Ask a CDCES: Why Was I Diagnosed with Type 2 Diabetes or Prediabetes?

You were just diagnosed with type 2 diabetes or prediabetes but were never given an explanation why. Knowing the potential reasons that could’ve contributed to your diagnosis can impact your outlook on life with diabetes, including your ability to manage it. A certified diabetes care and education specialist (CDCES) from the Association of Diabetes Care and Education Specialists (ADCES) is here to chime in with an answer to this question.

Dear CDCES: I was just told I have type 2 diabetes and I know someone who was told he has prediabetes. Why did this happen to us?

Dear Reader: The short answer is it’s complex. I recently went to a talk by a physician who has been researching the causes and problems with diabetes for years, and he said: “The only way to cure diabetes or prediabetes is to select different parents.”

Prediabetes and diabetes are conditions where genetic and environmental factors come together and result in insulin resistance. This happens years before the actual diagnosis and there are no specific tests for insulin resistance. You can’t change your genetics, but the good news is that you have some control over the changes in your environment and lifestyle, which can really impact managing these conditions—along with some medications that may be needed over time. 

Genetics

There is no genetic test to identify type 2 diabetes or people at risk for type 2 diabetes. But it tends to run in families, which suggests a strong genetic link. We also know that certain ethnic groups have a much higher risk of developing diabetes, including African Americans, Alaska Natives, American Indians, Asian Americans, Hispanics/Latinos, Native Hawaiians and Pacific Islanders.

Studies have identified hundreds of DNA variations that are associated with the risk of developing type 2 diabetes. Scientists surmise that it is the combination of those variants that helps determine a person’s likelihood of developing the disease.

Recently, there has been more discussion in the scientific community about using these gene variations, a person’s physiology and their clinical presentation to predict who is more or less likely to benefit from a specific treatment. They call this precision medicine, and if it becomes more widely utilized, will likely result in more types and subtypes of diabetes in the future. 

Environment

Although your genes may predispose you to develop prediabetes or diabetes, genetic variations likely act together with health and lifestyle factors to influence your overall risk. We may not be able to pinpoint a specific pattern of inheritance, but we do know that it all starts with something called insulin resistance. This means your body is resistant to the effects of insulin, which when working properly helps you to metabolize sugar, or glucose, in your blood. 

When you have insulin resistance, it takes more and more insulin to keep blood sugar levels in the normal range. Over time, the body can’t produce enough insulin to do this. This leads to first developing prediabetes and then potentially progressing to type 2 diabetes.

But not everyone with prediabetes is destined to get type 2 diabetes. This is where lifestyle change can make a huge impact. Increasing activity, eating less fat and losing just 5 percent of body weight has been shown to boost the body’s response to insulin. A lifestyle change program can you help hit these targets and reduce your risk of developing type 2 diabetes. 

I have personally seen many people who are healthier after they get diagnosed with prediabetes or diabetes than before. We are all human and sometimes we need something to kick us into the change mode to be able to build sustainable new lifestyle habits.

It’s never too late to start making those changes. A certified diabetes care and education specialist can help you manage the things you can change and cope with what you can’t. You can read more about the benefits of diabetes self-management education and support at DiabetesEducator.org/DCEShelp. 

For more information about prediabetes, visit DiabetesEducator.org/prediabetes.

Editor’s note: This content was produced in partnership with the Association of Diabetes Care and Education Specialists (ADCES), a founding partner of Beyond Type 2. 

WRITTEN BY JODI LAVIN-TOMPKINS MSN, RN, BC-ADM, CDCES, POSTED 07/28/20, UPDATED 08/01/23

Jodi Lavin-Tompkins is a North Carolina native and a Master’s prepared nurse with over 30 years’ experience in diabetes care. She is currently the director of accreditation/content development at the Association of Diabetes Care & Education Specialists. Jodi’s career has spanned working in academic settings as a nurse practitioner to positions in the pharmaceutical and medical device industries, to managing a diabetes self-management education and support program in a large midwestern health system. She is passionate about making sure people with diabetes have the knowledge and skills they need to manage diabetes to the best of their abilities. To Jodi, diabetes is personal; her mother, father, brother, niece, cousin, aunt and uncle all have diabetes.