Diabetes, commonly known as diabetes mellitus, has become one of the most widespread chronic diseases around the world. It impairs the body’s ability to use blood sugar, a major source of energy for our cells.
While many people assume diabetes comes from “eating too much sugar,” the truth is far more complex. It involves genetic, metabolic, and lifestyle factors that work together over time. As Dr Anukalp Prakash, Director of Gastroenterology, CK Birla Hospital, Gurugram, explains, “Understanding what truly causes diabetes is essential not just for treatment, but for prevention.”
Understanding How Diabetes Develops
To understand the causes of diabetes, it’s important to know how the body normally regulates blood sugar. After a meal, carbohydrates break down into glucose and enter the bloodstream. In response, the pancreas releases insulin, a hormone that helps drive glucose into the cells so it can be used for energy.
“In diabetes, this system breaks down,” says Dr. Prakash. “Either the pancreas doesn’t produce enough insulin, or the body becomes resistant to the insulin it makes.”
When this happens, glucose remains in the blood, slowly damaging organs over time.
Genetic and Family Factors
Genetics play a significant role in diabetes, particularly Type 2 diabetes. If one or both parents have diabetes, the risk increases substantially. Certain ethnic groups including South Asians, Hispanics, and African populations also have higher genetic vulnerability.
According to Dr Prakash, “A family history of diabetes increases risk, but it does not seal fate. Lifestyle choices often determine whether that genetic tendency turns into actual disease.”
Obesity and Insulin Resistance
One of the most common contributors to Type 2 diabetes is insulin resistance, strongly linked to obesity. Excess fat especially around the abdomen, disrupts how the body uses insulin. In response, the pancreas produces more insulin, but over time it becomes exhausted.
“Central obesity is one of the biggest red flags,” notes Dr Prakash. “When the waistline expands, insulin resistance almost always follows.”
Sedentary habits, high-calorie diets, and poor sleep patterns further worsen this cycle.
Unhealthy Eating Patterns
Diets high in refined carbohydrates, sugary beverages, and ultra-processed foods sharply elevate blood sugar levels, putting continuous stress on the pancreas.
Dr Prakash explains, “It’s not just what you eat but how you eat. Irregular meals, overeating at night, and relying on processed foods disturb metabolic rhythms.”
In contrast, whole grains, fiber, lean proteins, and healthy fats improve insulin sensitivity and stabilize glucose levels.
Chronic Stress and Hormonal Imbalance
Chronic stress triggers hormones like cortisol, which raise blood sugar. Over time, stress also promotes weight gain and worsens insulin resistance. Conditions such as PCOS (Polycystic Ovary Syndrome) create hormonal imbalances that increase diabetes risk.
“We cannot overlook stress, sleep, and gut health,” says Dr. Prakash. “These factors directly influence how the body handles glucose and insulin.”
Sleep deprivation and disturbed gut flora have also been shown to interfere with glucose metabolism.
Other Contributing Factors
Additional causes include exposure to environmental toxins, long-term steroid use, and certain viral infections that may damage pancreatic cells. Type 1 diabetes, though less common, arises from an autoimmune process where the body attacks its own insulin-producing cells.
Dr. Prakash emphasizes, “Not all diabetes is lifestyle-driven. Some forms result from autoimmune or environmental triggers and early diagnosis is key.”
The causes of diabetes extend far beyond sugar consumption. It is a multifactorial disease shaped by genetics, obesity, diet, stress, hormones, and environment.
“The good news,” says Dr. Prakash, “is that many risk factors can be reversed through lifestyle changes, healthy eating, weight control, physical activity, and stress management.”
By addressing the root causes early, individuals can prevent complications and maintain long-term metabolic health. “Prevention begins with awareness and timely action,” he concludes.
