Is diabetes closely related to genetics and lifestyle? What else should we pay attention to besides blood sugar?

Author: Li Guangwei, Chief Physician, Fuwai Hospital, Chinese Academy of Medical Sciences

Reviewer: Wu Xueyan, Chief Physician, Peking Union Medical College Hospital

Diabetes is a common and frequently occurring disease, a chronic systemic disease. It is a group of syndromes characterized by hyperglycemia, which is caused by defects in insulin secretion and action, leading to metabolic disorders of carbohydrates, proteins, fats, water and electrolytes.

The cause of diabetes is relatively complex. With the understanding of diabetes, it is believed to be related to many factors. In general, in addition to aging, genetic factors as the basis, and unhealthy lifestyles as catalysts, the combined effect of multiple factors has led to a significant increase in the incidence of diabetes compared to the past.

The correlation between diabetes and genetic factors;

The human body converts food into glucose through a complex process. Problems in any metabolic link in this process may lead to abnormal blood sugar levels. For example, if there are defects in substances related to glucose metabolism (especially insulin) in the body at birth, resulting in insufficient or lack of such substances in the body, abnormal blood sugar metabolism will occur. This situation is related to genetics.

Studies have shown that if both parents suffer from type 2 diabetes, the risk of their children developing diabetes increases by about 50%. This can be understood as a person has a template from birth to gradual development and maturity, and this template is the gene. Defects in the template will increase the risk of diabetes, so heredity is a very important factor in type 2 diabetes.

Figure 1 Original copyright image, no permission to reprint

The correlation between diabetes and social factors:

With the development of China's economy, people's lifestyles have changed dramatically. For example, people exercise much less than before. In the past, transportation was not well developed, and people basically traveled by walking or riding bicycles. Now people basically travel by car. Less exercise can easily increase blood sugar.

There is also a common phenomenon nowadays that people in the workplace work at desks for long periods of time, have high work pressure, poor sleep quality, cannot guarantee basic sleep time, and are in a state of tension and anxiety for a long time, which will also affect the body's metabolism.

The nutritional structure has also changed greatly. Nowadays, people eat more high-fat, high-sugar, and high-protein foods and consume more of them. The body is in a high-load state for a long time, and metabolic problems will gradually occur.

In addition, the unhealthy lifestyle of eating more and exercising less has led to an increasing number of obese people. As the fat increases, the body is prone to insulin resistance, the effect of insulin is weakened, and the ability to lower blood sugar decreases.

The combination of the above social factors has led to a gradual increase in metabolic diseases, and social factors have now become a very important high-risk factor for diabetes.

The relationship between blood sugar, blood lipids, blood pressure and uric acid:

The onset of diabetes is a complex metabolic disorder process. Under the combined effects of genetic and social factors, it leads to metabolic disorders in the human body and abnormal blood sugar metabolism.

When the body's metabolism is disturbed, other problems related to metabolism will also appear. Therefore, diabetic patients often have abnormal blood sugar levels, as well as abnormal blood pressure, blood lipids, and uric acid, because they have a common basis for the disease.

For example, genetic factors, unhealthy lifestyles, and long-term emotional stress can also lead to damage to blood vessel walls and increased blood viscosity, which can lead to high blood pressure and high blood lipids. 60% of diabetic patients also have high blood pressure or high blood lipids.

The incidence of hyperuricemia is also high in diabetic patients. As insulin resistance increases, uric acid clearance decreases. Diabetes can cause renal microvascular disease, and the kidney's clearance rate of uric acid will also decrease, which can easily lead to hyperuricemia.

In addition, they will influence and aggravate each other, and can be described as brothers in distress.

Figure 2 Original copyright image, no permission to reprint

Diabetes is a metabolic disease that is currently incurable and requires active intervention and treatment. The purpose of treatment is to delay the occurrence of complications, improve quality of life, and prolong life.

Without intervention and treatment, various complications will eventually occur, seriously affecting the quality of life and shortening life expectancy. 70% of diabetic patients die from myocardial infarction and cerebral infarction, 10%-20% of diabetic patients die from renal failure, and 5%-10% of diabetic patients die from other serious complications. Complications are not only related to high blood sugar, but also to high blood lipids, high blood pressure, high uric acid, obesity, etc.

Therefore, when monitoring and controlling diabetes, we should not only focus on blood sugar. In addition to controlling blood sugar, blood lipids should also meet the standard, especially low-density lipoprotein cholesterol, because atherosclerosis is mainly caused by it; blood pressure should be controlled within an appropriate range, too high blood pressure will aggravate atherosclerosis and easily lead to thrombosis or bleeding; coagulation function should be normal, due to metabolic disorders, the blood is relatively in a hypercoagulable state, and thrombosis is easy to form; hyperuricemia should be controlled, high uric acid is more harmful to the kidneys. In addition, weight should be controlled and reduced to a reasonable range.