The development of type 2 diabetes is caused by a combination of lifestyle and genetic factors.[21][23] While some of these factors are under personal control, such as diet and obesity, other factors are not, such as increasing age, female gender, and genetics.[17] A lack of sleep has been linked to type 2 diabetes.[24] This is believed to act through its effect on metabolism.[24] The nutritional status of a mother during fetal development may also play a role, with one proposed mechanism being that of altered DNA methylation.[25]