Genes Do Not Equal a Diabetic Destiny
Two important factors that affect risk--body weight and smoking--are within our control
When not managed properly, type 2 diabetes can lead to kidney failure, blindness, heart disease, stroke, high blood pressure, nerve damage, chronic pain, dental problems, amputations, and premature death. Now for the good news: When it comes to type 2 diabetes, genes are not destiny.
Different ways to consider risk
Several factors work together to determine type 2 diabetes risk. Health experts can combine these factors together to create risk scores. Both the Cambridge type 2 diabetes risk score and the Framingham offspring study type 2 diabetes risk score take into account age, gender, family history of diabetes, and overweight and obesity to determine diabetes risk.
The Cambridge score also considers medication use, while the Framingham score includes HDL ("good") cholesterol, triglycerides (fat in the blood), and blood sugar levels. Another way to consider disease risk is to look at genetic factors. Scientists have identified a number of places in the human genetic code where certain changes are associated with a greater susceptibility to type 2 diabetes.
If you have the genes that predispose a person to diabetes, it does not mean you will get the disease. It simply means that you are more likely to develop type 2 diabetes than someone without these gene versions. It also means that if you have other risk factors for diabetes, such as being overweight or obese, you have a higher risk of developing type 2 diabetes than an overweight person without the diabetes genes.
Genes are not destiny
To study diabetes risk, researchers enrolled 5,535 healthy British men and women, with an average age of 49 years into a study. After following these people for 10 years, 302 of them developed type 2 diabetes.
The researchers studied how well the Cambridge and Framingham risk scores predicted who developed diabetes in the group. They also looked at how 20 genetic changes that increase diabetes risk affected the ability to predict type 2 diabetes risk in the group.
Adding the genes to the risk scores did not significantly improve the ability to determine who would develop diabetes. In other words age, gender, family history of diabetes, body weight, smoking, and blood levels of cholesterol, triglycerides, and blood sugar are more effective for determining diabetes risk than genes.
You have the power to defeat diabetes
The most exciting thing about this study is that it tells us that we each have the power to positively affect our own health. Two important factors that affect diabetes risk--body weight and smoking--are within our control. By maintaining a healthy body weight and not smoking, we can lessen the chances that we develop diabetes, even if we have "diabetes genes."
You can't change your family medical history, age, or gender, but you can make your health a priority starting today. A healthy diet and regular exercise will keep obesity at bay and reduce diabetes risk.
(BMJ 2010;340:b4838. doi:10.1136/bmj.b4838; National Diabetes Information Clearinghouse. National Diabetes Statistics, 2007. Accessed February 13, 2010. Available: http://diabetes.niddk.nih.gov/DM/PUBS/statistics/#allages)
Suzanne Dixon, MPH, MS, RD, an author, speaker, and internationally recognized expert in chronic disease prevention, epidemiology, and nutrition, has taught medical, nursing, public health, and alternative medicine coursework. She has delivered over 150 invited lectures to health professionals and consumers and is the creator of a nutrition website acclaimed by the New York Times and Time magazine. Suzanne received her training in epidemiology and nutrition at the University of Michigan, School of Public Health at Ann Arbor.