Causes and complications

Diabetes results from the interaction of genetic predispositions with lifestyle issues and environmental factors. According to the WHO, this disease killed more people worldwide in 2015 than HIV/AIDS, tuberculosis (TB) and malaria combined.
Sugary drinks increase the risk of diabetes: Coca-Cola advertisement in Morocco. Widak/picture-alliance/NurPhoto Sugary drinks increase the risk of diabetes: Coca-Cola advertisement in Morocco.

Ninety percent of diabetics suffer from type 2 diabetes mellitus, which is frequently linked to excessive body weight, unhealthy diets and a lack of physical activity. Smoking is another important risk factor. But scientists are also paying increasing attention to the relevance of heavy environmental pollution, for instance in the form of persistent organic pollutants like dioxins or some insecticides.

Genetic predispositions put many people at a particularly high risk. That applies to many indigenous groups. According to recent studies, for example, Aboriginal Australians are more than twice as likely to develop diabetes than the general population. Compounding the problems, indigenous people often have poorer access to health care.

In addition to type 2 diabetes mellitus, people can also suffer from the congenital type 1 diabetes, as well as a variety of rarer forms. Gestational diabetes is one of the most common pregnancy complications worldwide. Another problem are the numerous interactions between diabetes and widespread infectious diseases like HIV/AIDS, malaria or tuberculosis.

If treatment sets in too late or not at all, the consequences of the metabolic disease are devastating. Developing countries and emerging markets are affected in particular. Sustained high blood sugar levels damage the blood vessels and nerves, for example. That can lead to reduced blood flow to the extremities and make amputations necessary. The optic nerve is also frequently affected. In South Africa, diabetes is one of the three most common causes of blindness, with over 8,000 new cases a year. On the other hand, Bangladesh, Tanzania and other countries conducted a pilot project 15 years ago to reduce the incidence of what is known as a diabetic foot. They managed to reduce the number of amputations.

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