What is the origin of type 2 diabetes?

⏱ 8 min read

14.11. is World Diabetes Day!

But where does type 2 diabetes actually originate?

Type 2 diabetes usually occurs in overweight people over the age of 40. However, due to the increase in childhood obesity, more and more young people are affected.

➤  The foundation stone is laid in childhood

Observations show that every 7th child in Germany is already overweight or obese. This worrying trend has far-reaching health consequences. According to a large-scale study in several European countries involving 2 to 9-year-olds, overweight children develop a high risk of metabolic disorders in the long term.

These include, for example

• High blood sugar levels and type 2 diabetes
• Cardiovascular diseases
• High blood pressure
• Poor blood and liver fat values

The study shows that obesity in children could actually be the starting point for the development of metabolic disorders.

After 6 years of observation, the following findings were made: Almost no child who was metabolically abnormal at the beginning of the observation series was considered physically healthy after the 6 years. Overweight children usually remained overweight and developed several metabolic disorders over time.

This makes it clear that it is extremely important to recognize and reduce obesity in children at an early stage and to promote a normal and healthy body weight. This is because developed metabolic disorders are hardly reversible.

➤ Every 7th child in Germany is overweight or obese!

How does type 2 diabetes develop in the body?

Insulin is the hormone that moves sugar (glucose) from the blood into the cells. In type 2 diabetes, two things go wrong at the same time: the tissues that normally react to insulin no longer respond to it properly, and the beta cells of the pancreas no longer release enough insulin to make up for this (Galicia-Garcia et al., 2020). The first problem is called insulin resistance.

As a result, sugar stays in the blood instead of reaching the cells, and blood sugar rises. According to the same review, the process is kept going by diet, too little physical activity and an imbalance of the gut bacteria.

This is where R-alpha lipoic acid comes in: in an analysis of 24 randomised trials in people with metabolic diseases, alpha lipoic acid lowered fasting blood sugar, insulin, insulin resistance and the long-term blood sugar value HbA1c (Akbari et al., 2018). The Diabetic Carefree Package combines R-alpha lipoic acid with the amino acid L-arginine. In a double-blind study of people with type 2 diabetes, L-arginine increased blood flow in the forearm by 36% and the body's glucose uptake during the test by 34% (Piatti et al., 2001).

View the Diabetic Carefree Package  ➜

✓ R-alpha lipoic acid + L-arginine

Genes or lifestyle: what counts more?

Both play a part. Type 2 diabetes runs in families: in a large European study, people with a family history of type 2 diabetes developed the disease almost three times as often as people without one. If both parents were affected, the risk was about five times as high (Scott et al., 2013).

Then there is body weight. Across 18 long-term studies, people who were overweight developed type 2 diabetes about three times as often as people of normal weight, and people with obesity about seven times as often (Abdullah et al., 2010).

The good news is that lifestyle can be changed:

• Weight loss and exercise: In a trial of 3,234 people whose blood sugar was already raised, a programme aiming for at least 7% weight loss and at least 150 minutes of physical activity per week lowered the number of new diabetes cases by 58% compared with placebo over an average of 2.8 years (Knowler et al., 2002).
• Exercise on its own: In an analysis of 81 studies, people with a high level of physical activity had a 35% lower risk of type 2 diabetes than people with a low level (Aune et al., 2015). Why sitting too much is so harmful is explained in the guide How does a lack of exercise increase the risk of premature death?
• Sleep: Across ten long-term studies, the risk of type 2 diabetes was lowest at seven to eight hours of sleep per day (Shan et al., 2015).

What is the main trigger for obesity?

Whether in children or adults, the number one trigger for obesity is and remains sugar in combination with too little exercise.

But why do we consume so much sugar?

Sugar makes us happy. This is because sugar releases serotonin - the happiness and feel-good hormone - and acts like a drug on our brain. Children in particular are exposed to it from an early age, as most children's products contain large amounts of added sugar. 

Therefore, always pay close attention to the list of ingredients.

➤ We consume an average of 40 kg of pure sugar per capita every year!

High sugar consumption, high carbohydrate meals and little exercise are fatal for our health. This leads to overweight and obesity, which in turn increases the risk of type 2 diabetes!

Poor diet  ➤ Overweight ➤ Type 2 diabetes

Don't just accept it! Around half of those suffering from type 2 diabetes could overcome the disease with targeted measures.

Our ultimate guide to type 2 diabetes

1) No added sugar

Drastically reduce your sugar intake and look for natural alternatives. Stabilize your blood sugar with healthy fats, proteins, fibre and nutrients.

2) Intermittent fasting

Repeatedly abstaining from food improves insulin sensitivity, leads to weight loss and helps to lower blood sugar.

3) More movement

Almost half of all adults do not get enough exercise. A sedentary lifestyle leads to metabolic disorders. The solution? Exercise regularly!

4) Proven recipe

R-alpha lipoic acid has an optimal therapeutic effect in diabetes. Advantages: Insulin resistance is improved and the nerves are protected from free radicals.

R-alpha lipoic acid is one of the two products in the Diabetic Carefree Package. The second is L-arginine, the amino acid that increased blood flow and glucose uptake in people with type 2 diabetes in the study mentioned above.

View the Diabetic Carefree Package  ➜

✓ R-alpha lipoic acid + L-arginine

Why is type 2 diabetes so common today?

Diabetes has been known for thousands of years, but it has never been as widespread as it is now. In 2022, an estimated 828 million adults worldwide had diabetes, 630 million more than in 1990 (NCD Risk Factor Collaboration, 2024).

The main drivers are the ones described above: more excess weight from childhood on, a lot of sugar and too little exercise. Sugary drinks stand out. Across eight long-term studies with 310,819 participants, people who usually had one to two servings of soft drinks, iced tea or energy drinks a day developed type 2 diabetes 26% more often than people who had none or less than one serving a month (Malik et al., 2010). More on this in the guide How does high sugar consumption promote type 2 diabetes?

Where does the name come from? A short history of diabetes

The question of where diabetes comes from also has a historical answer. The disease has been known since antiquity: descriptions are found in Egyptian papyri, in ancient Indian and Chinese medical texts and in the works of Greek and Arab physicians (Karamanou et al., 2016). The most important milestones:

• 2nd century AD: Aretaeus of Cappadocia gives the first accurate description of the disease and coins the term "diabetes".
• 1675: The British physician Thomas Willis adds the word "mellitus" (honey sweet), because the urine of those affected tastes extremely sweet.
• 1889: Oskar Minkowski and Joseph von Mering remove the pancreas of a dog, which then develops severe diabetes. This reveals the role of the pancreas.
• 1921: Frederick Banting and Charles Best isolate insulin and open a new era in diabetes treatment.
• 1955: With tolbutamide and carbutamide, the first blood sugar lowering tablets come onto the market (Ahmed, 2002).

Frequently asked questions

Where did type 2 diabetes come from?

The disease itself is ancient: diabetes was already described in Egyptian papyri, and the term goes back to Aretaeus of Cappadocia in the 2nd century AD. In the body, type 2 diabetes arises when the cells respond less and less to insulin and the pancreas can no longer make up for it. Excess weight, often from childhood on, a lot of sugar and too little exercise are the main drivers.

When was diabetes first diagnosed?

Symptoms similar to diabetes were described by the ancient Egyptians around 3,000 years ago. The first accurate description comes from Aretaeus of Cappadocia in the 2nd century AD. In 1776, the British physician Dobson was the first to confirm that excess sugar in urine and blood is the reason for their sweetness.

How was diabetes treated before insulin?

Before insulin was isolated in 1921, diet was the main tool. Low carbohydrate diets were in use, and in the decade before the discovery of insulin the American physicians Frederick Allen and Elliott Joslin advocated severe fasting and undernutrition to prolong the lives of their patients.

Is type 2 diabetes genetic or lifestyle?

Both. In a large European study, people with a family history of type 2 diabetes developed the disease almost three times as often as people without one. At the same time, being overweight raises the risk about threefold and obesity about sevenfold, and in a large trial weight loss and regular exercise lowered the risk by 58%.

Does eating too much sugar cause type 2 diabetes?

A lot of sugar raises the risk in two ways. Together with too little exercise, it is the number one trigger for obesity, which in turn increases the risk of type 2 diabetes. Sugary drinks add to this: people who had one to two servings a day developed type 2 diabetes 26% more often than people who hardly drank any.

Sources (in English):

Börnhorst, C., Russo, P., Veidebaum, T., Tornaritis, M., Molnar, D., Lissner, L. et al. (2019, October). Metabolic status in children and its transitions during childhood and adolescence - the IDEFICS/I.Family study. International Journal of Epidemiology, Volume 48, Issue 3, doi: 10.1093/ije/dyz097

Ungethüm, K., Jolink, M., Hippich, M., Lachmann, L., Haupt, F., Winkler, C. et al. (2019, March). Physical activity is associated with lower insulin and C-peptide during glucose challenge in children and adolescents with family background of diabetes. Diabetic Medicine, 36(3):366-375, doi: 10.1111/dme.13819

Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, Ostolaza H, Martín C (2020). Pathophysiology of Type 2 Diabetes Mellitus. International Journal of Molecular Sciences, 21(17):6275. doi: 10.3390/ijms21176275

Akbari M, Ostadmohammadi V, Lankarani KB, Tabrizi R, Kolahdooz F, Khatibi SR, Asemi Z (2018). The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials. Metabolism, 87:56-69. doi: 10.1016/j.metabol.2018.07.002

Piatti PM, Monti LD, Valsecchi G, Magni F, Setola E, Marchesi F, Galli-Kienle M, Pozza G, Alberti KG (2001). Long-term oral L-arginine administration improves peripheral and hepatic insulin sensitivity in type 2 diabetic patients. Diabetes Care, 24(5):875-880. doi: 10.2337/diacare.24.5.875

Scott RA, Langenberg C, Sharp SJ, Franks PW, Rolandsson O, Drogan D et al. (2013). The link between family history and risk of type 2 diabetes is not explained by anthropometric, lifestyle or genetic risk factors: the EPIC-InterAct study. Diabetologia, 56(1):60-69. doi: 10.1007/s00125-012-2715-x

Abdullah A, Peeters A, de Courten M, Stoelwinder J (2010). The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies. Diabetes Research and Clinical Practice, 89(3):309-319. doi: 10.1016/j.diabres.2010.04.012

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6):393-403. doi: 10.1056/NEJMoa012512

Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ (2015). Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis. European Journal of Epidemiology, 30(7):529-542. doi: 10.1007/s10654-015-0056-z

Shan Z, Ma H, Xie M, Yan P, Guo Y, Bao W, Rong Y, Jackson CL, Hu FB, Liu L (2015). Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care, 38(3):529-537. doi: 10.2337/dc14-2073

NCD Risk Factor Collaboration (NCD-RisC) (2024). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants. Lancet, 404(10467):2077-2093. doi: 10.1016/S0140-6736(24)02317-1

Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB (2010). Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care, 33(11):2477-2483. doi: 10.2337/dc10-1079

Karamanou M, Protogerou A, Tsoucalas G, Androutsos G, Poulakou-Rebelakou E (2016). Milestones in the history of diabetes mellitus: The main contributors. World Journal of Diabetes, 7(1):1-7. doi: 10.4239/wjd.v7.i1.1

Ahmed AM (2002). History of diabetes mellitus. Saudi Medical Journal, 23(4):373-378.

Mazur A (2011). Why were "starvation diets" promoted for diabetes in the pre-insulin period? Nutrition Journal, 10:23. doi: 10.1186/1475-2891-10-23