"Diabetes Runs in My Family - Am I Doomed?"
A strategy to help you avoid the diabetes that runs in your family. Evidence-based and practical.
If you’ve watched your parents suffer the steady decline of type 2 diabetes, you may wonder if you’re bound to end up with the same disease.
Type 2 diabetes has a strong genetic component. But genes alone aren’t enough. You can design a lifestyle plan for yourself to avoid it.
Genetics ≠ Diabetes.
Welcome to the Healthy Aging Newsletter, a free publication translating trustworthy medical research into simple habits to age well, free of chronic disease. I’m Dr. Ashori, a family medicine doctor turned health coach.
Factors Most Likely to Lead to Diabetes
I only have one grandmother who developed diabetes late in life. But even without a family history, anyone can develop diabetes, given the right factors.
Back in the day, genes that raised the risk of type 2 diabetes conferred survival advantages. But since we no longer live in those calorie-starved environments these genes are more of a liability.
1. Visceral Fat
Visceral fat is the enemy here. With enough of it, the pancreas and liver will have a hard time functioning properly.
Fat can also make its way into the muscle and prevent glucose balance. Think of that prized marbled beef - it’s a cow with metabolic disease. It’s not what we want for our own muscles.
What we do in my practice:
We build moderate intensity exercises to maintain a high aerobic capacity which burns fat. This forces visceral fat to melt off. We confirm it with a DEXA scan and/or Waist-to-Height Ratio.
2. Break up Sedentary Stretches
If you have any diabetes risk, it’s more important to avoid being sedentary rather than just getting workouts in. Exercise is important, but constant low-level movement may matter more.
It is also possible that the same thrifty genes that raise diabetes risk make maintaining high activity levels more difficult in today’s low-demand environment.
We do this in my practice:
We want our patients to maintain regular activity by breaking up long sitting. 2 hours of watching Netflix should be 30 minutes at a time, with a break to go and do some dishes. Try a walk after heavier meals.
3. High Cortisol Levels
It may be the cortisol hormone or how stress affects our appetite for calorie-dense foods. Stress can’t be avoided but we can build strong coping techniques.
Today is Friday and I have a long list of things to hand off to my team before the weekend. But I try to keep my focus on what I’m doing in the moment. I don’t think about the growing to-do list.
We do this:
We teach meditation to our patients - even those with experience meditating. Time is finite and the more you squeeze into one day the more stress you’ll feel. You have much less control over your life than you realize. This is liberating.
4. Calorie-Dense vs. Nutrient-Dense Eating
A bowl of broccoli tastes bland. Sprinkled with some olive oil and we’re getting somewhere. Covered in Sriracha Mayo and now we’re talking.
Your diabetes genes are clever and crave something calorie-dense. I’ve seen it over and over again with my patients. It’s just that we no longer live in those food-scarce environments.
We do this:
Trick your body with healthy high-volume food instead of calorie-density. This is going to need a little habit formation. More fiber added to your meals will leave you more satiated. Fill up with some nuts, hummus, and fruits if you still need to satisfy your calorie cravings.
5. Functional Musculature
Muscles are a great way to dampen the glucose spikes from meals. You don’t need large muscles but functional ones.
As we age we lose some muscle. We also lose it when we are sedentary. And the times we are at peak muscle activity is right after a heavy exercise. This is the time to have your highest-carb meals.
We do this in my practice:
We time sweet foods like dessert after your fiber-rich meals or after a good hike. It’s not to say that you can’t have it at other times. But when you understand the inner workings of your physiology you have a leg up.
Need help designing a custom lifestyle plan? Don’t wait until you have borderline high blood sugars. Being proactive here means that you’ll save yourself decades of financial and physical headaches. You’re not alone in this.
Disclaimer:
Dr. Mohammad Ashori is a U.S.-trained family medicine physician turned health coach. The content shared here is for education and general guidance only. It is not personal medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Humans are complicated and context matters. Always talk with your own healthcare team before making medical decisions, changing medications, or ignoring symptoms. This information is to help you add more depth to those conversations.
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