Genetics and Diabetes: Demographics, Family Health, Types, and More (2023)
Tijd om te lezen min
Tijd om te lezen min
Over 400 million people worldwide live with some form of diabetes, and 1.5 million deaths yearly are linked to this chronic condition.
Diabetics now have several ways to manage their illness and live a full, healthy life, but for some, the condition may even be completely avoidable with a few key life adjustments.
The question begs: Is diabetes genetic, and, therefore, can you know you’re at risk before showing any signs? How can you protect yourself if the condition runs in your family? Find out all the answers and more in this guide.
Genes may have a say in how your body regulates its blood glucose, depending on the number of genes involved. Hence, there are two broad classifications of diabetes.
Polygenic Diabetes: This is caused by multiple gene mutations and is present in the most common types of diabetes mellitus, such as type 1 and 2.
Monogenic Diabetes: It’s caused by mutations in a single gene.
With polygenic diabetes, the illness is caused by a combination of family history, which makes you predisposed to this illness, and certain environmental factors that end up triggering it. Therefore, people with a genetic predisposition to diabetes don’t necessarily become sick, and not all people diagnosed with diabetes have a family history of it.
Monogenic diabetes, on the other hand, has a stronger link to genes and is usually caused by inheriting some genes from your parents or genetic mutations that occur in your cells (known as somatic mutations). In these cases, you can develop diabetes even without exposure to common environmental factors.
Here’s a breakdown of all types of diabetes, their risk factors, and whether they have a genetic cause:
Type 1 diabetes is an autoimmune condition, meaning the body’s immune system attacks the insulin-producing cells. Usually, the pancreas releases insulin to regulate blood sugar and transfer glucose to the body’s cells.
People with type 1 diabetes don’t produce enough insulin, or any at all, which means the sugars build up in the bloodstream and can lead to serious health complications down the line.
This type of diabetes is usually insulin-dependent, meaning people diagnosed with it need hormone injections to regulate their blood glucose levels. It’s mostly common in children and young adults, but it can be developed at any age.
Genetics can play a role in whether you get it, but it’s not the whole story. First, there’s no specific diabetes gene to look for. And the predisposition is determined by multiple genes and environmental factors.
Family History: If a parent or a sibling has type 1 diabetes, you may have a higher risk of developing it too.
Age: The condition is usually diagnosed between the ages of 4 and 7 and then between 10 and 14. Still, people can develop type 1 diabetes at any age.
Ethnicity: Non-Hispanic White, African American, and Hispanic American groups have a higher risk of type 1 diabetes.
Unfortunately, we still don’t fully understand why some people develop this condition and others don’t. There are even cases of identical twins who have the same genes and environment, where one twin has type 1 diabetes but the other has only a 50/50 chance of getting it.
Type 2 diabetes is the most common type of this disease, which occurs when the blood glucose levels are too high.
People with this condition also don’t produce enough insulin, or their bodies don’t know how to use insulin well (insulin resistance), allowing sugars to stay in the blood and never reach the body’s cells.
Family History: People with a parent or sibling diagnosed with type 2 diabetes have an increased risk of developing it themselves.
Weight and Nutrition: Excess weight and an unhealthy diet put people at higher risk for the condition.
Exercise Habits: A sedentary lifestyle increases the risk of weight gain and type 2 diabetes.
Other Types of Diabetes: Diagnosed with prediabetes or gestational diabetes may also lead to a type 2 diabetes diagnosis without proper precautions.
Ethnicity: Those with an African American, Native American, or Hispanic background have a higher risk than other ethnic groups.
Class: Poverty also increases the risk of developing type 2 diabetes compared to the middle class
Gestational diabetes is a condition where pregnancy leads to high blood sugar. In most cases, the condition goes away once a person gives birth, but gestational diabetes can also increase the risk of developing type 2 diabetes later.
There isn’t a clear link between genetics and gestational diabetes; however, those diagnosed with it usually have at least one family member diagnosed with type 2 diabetes.
Age: Patients over 40 have a higher risk of developing gestational diabetes during pregnancy.
Weight: Being overweight, whether as a result of the pregnancy or was present before, also increases a patient’s risk.
Ethnicity: A Black, Middle Eastern, Asian, or African-Caribbean background may increase the risk.
Previous Medical Interventions: Patients who’ve undergone weight loss surgeries such as a gastric bypass may develop diabetes during pregnancy.
Having prediabetes means your blood sugar is higher than normal but not high enough to be diagnosed with type 2 diabetes.
If you’re diagnosed with prediabetes, you have a strong chance to prevent the disease through several strategies, including dietary changes and weight loss.
While we don’t know the exact cause of prediabetes, family history and genetics may play a crucial role.
Prediabetes risk factors are virtually identical to those of type 2 diabetes.
If you have a generally unhealthy lifestyle, a family history of this condition, and come from certain ethnic and economic backgrounds, you may be at a higher risk for prediabetes.
These other types of diabetes are less common but may be identified through genetic testing:
Maturity-Onset Diabetes of the Young (MODY): This is a rare form of monogenic diabetes caused by the mutation of a single gene. People with this mutation are highly likely to develop MODY regardless of lifestyle, weight, or other known risk factors.
Neonatal Diabetes Mellitus: This condition is usually diagnosed in children under six months and it’s often confused with type 1 diabetes because the infant can’t produce insulin. It’s also a form of monogenic diabetes.
Type 3c Diabetes: This condition develops when the pancreas is damaged, usually due to cystic fibrosis or pancreatitis.
Steroid-Induced Diabetes: A severe side effect of long-term steroid use.
Latent Autoimmune Diabetes in Adults (LADA): This condition forms in adulthood and is similar to type 1 and type 2 diabetes. However, most LADA patients don’t need insulin to manage it, but they may be genetically predisposed.
Alström Syndrome: A rare genetic disorder that may cause insulin resistance, type 2 diabetes, vision loss, and other health problems.
Wolfram Syndrome: Another rare genetic disorder that causes diabetes insipidus (which causes frequent urination), diabetes mellitus (such as type 1 or type 2 diabetes), and vision and hearing problems.
Being genetically predisposed to diabetes doesn’t automatically mean developing this condition. However, having this knowledge may help you access the right treatment or prevent developing complications from diabetes.
For example, some types of monogenic diabetes, such as maturity-onset diabetes, may be misdiagnosed as type 1 or type 2 diabetes. This means these patients are subjected to the wrong treatment and are unaware they can pass these genes to their children.
Other potential benefits of genetic testing for diabetes may include:
Implementing new lifestyle and diet habits to reduce the risk of diabetes.
Potentially learning the exact type of diabetes you’re predisposed to.
Getting an early diagnosis of genetic conditions such as Alström Syndrome or Wolfram Syndrome.
Implementing early prevention techniques for children, etc.
Genetic testing can determine if you have an increased risk for this condition. However, these screenings could also be useful if you’re already diagnosed with polygenic diabetes but showcase unusual symptoms.
Some instances where genetic testing could be beneficial include:
You had a healthy weight during pregnancy but still developed gestational diabetes.
You were diagnosed with type 2 diabetes in early adulthood but had no common risk factors.
You were diagnosed before you were six months old.
You have been diagnosed with type 1 diabetes but don’t have the usual autoantibodies.
You have other co-occurring health problems not typically considered diabetes complications.
If you’re in any of the above categories, a genetic screen may help you determine if you have monogenic diabetes. You can see a specialist to get the appropriate treatment for your condition.
Screening for diabetes is done through a predictive genetic test. It looks at all your genes to determine if you have mutations that could indicate a type of monogenic diabetes or look for certain markers associated with other types of diabetes.
You’ll need to give a blood or saliva sample directly at the clinic’s lab or by sending it in yourself, which will then be screened for genetic mutations.
Many clinics allow you to get a genetic test without a referral; however, it’s best to consult with your doctor beforehand and have them interpret your results to get an accurate diagnosis.
Whether you choose to get a genetic test or have diabetes run in your family, there are some things you can do to either reduce your risks or manage your condition:
Your physician most likely has access to your family history to some degree. Still, you should also talk to them about your family history of diabetes, especially if it concerns you.
They can help create a more comprehensive plan to either detect diabetes or change your lifestyle to reduce your risks.
You may also talk to them about a potential genetic screening, especially if types of monogenic diabetes run in your family, such as MODY or neonatal diabetes mellitus.
The National Institutes of Health recommends testing for diabetes every three years if the previous results came back normal.
You can also take yearly blood tests to determine if your blood sugar levels are normal. Depending on your results, a doctor may diagnose you with prediabetes if your levels are somewhat high or begin screening for type 1 or type 2 diabetes.
Though genetics put you at an increased risk for diabetes, you don’t have to check your blood glucose levels weekly or even daily. Other tactics can be even more beneficial in helping you reduce the chances of becoming sick.
Knowing the symptoms of diabetes is crucial, especially if it runs in your family.
For example, even if your last blood test came back with normal blood glucose levels, any of the following signs could indicate you need more tests:
Frequent urination, especially at night.
Fatigue, even after resting.
Losing weight without exercising more or dieting.
Tingly hands and feet.
Feeling hungry or thirsty all the time.
All these symptoms could also be explained by other conditions. However, if some family members are diagnosed with diabetes, experiencing these signs may be a good enough reason to ask your doctor about a blood sugar test.
A diabetes diagnosis often means changing your diet to include only healthy foods in moderate amounts. However, these nutrition choices can also benefit those with prediabetes or who have a family history of the illness.
These foods can help reduce the risk of high blood pressure, heart disease, and other illnesses.
Foods Rich in Fiber: These foods are broken down slowly by your digestive system and can help control blood glucose levels. You can enjoy nuts, fruits and vegetables, legumes, and whole grains.
Fish: Salmon, tuna, and other fish rich in omega-3 fatty acids may help reduce high blood pressure and insulin resistance.
Healthy Carbs: Carbohydrates are generally not the best in a diabetes diet since they get broken down into blood glucose. However, you can enjoy some healthy options, such as low-fat dairy, legumes, fruits, and vegetables.
Healthy Fats: Some fats may help lower cholesterol levels, such as avocado or olive oil, so you can add them to a healthy diet in moderation.
Unprocessed Foods: Opting for natural, unprocessed foods as much as possible is one of the best ways to approach your diabetes diet.
These healthy food choices can help you maintain healthy blood glucose levels and experience other secondary benefits like losing weight, having more energy, and improving digestion.
One of the key lifestyle factors that influence your risk for diabetes is how physically active you are.
If you have a family history of this illness or other conditions like heart disease, adopting a more active lifestyle is a fantastic way to improve your health and potentially avoid some serious health problems.
The amount of physical activity you need generally depends on a few factors. Here are some daily guidelines from the World Health Organization:
Infants: At least 30 minutes in the prone position.
Children Under 17: At least 180 minutes.
Adults Aged 18 or Older: At least 150–300 minutes of moderately intense physical activity.
Your health and age may influence the amount of physical activity or even the type of exercise routine you can follow. You should talk to your doctor about improving your physical activity to get some recommendations for your specific case.
Working with a personal trainer may also be beneficial, as they can help you perform the exercises safely and create a personalized workout plan.
Understanding your health and diabetes can help you stay vigilant and make the essential lifestyle changes to protect your health over the long term. Knowing this information may be especially useful if you have children.
Research has shown that people with knowledge about diabetes are more likely to:
Take the proper prevention measures.
Get their yearly blood tests without fail.
Take the proper medications, even when diagnosed.
Monitor their blood glucose levels as instructed.
Avoid developing diabetes-related complications, such as heart or kidney disease.
All forms of diabetes have some relationship to your genes, but to differing degrees; monogenic diabetes is the one most strongly associated with your genes.
Unlike type 1 or type 2 diabetes, environmental factors don’t play a role in these conditions. You can develop monogenic diabetes even if you don’t present any of the common risk factors simply because you inherited certain genes from your parents.
If you have diabetes of any kind, it doesn’t necessarily mean you’ll pass it on to your child or grandchild.
Type 2 diabetes has a stronger genetic link, but it’s also one people can successfully avoid by improving their nutrition and diet.
If you’re concerned about your child developing diabetes, talk to your pediatrician about early screening and prevention tactics.
Yes. Your genes don’t determine whether you’ll develop diabetes; they only determine if you have a potential risk for it.
Around 90% of people diagnosed with type 1 diabetes don’t have it in their family history, and many with type 2 diabetes have it because of other risk factors such as a poor diet or a lack of physical activity.
Even if other family members have diabetes, that doesn’t mean someone will automatically develop this condition. And if you’re already diagnosed, there are still plenty of ways to manage your condition to get normal blood sugar levels and lead a happy and healthy life.
Insulin injections may be the way to manage your condition, but other options are available if you or your child aren’t particular fans of needles.
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