Not Just Sugar – It’s Complex Biology:

Type 2 diabetes develops when your body:

-Becomes resistant to insulin

-Can’t make enough insulin from the pancreas

What Causes It?:

Factor Role

Genetics Strong family history increases risk

Obesity Especially abdominal fat (visceral adiposity)

Inactivity Lowers insulin sensitivity

Poor diet High-carb, sugary, ultra-processed foods

Stress & ample Sleep

issues Disrupt hormones that regulate glucose

Can We Predict It Genetically?:

Not yet for individuals — but we know certain ethnicities (like South Asians) are more prone

due to higher fat-to-muscle ratio and insulin resistance even at lower BMIs.

Pathway Summary:

1. Insulin resistance increases

2. Pancreas compensates by overproducing insulin

3. Beta cells exhaust → sugar levels rise

4. Overt diabetes develops

Why Indians Get Diabetes at Lower Weights:

-Genetic “thrifty gene” hypothesis

-More visceral fat even at normal BMI

-Low muscle mass (“thin-fat” phenotype)

Take-Home messages:

You inherit genes, but you control your lifestyle. Even with risk, diabetes can be delayed or

avoided.

References: ADA 2025, RSSDI 2024, Endocrine Society of India