How does type 2 diabetes develop?

Type 2 diabetes develops over a long period of time and usually without the affected person feeling any signs of the disease. Scientists are intensively investigating what causes, how and why exactly lead to type 2 diabetes. In addition to a hereditary predisposition, an unhealthy lifestyle with obesity and lack of exercise plays a role.

What increases the risk of type 2 diabetes?

A number of factors favor the occurrence of type 2 diabetes:

  • Frequencies in the family of type 2 diabetes
  • Older age
  • Obesity, high blood pressure and high blood lipids (for example cholesterol)
  • Unhealthy lifestyle:
  • Smoke
  • Sedentary lifestyle
  • Low-fiber and / or high-fat diet
  • Diabetes in Pregnancy
  • Drugs that worsen the metabolism of sugar (for example, cortisone)
  • Other hormonal disorders (for example, polycystic ovarian syndrome)

Which processes in the body are disturbed in type 2 diabetes?

In type 2 diabetes, insulin no longer works properly on the body cells. Insulin is a vital hormone in the human body. It is produced in the beta cells of the islets of Langerhans in the pancreas. The pancreas is located in the upper abdomen behind the stomach.

After a meal, the pancreas releases insulin into the blood. The insulin ensures that the sugar (more precisely: grape sugar or glucose) from food reaches the cells of the various organs, for example the liver, muscles or fat tissue. The sugar serves the body’s cells as vital energy.


In type 2 diabetes, 2 processes of the action of the insulin are disturbed, as a result of which the blood sugar increases:

The insulin can only have a weak or insufficient effect on the cells of the various organs. As a result, the sugar cannot be absorbed into the body cells and remains in the blood. Experts call this disorder insulin resistance.


Because the body’s cells only react weakly to insulin, the pancreas produces more and more insulin to lower blood sugar levels. This high level of exertion causes the beta cells in the pancreas to become increasingly exhausted. You are no longer making enough insulin and too little insulin is getting into the blood. There is an insulin deficiency. Experts also speak of a relative insulin deficiency, because the pancreas is still producing insulin. However, the amount of insulin is not enough for the insulin-resistant cells of the body to absorb the sugar from the blood.

What is prediabetes? The quiet development of type 2 diabetes

Type 2 diabetes develops gradually over a long period of time. Before people become ill, in most cases they have been suffering from a precursor of type 2 diabetes, known as prediabetes, for a long time and unnoticed. People with prediabetes already have high blood sugar levels. However, the values ​​are not yet so high that experts speak of diabetes. Specialists also call this condition impaired glucose tolerance or abnormal fasting blood sugar.

Good to know:

The preliminary stage of type 2 diabetes is called prediabetes.

Due to the increased blood sugar levels, people with prediabetes have a greatly increased risk of developing type 2 diabetes later on. However, people with prediabetes can often prevent the development of type 2 diabetes, for example through more exercise and weight loss.


Find out more about type 2 diabetes diagnosis here!

What exactly is insulin resistance?

Long before people develop type 2 diabetes or prediabetes, they are already suffering from insulin resistance. In this preliminary stage, the body cells – especially in muscles, liver and adipose tissue – no longer respond adequately to the hormone insulin. As a result, the insulin can no longer effectively transport the sugar from the blood to the body cells.


There is often a time lag of several years or even decades between the onset of insulin resistance and the development of high blood sugar levels. In this phase there are initially only very mild, often imperceptible changes in certain functions in the sugar metabolism.


In addition to the risk of type 2 diabetes, insulin resistance also increases the risk of high blood pressure, cardiovascular diseases, lipid metabolism disorders and obesity. If these diseases are present at the same time, experts refer to this as “metabolic syndrome”.


You can find more information about the metabolic syndrome here!

How does insulin resistance develop?

Hereditary predisposition in the family plays an important role in the development of insulin resistance. But certain lifestyle habits also favor the development. Important risk factors are

  • Sedentary lifestyle,
  • improper diet and
  • Obesity.


Exactly how obesity and sedentary lifestyle increase insulin resistance is not yet fully understood. According to studies, the cells of the adipose tissue in people with insulin resistance, especially in the abdominal area, no longer work as they do in people without insulin resistance.

These cells in adipose tissue absorb less sugar from the blood and release more fats into the blood. Researchers also suspect a change in the release of messenger substances from adipose tissue. These messenger substances put the body in a kind of inflammatory state, which can also be responsible for the reduced effect of insulin on the body cells in muscles, liver and adipose tissue.

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