Etiology of diabetes:
The detailed roles of obesity, nutrition, physical activity, and age factors in the occurrence of diabetes are not yet clear, but most epidemiological investigations have found that obesity, dietary types and quantities, and lack of physical activity are all related to the occurrence of diabetes. People who drink milk from a young age are prone to type 1 diabetes, while obese individuals are more likely to develop type 2 diabetes.
Dietary factors:
Statistical analysis shows a significant relationship between the prevalence of type 2 diabetes and intake of meat, eggs, sugar, and calories. Taking China as an example, a 1980 survey of 300,000 people in 14 provinces and cities found a diabetes prevalence of 0.67%, which increased to around 2.5% in 1994, likely due to the improved living standards since 1978..
Obesity:
Obesity is another contributing factor to type 2 diabetes. Fasting and postprandial plasma insulin levels are significantly higher in obese individuals than in normal people, and the number of insulin receptors decreases in obese individuals. Glucose metabolism rate decreases significantly, leading to secondary insulin resistance and hyperinsulinemia. In severe cases, pancreatic β-cell function becomes compensated, glucose tolerance decreases, and eventually develops into type 2 diabetes.
Age is also related to the occurrence of type 2 diabetes.
In 1981, a survey conducted in Beijing found a prevalence of 6.41% of type 2 diabetes among 203 individuals aged 60-69 years old. By 1991, the prevalence had increased to 12.56% among 637 individuals in the same age group, a doubling in a span of 10 years.
Mental factors are also related to the incidence of diabetes, with evidence mainly derived from epidemiological survey data. Statistical analysis found that populations living with high stress and fast-paced work have a higher prevalence of diabetes.
Recent studies on neural factors have revealed that a region in the human brain called the hypothalamus can regulate insulin secretion. Stimulating the lateral hypothalamic nucleus increases insulin secretion, while stimulating the medial hypothalamic nucleus decreases it. In particular, a connection was discovered between cerebropeptide levels and type 2 diabetes. Cerebropeptide is a neuropeptide substance, and its increased levels or increased sensitivity can induce hyperglycemia, possibly serving as a trigger for type 2 diabetes.
Malnutrition-related diabetes
There is a type of diabetes associated with malnutrition, particularly protein malnutrition, known as “malnutrition-related diabetes”. It was previously called “tropical diabetes” because it mainly occurs in tropical regions. This type of diabetes is prevalent in African and Southeast Asian tropical countries where cassava is the main staple food. Its clinical manifestations differ from those of type 1 and type 2 diabetes. It requires insulin treatment, but it is less likely to develop diabetic ketoacidosis. The etiology may be related to cassava consumption.
Cassava contains only 0.4% protein but a large amount of linamarin, which can be hydrolyzed into harmful cyanides for the pancreas. Other studies have found that long-term protein malnutrition can lead to insufficient insulin secretion and abnormal glucose tolerance. This type of diabetes was named “malnutrition-related diabetes” by the World Health Organization in 1985 but was later removed from the latest classification criteria.
