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Chances are, you know someone with diabetes, that not-so-sweet disease most associated with sugar. Maybe it’s your sister, aunt or best friend. Or perhaps you have it. If so, you’re in good company—Halle Berry, Tom Hanks and Nick Jonas are among the celebrities that also struggle with diabetes, along with more than 100 million Americans who live with diabetes or prediabetes, according to the Centers for Disease Control and Prevention.

In fact, it’s one of the most common conditions in the United States, and the numbers are growing. Diabetes has become the 7th largest cause of death in the United States. And the 10 states with the highest rates of type 2 diabetes are in the South. It’s not surprising then that the South has its own moniker for the disease: “the sugar.”

So you probably think the cause of diabetes is pretty self-evident, right? It’s the sugar! Think again. This sweet science report reveals the actual #1 cause. Read on—and to ensure your health and the health of others, don’t miss this urgent news: Here’s How You Can Catch COVID Even If You’re Vaccinated.

What is Diabetes, Anyway?

Before we get into the cause, we have to define what diabetes is.

Diabetes occurs when your blood glucose—or blood sugar—is too high. Blood glucose is the body’s primary source of energy and is derived from the food you eat. Enter insulin: a hormone made by your pancreas. Endocrine Web shares that “insulin is often described as a key, which unlocks the cell to allow sugar to enter the cell and be used for energy.” But sometimes your body doesn’t make enough insulin—or any at all—or just doesn’t utilize insulin well.

What happens then is that glucose stays in your blood, and doesn’t reach your cells—causing glucose to build up in the blood, spiking your blood sugar levels. Having too much glucose in your blood can cause some pretty significant health problems.

There are several types of diabetes: type 1, type 2, gestational, and for those on the cusp, prediabetes. While each is distinct, they all share the same underlying issues with blood sugar. Type 1 and type 2 diabetes are chronic conditions. Prediabetes is a precursor to chronic diabetes, and gestational diabetes often resolves on its own after the baby is born.

And What Happens if You Have It?

So what can happen if your body is not able to properly use glucose to produce energy? The two main types of diabetes—type 1 and type 2—have similar tell-tale warning signs, though with type 1, onset of symptoms may be faster, showing up in a matter of days or weeks, and tend to be more severe. According to the American Diabetes Association, you might experience frequent urination, a sign that your kidneys are trying to expel excess sugar in your blood.

Extreme thirst almost always accompanies frequent urination because your body becomes dehydrated from all the peeing. In the same vein, lack of fluid in your body can give you dry mouth and itchy skin. You might also feel increased hunger or have unexpected weight loss due to your body’s inability to get sufficient energy from the food you’re eating.

High blood sugar levels, over time, can impact blood flow and cause nerve damage, which makes healing difficult–slow-healing cuts or sores are another diabetes warning sign. Last, but certainly not least: frequent yeast infections for both men and women is another hallmark symptom of diabetes due to yeast feasting on excess sugar in the blood.

How Do I Know I Have It?

Symptoms vary from person to person, and also by how much your blood sugar is elevated. According to the NIH, type 1 diabetes symptoms can start quickly, sometimes over just a few weeks. With type 2 diabetes, symptoms often develop more slowly, over several years, and for some may be so mild that they’re not noticeable. In fact, many people with type 2 diabetes actually have no symptoms, and only find out they have the disease when they develop diabetes-related health problems like increased thirst and urination or heart trouble.

It’s key to pay attention to what’s happening in your body—if something feels off, don’t ignore it: go see your doctor and get checked out.

Here are the Top Contributing Factors—Broken Out by Diabetes Type:

Type 1 diabetes can occur at any age, in people of all races, shapes, and sizes–and accounts for 10% of all cases of diabetes according to the NIH. It occurs most frequently in people of European descent. This type of diabetes occurs when your immune system attacks and destroys the insulin-producing beta cells of the pancreas. Researchers do not know exactly what causes type 1 diabetes—but believe that a combination of genetic and environmental factors, like certain common childhood viruses, may trigger the disease.

Type 2 diabetes is the most common form of diabetes, affecting between 90 to 95% of people with the condition according to the CDC. It is often preceded by a period of prediabetes, when there is a greater opportunity to halt the progression of the disease. Both lifestyle factors and genes play into the development of type 2. Family history of the condition? You are more likely to develop diabetes as well. Physically inactive (we’re talking to you desk jockeys)—overweight or obese? These are also major risk factors for developing type 2 diabetes.

Gestational diabetes is a form of the disease that develops during pregnancy and is brought on by hormonal changes, as well as genetic and lifestyle factors. Hormones made by the placenta contribute to insulin resistance in the later trimesters—this happens to all women, but some can’t produce enough extra insulin to compensate and develop gestational diabetes. Being overweight or obese raises the risk of this condition.

So Tell Me, What’s the #1 Cause???

So what is the #1 cause of diabetes? As we said: it’s not sugar. High blood sugar is a symptom—not the cause—of diabetes. The #1 cause of diabetes is your body’s inability to respond normally to insulin.

How to Prevent It

The road to diabetes is paved by many contributing factors, some out of your control, but many within. In terms of the most common form of diabetes, type 2, there’s a lot you can do to prevent the disease.

Move your body. A sedentary lifestyle is now seen as a significant health risk. Walk. Dance. Do something you enjoy, just make sure you move.

Eat well. You’ve heard it before, you’ll hear it again: you are what you eat. A carb-heavy diet is more likely to spike your blood sugar, so go easy on the bread, pasta, beer, rice, and potatoes. A rule of thumb from our friends at Eat This, Not That! (and the American Heart Association): Eat your colors. Orange (carrots, bell peppers). Red (strawberries, raspberries). Green (all the greens from broccoli to kale to peas). Blue (blueberries, blackberries).

Keep your weight in normal range. If you are struggling with losing weight, see your doctor and ask for a referral to a nutritionist. Together, you can come up with a plan that you can live happily with.

What to Do When You Notice Symptoms

If you notice symptoms like frequent urination and immense thirst together, or have cuts that are slow to heal, talk to your healthcare provider. If you catch diabetes in the prediabetes stage, a smart regimen of regular exercise and a healthy (often low-carb) diet can actually prevent you from developing the disease! And to get through this pandemic at your healthiest, don’t miss these 35 Places You’re Most Likely to Catch COVID.