Why do people get diabetes?

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Diabetes has different causes depending on the type. Type 1 results from an autoimmune reaction that destroys insulin-producing cells, while type 2 mainly develops from a combination of genetic factors and lifestyle choices such as obesity, physical inactivity, and unhealthy diet.

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Diabetes – a growing public health issue

Diabetes is now one of the most widespread chronic diseases in Sweden and worldwide. In Sweden, more than half a million people live with the diagnosis, and the number is steadily increasing every year (1). But what exactly causes some people to develop diabetes while others do not? The answer depends on whether we are talking about type 1 or type 2 diabetes, and both genetics, the immune system, and lifestyle play a role.

Type 1 diabetes – an autoimmune disease

Type 1 diabetes often develops in childhood or young adulthood, but it can sometimes appear later in life. In this form of diabetes, the body’s own immune system attacks the insulin-producing beta cells in the pancreas. Once these cells are destroyed, the body can no longer produce insulin.

Insulin is essential for regulating blood sugar. Without it, glucose levels rise rapidly, leading to symptoms such as thirst, weight loss, and fatigue. The exact reason why the immune system begins attacking the body’s own cells is not fully understood. Researchers believe it is due to a combination of genetic vulnerability and external factors, such as viral infections at an early age (2).

Type 2 diabetes – strongly linked to lifestyle

Type 2 diabetes is much more common than type 1, accounting for around 85–90% of all cases (3). Unlike type 1, the body still produces insulin, but the cells gradually become less sensitive to it — a condition known as insulin resistance. Over time, the pancreas may also produce less insulin, making it difficult to keep blood sugar levels stable.

The most common risk factors for type 2 diabetes are:

• Overweight, especially abdominal obesity – belly fat increases the risk of insulin resistance.

• Physical inactivity – sedentary lifestyles reduce the muscles’ ability to use glucose.

• Unhealthy diet – diets high in sugar, red meat, and processed foods raise the risk.

• Age – risk rises significantly after age 45.

• Stress and sleep deprivation – these affect the body’s hormone balance and can promote insulin resistance.

• Smoking and alcohol – both increase the risk of diabetes and worsen its progression.

Genetics and hereditary factors

Genetics play a role in both types of diabetes, but in different ways. For type 1, heredity is less pronounced – even with a close relative who has the disease, the individual risk is still relatively low. For type 2, heredity is much stronger. Having a parent or sibling with type 2 diabetes significantly increases the risk, especially when combined with overweight and an inactive lifestyle (4).

The decisive role of lifestyle

Even though you cannot influence your genes, lifestyle has a huge impact – especially in type 2 diabetes. Studies show that regular physical activity can reduce the risk of developing type 2 diabetes by up to 50% (5). Even modest weight loss can make a big difference. Losing 5–10% of body weight can significantly improve insulin sensitivity.

A balanced diet with plenty of vegetables, whole grains, legumes, and fish, along with limited sugar and red meat, are key protective factors. Adequate sleep and stress management are also crucial, as chronic stress negatively affects both blood sugar and body weight.

Diabetes and increased risk of falls

One lesser-known but very important consequence of diabetes is the increased risk of falls. This is due to several factors:

• Neuropathy (nerve damage) – prolonged high blood sugar can damage nerves, especially in the feet and legs, leading to reduced sensation and poor balance.

• Vision problems – diabetes can cause retinopathy and other eye diseases, making it harder to detect obstacles.

• Low blood sugar (hypoglycemia) – with insulin treatment or certain medications, blood sugar can drop rapidly, causing dizziness and weakness.

• Muscle weakness – long-term diabetes may negatively affect muscles, making it harder to maintain stability.

Falls are especially serious for older adults with diabetes, as they often result in fractures and long recovery times. Preventive measures such as balance training, regular foot and eye check-ups, and safety devices like fall alarms are therefore an important part of care.

Safety alarm with automatic fall alarm can increase safety for people with an increased risk of falling

Sensorem’s personal alarm is an example of a technical aid specially developed for people who have an increased risk of falling. The personal alarm can automatically trigger the alarm in the event of a fall and then call relatives using the watch’s built-in speakerphone with two-way communication. The personal alarm works outdoors and has built-in GPS positioning so that relatives can see the user’s position on a map in the Sensorem app.