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However, environmental factors (almost certainly diet and weight) play a large part in the development of type 2 diabetes in addition to any genetic component. Genetic risk for type 2 diabetes changes as humans first began migrating around the world, implying a strong environmental component has affected the genetic-basis of type 2 diabetes.
Obesity has been found to contribute to approximately 55% of cases of type 2 diabetes; [10] chronic obesity leads to increased insulin resistance that can develop into type 2 diabetes, [11] most likely because adipose tissue (especially that in the abdomen around internal organs) is a source of several chemical signals, hormones and cytokines, to other tissues.
Dietary factors also influence the risk of developing type 2 diabetes. Consumption of sugar-sweetened drinks in excess is associated with an increased risk. [ 39 ] [ 40 ] The type of fats in the diet are important, with saturated fat and trans fatty acids increasing the risk, and polyunsaturated and monounsaturated fat decreasing the risk. [ 32 ]
In 2021 there were 4.1 million people in the UK diagnosed with diabetes, 90% of them having type 2. There were a further 1 million people with undiagnosed type 2 diabetes and 13.6 million people were at risk of developing type 2 diabetes, half of which could be prevented. [24]
[3] [4] [5] Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender, and genetics may influence risk. Other health problems compound the chronic complications of diabetes such as smoking , obesity , high blood pressure , elevated cholesterol levels, and lack of regular exercise .
In people with impaired glucose tolerance or impaired fasting glucose, presence of metabolic syndrome doubles the risk of developing type 2 diabetes. [37] It is likely that prediabetes and metabolic syndrome denote the same disorder, defining it by the different sets of biological markers.
Diabetes affects the blood vessels in the body, such as capillaries and arteries, which are the routes blood take to deliver nutrients and oxygen to the organs in the body. [4] By affecting the blood flow, diabetes increases the risk of other conditions such as strokes and heart disease (heart attacks). [2]
The major risk factors for developing diabetic retinopathy are duration of diabetes, poor blood sugar control, and to a lesser extent high blood pressure. [22] Five years after diabetes diagnosis, around 25% of those with type 1 diabetes have some degree of diabetic retinopathy, while 2% have proliferative diabetic retinopathy.
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