When I practiced medicine, I loved making complex medical information understandable for patients and their families.

For those with type 2 diabetes, that meant encouraging them to reduce time in front of computer and TV screens, become more active and eat a healthier diet. I sought to empower patients by emphasizing the things over which they had some control.

However, the unintended consequence of this message has been a misunderstanding about the causes of type 2 diabetes, contributing to stigmatization of those living with it.

The reality is that type 2 diabetes is a complex condition with roots in genetics, the environment and individual behavioural choices. Approximately 90 per cent of Canadians with diabetes have type 2 diabetes, where the body either cannot properly use or make enough insulin. The role of genes is clear when you examine patterns across countries, ethnicities and families. It runs in families, and most people diagnosed with type 2 diabetes have at least one relative with it as well. It is also more common among our First Nations and people of South Asian, South East Asian or Caribbean origin. For some who carry a strong genetic risk, no amount of physical fitness or healthy eating will protect them from developing diabetes.

A second factor in the growing diabetes epidemic is the role of the environment, specifically things such as the walkability of neighbourhoods and having reliable and affordable access to healthy foods and health-promoting facilities and services.

For those who are at high risk for diabetes, a sedentary lifestyle and other behaviour choices that lead to obesity can also increase the risk of developing diabetes. Programs that improve diet and encourage physical activity have been shown to reduce that risk by nearly 60 per cent, even with only a modest change in weight - on average a loss of 10 to 20 pounds for a 200 pound person.

Unfortunately, emphasizing the importance of personal behaviour change may have inadvertently contributed to an oversimplification based on a partial truth. For newly diagnosed patients, keeping the message simple so they can take action is essential. But for diabetes, we have to remember that this simple message to help them manage their disease is not the whole story.

In recognition of Diabetes Awareness Month this November, the Canadian Diabetes Association encourages Canadians to take the CANRISK diabetes test at DontBeRisky.ca to find out their risk of developing type 2 diabetes and prediabetes.