World Diabetes Day is a crucial opportunity to draw attention to one of the most widespread chronic conditions worldwide. Today more than ever, it is essential to talk about diabetes: its prevalence continues to rise, affecting not only those already diagnosed but also those at risk of developing it in the future. Education, prevention, and early diagnosis remain fundamental tools for safeguarding health.

Understanding the causes of diabetes, the role of nutrition, and the remarkable advances in research—especially regarding type 1 diabetes—means giving people concrete tools to better manage the condition or reduce their risk. In this context, explaining how lifestyle influences type 2 diabetes and clarifying the most common misconceptions is an important step toward raising awareness and improving the quality of life for many.

Today we explore this topic with Professor Alfonso Bellia, endocrinologist and diabetologist at Arsbiomedica Clinic.

1 — How much does nutrition affect the risk of developing type 2 diabetes?

Nutrition certainly has an impact, but rather than focusing solely on diet itself, I would emphasize excess weight.
People who are overweight—whether due to a particularly sedentary lifestyle or a high-calorie diet maintained over long periods—are at greater risk of developing type 2 diabetes, especially if they have at least one first-degree relative with the condition.

If a person has that genetic predisposition combined with an unhealthy lifestyle, the likelihood of developing type 2 diabetes increases significantly.

2 — Are there “good” and “bad” foods for blood sugar?

One of the most common misconceptions comes from patients who tell me:
“Doctor, I’ve never eaten sweets, I don’t eat much pasta or desserts.”

And I reply that the origin of diabetes—both type 1 and type 2—is far more complex than people imagine. It does not come simply from eating sugar.

In type 2 diabetes, factors such as family history, lifestyle, and the way the body processes glucose all play a role.
In type 1 diabetes, however, the issue arises from the immune system, which mistakenly attacks the insulin-producing cells: it is a process that has nothing to do with diet.

Can you explain the role of the new “smart” medications that also help with weight loss, particularly for people with diabetes?

It is important to dispel some widespread misconceptions about diabetes, especially those that attribute the onset of the disease to specific foods. Certain industrially processed foods or typical fast-food items, while extremely high in calories and rich in fats, offer very poor nutritional value. Frequent consumption of these products—characterized by excessive amounts of carbohydrates and lipids—promotes weight gain and can significantly increase the risk of developing type 2 diabetes.

Professor, you are also involved in research. Can you tell us how close we are to achieving a “definitive cure” for type 1 diabetes?

At the root of type 1 diabetes lies a dysfunction of the immune system, which produces autoantibodies directed against the pancreatic β-cells. This autoimmune attack progressively destroys these cells, permanently compromising the body’s ability to produce insulin.

This form of diabetes affects young adults and children, and at present it can be treated only through the administration of insulin.

However, research is making remarkable progress, and today we have medications capable of intervening at an early stage, helping slow the progression of type 1 diabetes. These treatments can prolong the period during which patients retain some residual β-cell function, thereby delaying the need for insulin therapy.