“I’m not sure why I got diabetes. My friend eats tons of sugar and she doesn’t have it. I don’t even like sweets.”

When talking with patients about diabetes, I often hear statements like this. It’s confusing. Why do some people get diabetes even when they have healthy lifestyles? And other people without the healthiest lifestyles never get diabetes?

The truth is that genetics, the factors that you inherit from your parents, play a large role in whether or not you’ll develop type 2 diabetes. Researchers have found over 150 DNA variations that are associated with the development of type 2 diabetes. This means that your genetics can make it easier or harder for you to develop diabetes.

There is still a lot to learn about genetic variations that increase risk of type 2 diabetes. Some genetic changes affect how your beta cells develop and function. Beta cells are the cells that release insulin from your pancreas. Other genetic changes impact how well your body releases or processes insulin. And other changes impact how well your liver and muscle cells respond to insulin to get sugar out of the blood and into your cells. If you have these types of genetic variations that interfere with your body’s normal functions, you will be more likely to develop diabetes.

How do you know if you’re high risk? Most people with type 2 diabetes have at least one close family member, such as a parent or a sibling, with type 2 diabetes. The greater the number of family members with type 2 diabetes, the higher your risk. Additionally, having health conditions like overweight or obesity, insulin resistance, and a history of gestational diabetes, will increase your risk of type 2 diabetes.

The good news is that lifestyle still matters. Lifestyle includes eating habits, physical activity, sleep patterns, stress levels, and use of cigarettes. Even if you have an increased risk of type 2 diabetes from your genetics, a healthy lifestyle can delay or prevent type 2 diabetes. Research studies with the Diabetes Prevention Program (DPP) have shown that weight loss and exercise reduced the chances of developing type 2 diabetes by 58%. The participants in these studies were at high risk for diabetes. They tried to lose 7% of their body weight (14 pounds for someone who weighs 200 pounds) and exercised 150 minutes per week. In these studies, the lifestyle changes were even more effective at delaying or preventing diabetes than taking medications.

What if you are trying to live your healthiest life and you still develop type 2 diabetes? It’s not your fault! Some people get dealt a tough hand with their genetics. You might be frustrated or feel like you are being punished. Use your support system or work with a therapist to keep a healthy mindset and to avoid self-blame. You can’t control your genetics but you can continue to life a healthy life with diabetes. People only have complications from diabetes when it is not well-managed so all of your healthy efforts are still important.

If you do have type 2 diabetes, get the support you need to be able to live your healthiest life. We have many resources on the Cecelia Health website. If you don’t have type 2 diabetes, learn about your risk. This blog has seven simple questions to determine your risk of type 2 diabetes. Remember that even people who are high risk can delay or prevent type 2 diabetes with a healthy lifestyle. Your genetics don’t have to define your health!