Health

6 Unexpected Things That Can Lead To Diabetes

And they have nothing to do with food.

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Diabetes, where your body has a hard time producing or processing adequate amounts of the hormone insulin, attracts a lot of myths and assumptions, specifically around food. When it comes to potential causes of diabetes, the picture is a lot more complex than you'd think.

According to the Centers for Disease Control and Prevention (CDC), over 30 million people in the United States have diabetes, and another 88 million have prediabetes — meaning your blood sugar is higher than usual, but not high enough to be classified as type 2 diabetes. (Blood sugar is the amount of glucose in your blood; insulin tells your cells to convert glucose into energy.)

Diabetes is common, yet one in four people don't know they have it. There are many subtle signs of diabetes to watch out for, like being thirsty often or needing to pee all the time. But when it comes to getting the disease, many assume it's limited to lifestyle choices, like eating a lot of sugary foods.

"It can be difficult to separate fact from fiction when you’re researching what things might put you at higher risk of diabetes," Dr. Seema Sarin M.D., director of lifestyle medicine at EHE Health, tells Bustle. For example, it was once believed that having an STI could cause diabetes; Dr. Nate Favini M.D., medical lead at Forward, a healthcare provider, tells Bustle that it's a case of association, not causation. "This increase in blood sugar [from diabetes] puts you at risk of developing many more viruses and bacterial infections," he says. Another instance of association, not causation? Not getting enough sun. Though people with low levels of Vitamin D are more likely to develop diabetes, says Dr. Favini, it's more likely that people who don't get outside a lot might also not exercise that much, which is another diabetes risk factor.

Here are some lesser-known factors that are linked to developing diabetes.

1
Using Mouthwash Daily

A 2017 study published in the journal Nitric Oxide found using mouthwash more than twice a day can increase your risk of developing pre-diabetes or diabetes. "There is a plausible biological mechanism here, in that mouthwash kills oral bacteria, and oral bacteria break down nitrates in your food," Dr. Favini says. "The byproducts of that breakdown may help with the regulation of your metabolism."

2
Having The Flu

Turns out the flu isn't just a short-term bout of misery that fills your bed with used tissues. A 2012 study in the Journal of Virology found having the flu virus can potentially trigger type 1 diabetes. The flu virus can trigger a set of inflammatory cells which recognize insulin-producing cells and destroy them. However, this response has mostly been observed in animals. If you're concerned about this link, you should get yourself a flu shot.

3
Having A Sleep Disorder

Your snoring might not be an annoyance; it could also be a signal that you occasionally stop breathing in the night, a condition called sleep apnea that's been linked to diabetes. (OK, yes, it is also an annoyance.) "Undiagnosed and/or untreated sleep apnea may cause, or worsen, both type 1 and type 2 diabetes, so it’s recommended that all adults with diabetes be screened for sleep apnea," Dr. Joseph Krainin M.D., chief Medical Advisor for sleep equipment company SoClean, tells Bustle.

A 2014 study published in North American Journal of Medical Sciences found that having moderate or severe sleep apnea was linked with insulin resistance, a marker of diabetes. If you are experiencing sleep issues like snoring, fatigue, daytime mood swings, and waking up with an unexplained headache, chat with your doctor.

4
Long-term Use Of Certain Medications

Unfortunately, medication can be a balancing act. People with inflammatory diseases such as rheumatoid arthritis, psoriasis, or asthma often are placed on long-term steroids, which can increase the risk for developing diabetes.

High dosages of prolonged steroid use can elevate blood sugar levels. "Patients should be aware that elevated blood sugar leads to elevated insulin levels," Dr. Jeff Stanley M.D. with Virta Health, a diabetes care service, tells Bustle. "If the body builds a resistance to insulin, a person is at risk of developing type 2 diabetes."

5
Using Plastic Containers

The endocrine system produces hormones that regulate things like your blood glucose levels. But those cheap plastic household goods – and, uh, vibrators — might not be helping your endocrine system. A 2017 study published in the journal Environmental Research found a link between phthalates, a group of chemicals found in plastics and other consumer products, and type 2 diabetes. In a study of 1,500 men, 99.6% were found to have phthalates in their urine. Participants with higher levels of phthlates were more likely to have type 2 diabetes.

"Plastics are a main source of environmental endocrine-disrupting material. As plastics break down over time, the chemicals leach from the plastics into the air," Allison Caggia, editorial director at Diabetes Daily, tells Bustle. Food that's sold in cans or plastics, or heated in plastic containers, can absorb chemicals too. If you can, keep your use of cheap plastics to a minimum.

6
Your Birth Order

Being the first born sibling in your family can mean a lot of different things: you get in trouble more, and you're seen as "the responsible one." But it may also mean your likelihood of getting diabetes is higher. A 2013 study published in Journal of Clinical Endocrinology & Metabolism found first-born children have more difficulty absorbing sugars into the body and have higher daytime blood pressure.

These factors, of course, aren't the only ones that can lead to diabetes: genetics and other health issues also play a role. But the good news is, there are easy ways to reduce your risk of getting diabetes: getting outside, eating nutrient-dense foods, and moving in ways you enjoy. Oh, and apparently ditching your mouthwash habit.

Experts:

Allison Caggia

Dr. Nate Favini M.D.

Dr. Joseph Krainin M.D.

Dr. Seema Sarin M.D.

Dr. Jeff Stanley M.D.

Studies cited:

Anderson, A. E., Kerr, W. T., Thames, A., Li, T., Xiao, J., & Cohen, M. S. (2016). Electronic health record phenotyping improves detection and screening of type 2 diabetes in the general United States population: A cross-sectional, unselected, retrospective study. Journal of biomedical informatics, 60, 162–168. https://doi.org/10.1016/j.jbi.2015.12.006

Ayyavoo, A., Savage, T., Derraik, J. G., Hofman, P. L., & Cutfield, W. S. (2013). First-born children have reduced insulin sensitivity and higher daytime blood pressure compared to later-born children. The Journal of clinical endocrinology and metabolism, 98(3), 1248–1253. https://doi.org/10.1210/jc.2012-3531

Baburao, A., & Souza, G. D. (2014). Insulin resistance in moderate to severe obstructive sleep apnea in nondiabetics and its response to continuous positive airway pressure treatment. North American journal of medical sciences, 6(10), 500–504. https://doi.org/10.4103/1947-2714.143280

Bai, P. Y., Wittert, G., Taylor, A. W., Martin, S. A., Milne, R. W., Jenkins, A. J., Januszewski, A. S., & Shi, Z. (2017). The association between total phthalate concentration and non-communicable diseases and chronic inflammation in South Australian urban dwelling men. Environmental research, 158, 366–372. https://doi.org/10.1016/j.envres.2017.06.021

Capua, I., Mercalli, A., Pizzuto, M. S., Romero-Tejeda, A., Kasloff, S., De Battisti, C., Bonfante, F., Patrono, L. V., Vicenzi, E., Zappulli, V., Lampasona, V., Stefani, A., Doglioni, C., Terregino, C., Cattoli, G., & Piemonti, L. (2013). Influenza A viruses grow in human pancreatic cells and cause pancreatitis and diabetes in an animal model. Journal of virology, 87(1), 597–610. https://doi.org/10.1128/JVI.00714-12

Joshipura, K. J., Muñoz-Torres, F. J., Morou-Bermudez, E., & Patel, R. P. (2017). Over-the-counter mouthwash use and risk of pre-diabetes/diabetes. Nitric oxide : biology and chemistry, 71, 14–20. https://doi.org/10.1016/j.niox.2017.09.004

La Merrill, M.A., Vandenberg, L.N., Smith, M.T. et al. (2020) Consensus on the key characteristics of endocrine-disrupting chemicals as a basis for hazard identification. Nat Rev Endocrinol16, 45–57. https://doi.org/10.1038/s41574-019-0273-8

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