Why Lifestyle, Not Genetics, Is Driving the Diabetes Surge
As diabetes cases continue to climb worldwide, many people still believe the condition is largely genetic or inevitable. But according to general practitioner Dr Sam Musekura, most blood sugar problems are deeply rooted in lifestyle choices. In this interview, he shifts the focus from medication to prevention, explaining why daily habits, not destiny, are fueling the diabetes surge and what individuals can do before it is too late.
Q: Many people believe diabetes is mainly inherited. How much of it is actually lifestyle-driven? A: Genetics does increase risk, especially if there is a family history of diabetes. Age is also a factor, as the body becomes less efficient at processing glucose over time. However, lifestyle plays a far greater role than most people realise. Poor diet, physical inactivity, excess weight, chronic stress, and lack of sleep significantly increase the risk of developing high blood sugar. Even individuals with a genetic predisposition can delay or prevent diabetes through healthy habits.
Q: For readers who may not understand it fully, what exactly happens in the body when blood sugar becomes too high? A: Blood sugar, or glucose, is the body’s main source of energy. After we eat carbohydrates, glucose enters the bloodstream and the pancreas releases insulin to help cells absorb it. When this system does not function properly, glucose remains in the blood. Persistently high blood sugar damages blood vessels and organs over time. It can affect the heart, kidneys, nerves, and eyes. The danger is that damage often begins long before severe symptoms appear.
Q: What are the early warning signs people often ignore? A: Frequent urination, excessive thirst, unusual hunger, fatigue, blurred vision, dry skin, slow-healing wounds, and tingling in the hands or feet are common symptoms. Many people dismiss these signs or attribute them to stress or aging. By the time they seek medical help, complications may already be developing. Early testing is crucial.
Q: How serious are the long-term consequences if high blood sugar is not controlled? A: The complications can be life-altering. Prolonged high blood sugar can lead to heart disease, stroke, kidney failure, nerve damage, blindness, and foot ulcers that may result in amputation. These are not rare outcomes. They are common in poorly managed diabetes. The good news is that most of these complications are preventable with proper glucose control and consistent lifestyle management.
Q: What practical lifestyle changes make the biggest difference? A: The most effective changes are often simple but require consistency: • Regular physical activity to improve insulin sensitivity • A balanced diet rich in fibre, lean proteins, fruits, vegetables, and whole grains • Limiting refined carbohydrates and sugary drinks • Maintaining a healthy weight • Managing stress • Getting adequate sleep Even modest weight loss can significantly improve blood sugar control.
Q: Many patients rely heavily on medication. Can lifestyle changes reduce the need for drugs? A: In some early cases, lifestyle modification alone can control blood sugar. For others, medication is necessary, but healthy habits improve the effectiveness of treatment and may reduce the required dosage. Treatment must always be individualised. Medication manages diabetes, but lifestyle determines long-term outcomes.
Q: What myths are most harmful when it comes to blood sugar? A: One major myth is that eating sugar directly causes diabetes. Excess sugar contributes to weight gain, which increases risk, but diabetes is more complex than that. Another myth is that people with diabetes must avoid all carbohydrates. Healthy carbohydrates, such as fruits and whole grains, are important when eaten in moderation. There is also the misconception that insulin cures diabetes. It does not. It helps manage blood sugar.
Q: Botswana has seen rising rates of type 2 diabetes. What is driving this trend? A: Urbanisation, sedentary lifestyles, processed food consumption, and rising obesity rates are major contributors. Childhood obesity is also increasing, which is concerning because it leads to earlier onset of type 2 diabetes. Prevention efforts must start with education in families and schools.
Q: The term “diabesity” is increasingly used. What does it mean? A: “Diabesity” describes the strong link between obesity and type 2 diabetes. Excess body fat causes insulin resistance, meaning the body does not use insulin effectively. Over time, this leads to high blood sugar. Addressing weight and glucose control together is essential for long-term health.
Q: What is your message to people who feel overwhelmed by the rising numbers? A: Diabetes is serious, but it is not inevitable. Small, consistent changes can make a significant difference. Get screened regularly, especially if you have risk factors. Stay active, eat balanced meals, and seek medical advice early. Prevention is always easier than treatment.