including coma and death. With Type 1 diabetes, cells in the pancreas that make insulin (beta cells) stop doing so. It can be from the body’s own immune system attacking these cells, or from an outside agent, but the end result is that beta cells stop producing insulin. Because the person must have insulin shots from that point on to survive, it has been called insulin dependent diabetes mellitus, or IDDM for short. Since it usually occurs at ages under about 30, and especially in children, it has also been called juvenile diabetes, or childhood-onset diabetes.
Theories for why the body would attack itself include:
None have been definitively proven, but anything that triggers the body’s immune system to attack beta cells, or any chemical that attacks beta cells directly is suspect. At least these are good clues to help determine what causes diabetes.
Additional information about Type 1 diabetes will be added shortly, but specifically what causes diabetes in Type 1 cases is both unknown and unfortunately unpreventable today. But no panics – now that we have an alternate source of insulin, Type 1 diabetes is something that can usually be controlled. If you look up the history of diabetes, (Wikipedia has a great article on it at http://en.wikipedia.org/wiki/Diabetes), you’ll see that a diagnosis of diabetes was considered a death sentence not too terribly long ago. We’ve come a long way since then.
Unlike Type 1, Type 2 diabetes may take years to develop. Many don’t even know they have it. In fact, I didn’t realize I had Type 2 diabetes until the disease progressed to the point the symptoms could no longer be ignored. (The author page has more on that memorable experience if you would like to compare notes).
In Type 1, beta cells no longer work, and that results in an insulin shortage. With type 2 diabetes mellitus, the problem may be reduced insulin production, or it could be that the cells themselves have become resistant to the insulin that is present. Or both.
With Type 1 diabetes, a condition called Ketoacidosis is not uncommon. This is a situation where insufficient insulin sends a signal for the liver to start using fat reserves (body cells think they are starving) and the liver does just that. Since the pancreas doesn’t make enough insulin anymore, nothing triggers the body to stop the process. The end result is a toxin level in the bloodstream that can cause coma and if not treated, death. Because of the typical gradual onset with few noticeable symptoms (at least initially) ketoacidosis is uncommon in type 2 diabetes.
Type 1 diabetes may occur in older adults, but is most common for those under 30. In contrast, type 2 diabetes can occur in children, but usually occurs in older adults.
Risk factors associated with what causes diabetes type 2 include:
Again, none have been definitively proven to be what causes diabetes in the type 2 case, but obesity certainly appears to have a strong link with it. Sedentary lifestyles, high caloric intake, or reduced exercise and weight gain as we age seem to be common factors with the disease. Apart from toxins in our food wrappers or medications that affect insulin production directly, (or heredity itself), it would appear a healthy diet and active lifestyle are good ways to reduce the risk. I can certainly say from first hand experience that diet and exercise alone allowed me to get off prescribed medications for type 2 diabetes fairly fast.
Women who are pregnant and have not had diabetes in the past, but develop high blood sugar levels during the pregnancy are said to have gestational diabetes.
There are many similarities between type 2 and gestational diabetes, and it is possible that hormonal production during pregnancy effects the ability of the body to use insulin, just like in type 2. Although the exact cause is not known, insulin resistance and high blood sugar levels are the result.
Symptoms usually disappear once the baby is delivered, but there is a risk that the mother will develop type 2 diabetes later in life. Risks to the baby are always a concern, so close monitoring and control of blood sugar levels, just like with Type 2 diabetes is needed.
It is interesting to note that in almost every case where expectant mothers are diagnosed with gestational diabetes, they are placed on strict diets and an exercise program to control blood sugar levels. Although medications up to and including insulin shots may also be required, diet and exercise are an integral part of the plan.
As noted in the first paragraph, medical science has not yet cracked to code on what causes diabetes. However, they do know what it does to the body. Since Type 2 diabetes is statically more common than Type 1, most can be controlled by diet and exercise … and medications up to and including insulin.
My hope is that diet and exercise will be your cure. What causes diabetes is important to know, but until we do, my strongest recommendation would be not to leave symptom control to the doctor’s prescription pad.