Consistent Study of Metabolism and Diabetes Continues
Diabetes is a chronic health condition affecting how your body turns food into energy (metabolism). The body breaks down food consumed into sugar (glucose) and releases it into the bloodstream. Diabetes should also be considered when examining metabolism and medicine. When blood sugar goes up, your pancreas releases insulin. Insulin is key to letting the blood sugar into your body’s cells for use as energy. For people with diabetes, the body doesn’t make enough insulin or can’t use it as it should. Too much blood sugar stays in your bloodstream when there isn’t enough insulin or cells stop responding to insulin. Over time, that can cause serious health problems like heart disease, vision loss, and kidney disease.
The information above is a short observation of what we’ve learned about diabetes thus far, but there is much more to learn. The article below examines the most recent diverse genetic study on type 2 diabetes. Type 2 diabetes is one of the first diagnostic levels of diabetes known today. Of course, we can examine and diagnose pre-diabetes, but that comes with the patient’s ability to change course before an official diabetic diagnosis.
Through this study, genetics have now been identified to contribute to a type 2 diabetes diagnosis, and there are some interesting findings. The study identified more than 100 genes and 200 genomic regions associated with the risk of type 2 diabetes.
This is important because many patients have long asked if diabetes is genetic and linked to family history. The outcomes of the study provide a definitive yes to that question and extend the conversation of family history to eating patterns, obesity, and lifestyle that offers more information on the genetic disposition of a patient and their risk of becoming diabetic.
This study outlines some new information that patients and professionals should take time to absorb and consider. For people with diabetes, this study should be part of your following conversation with the family physician or an endocrinologist. If you want a deeper dive into diabetes, and hormones, check out a book I wrote based on more than thirty years of experience, research, and practice, “Metabolism & Medicine.” This two-part book series details several schools of thought and disciplines, including physics and biochemistry, to describe how metabolic processes work. It also details what happens when these systems are misaligned, including insulin production and signaling related to stress responses and steps people can take to lower their risks.
Type 2 Diabetes: New Study Identifies 40 More Genes Linked to the Disease
Recently published research in Nature GeneticsTrusted Source featured the most diverse genetic study on type 2 diabetes.
While scientists are aware of certain factors that may increase a person’s risk of developing type 2 diabetes, one major question is what role genetics plays.
Researchers from the US and England collaborated to analyze the DNA profiles of thousands of people of varying ancestries. In doing so, they not only identified new genes that contribute to type 2 diabetes, but they also became a step closer to developing a genetic risk score for the disease.
Type 2 diabetes: What to know
Type 2 diabetes occurs when a person’s body does not make enough or use insulin effectively, making it difficult for the body to regulate blood sugar levels. It can be life threatening if someone’s blood sugar levels get too high or low.
The Centers for Disease Control and PreventionTrusted Source reports that around 37 million Americans have diabetes, and around 90-95% of these people have type 2 diabetes.
According to the American Diabetes Association, a person with type 2 diabetes may experience some of the following symptoms:
- Blurry vision
- Increase in thirst and hunger
- Wounds that heal slowly
- Frequent urination
If a person suspects they have type 2 diabetes, they can consult with their physician, who can order a blood test to check for the disease.
There is not a cure for type 2 diabetes, but people with the disease can manage their blood sugar levels by taking medications and avoiding foods that spike blood sugar levels.
Importance of diversity
While there is a lot of research on type 2 diabetes, much of it has primarily targeted people of European ancestry.
“Risk scores derived from one ancestry often do not transfer well to others,” explained Professor Nathan Tucker in an interview with Medical News Today. “Inclusion of diverse ancestries helps us understand the mechanisms of the risk, improving the probability of successful therapeutic development.”
Prof. Tucker is an assistant professor and genetics core manager at Masonic Medical Research Institute in Utica, NY.
The authors also noted that genetic risk scores “provide unreliable prediction when deployed in other population groups.”
The researchers accessed data from other studies to create the Diabetes Meta-Analysis of Trans-Ethnic association studies (DIAMANTE) Consortium. They analyzed the genetic makeup of 180,834 individuals with type 2 diabetes and compared it to 1,159,055 people without diabetes.
The scientists placed people in 1 of 5 groups: European ancestry (51.1%); East Asian ancestry (28.4%); South Asian ancestry (8.3%); African ancestry (6.6%); and Hispanic ancestry (5.6%).
Type 2 diabetes study results
By comparing the DNA of the people with type 2 diabetes to those without, the researchers were able to identify more than 200 loci that were genetically significant in terms of developing the disease.
According to the National Human Genome Research InstituteTrusted Source, a locus (or loci in the plural form) “is a physical site or location within a genome (such as a gene or another DNA segment of interest.).”
“This study identifies 237 genomic regions that are associated with altered risk of type 2 diabetes, with nearly 100 evidence-based targets that are prioritized for the next stages of therapeutic development,” Prof. Tucker explained.
The researchers also identified genes that may contribute to developing type 2 diabetes.
“We have now identified 117 genes that are likely to cause type 2 diabetes, 40 of which have not been reported before. That is why we feel this constitutes a major step forward in understanding the biology of this disease,” says Professor Anubha Mahajan.
Dr. Mahajan is a human genetics researcher and professor at the University of Oxford in England.
The sheer magnitude and diversity of this study create enormous potential for being able to one day identify a person’s genetic risk for type 2 diabetes.
“Inclusion of diverse ancestries helps us understand the mechanisms of the risk, improving the probability of successful therapeutic development,” Prof. Tucker commented.
Dr. Brian Fertig, the Founder and President of the Diabetes and Osteoporosis Center in Piscataway, NJ, also spoke with MNT regarding the study.
“The findings of this study are not surprising because diagnostic and therapeutic stratifications are too often overly simplified as ‘one size fits all,” Dr. Fertig said.
Dr. Fertig also thought the study emphasized the importance of diversity and inclusion in research.
“This data underscores the need for a precision, personalized and dynamic scale of medicine, as it’s rare to see two diabetics with the same clinical and biochemical profile,” Dr. Fertig commented. “Every individual is unique and as such should have individualized treatment plans.”
Is type 2 diabetes genetic?
According to the National Diabetes Statistics Report 2020, more than 34 million AmericansTrusted Source have diabetes (about 1 in 10), and approximately 90–95% of them have type 2 diabetes. Usually, type 2 diabetes develops in adults over 45 years old, but it is becoming more common among young adults, teens, and children.
Age, inactivity, and having obesity are risk factors of type 2 diabetes, but a person’s genes can also play a role.
Read on to learn more about the genetic link with type 2 diabetes, which genes it can involve, and how someone might be able to influence whether they develop the disease.
Genetics in type 2 diabetes
The American Diabetes Association (ADA) states that type 2 diabetes has a stronger link to family history and lineage than type 1. It goes on to say that studies of twins have shown that genetics play a key role in the development of type 2 diabetes.
The ADA also advises that race can also play a role, and researchTrusted Source indicates a higher prevalence among Asian, Black, and Latino people. But this may not be entirely due to genetics.
Environmental factors such as diet and lifestyle also influence the risk of developing type 2 diabetes. The ADA notes that it is possible to help prevent type 2 diabetes by exercising and reaching or maintaining a moderate weight.
There can also be a genetic role in obesity, and families often develop similar eating habits. This can put someone with a genetic predisposition at more risk for developing type 2 diabetes.
Which genes could cause type 2 diabetes?
According to a 2013 reviewTrusted Source, the following genes can lead to an increased likelihood that a person will develop type 2 diabetes:
- CAPN10: This gene encodes enzymes that degrade proteins. It was the first gene that scientists confirmed had a definitive link with type 2 diabetes.
- TCF7L2: This protein-coding gene has the strongest links to type 2 diabetes across all racial groups.
- ABCC8: This gene may impair the release of insulin.
- GCGR: This gene is a glucagon receptor.
- GCK: This is a gene for the enzyme glucokinase, which speeds up glucose metabolism and acts as a glucose sensor.
- GLUT2: This gene encodes for a glucose transporter, which regulates the entry of glucose into pancreatic beta cells.
- SLC2A2: This gene regulates the entry of glucose in pancreatic beta cells and triggers insulin secretion.
- HNF4A: This regulates genes in the liver and pancreas.
- HNF4A: This is the insulin hormone gene.
- KCNJ11: This is the gene for the potassium channels that trigger the release of insulin.
- LPL: This is the enzyme lipoprotein lipase, which breaks down triglycerides (fats).
- PPARG: This gene regulates fat cell differentiation.
- PIK3R1: This gene has a role in insulin signaling.
Environmental factors can also influence if someone will develop type 2 diabetes, and we explain this next.
The gene-environment interaction
A person’s genes interact with their environment to either switch their genes off or on. This process is called epigeneticsTrusted Source and can also play a role in the development of type 2 diabetes.
Epigenetics changes do not change the DNA sequence, but instead affect gene expression. In addition, environmental factors such as diet, exercise, and infection can result in epigenetic changes.
For example, a 2020 review indicates that dietary carbohydrates and fiber can be modifiers of some genetic variants in type 2 diabetes. Another example is smoking.
What are the chances of inheriting type 2 diabetes?
A 2013 reviewTrusted Source on the genetics of type 2 diabetes suggests the chances of inheriting the disease are as follows:
- One parent: There is a 40% lifetime risk for someone with one parent who has type 2 diabetes.
- Both parents: There is a 70% lifetime risk for someone who has both parents with type 2 diabetes.
- First-degree relative: A person is three times more likely to develop type 2 diabetes if a first-degree relative has the condition. A first-degree relative is someone with whom a person shares 50% of their genes, such as a parent or full sibling.
Prevention of type 2 diabetes
Diet and behavioral factors can influence whether a person with a genetic predisposition to type 2 diabetes develops the disease.
Keeping to a moderate weight is essential in reducing the risk of developing type 2 diabetes. But in 2013–2016, 89%Trusted Source of American adults whose doctors had recently diagnosed them with diabetes had overweight or obesity.
For example, a 2020 study published in The Lancet looked at the effect of an intensive lifestyle intervention on young people with early diabetes. The researchers found that a low-energy diet and physical activity led to significant weight loss and diabetes remission in over 60%Trusted Source of participants.
Research from the Diabetes Prevention Program shows that people with obesity may delay or help prevent diabetes by losing 5–7%Trusted Source of their starting weight. Individuals could try eating smaller portions, choosing foods with less fat, and avoiding sweetened drinks.
Additionally, some research indicates that antioxidants in fruits and vegetables and magnesium can lower the risk of developing the disease.
A 2020 review outlines lifestyle factors that studies have associated with the disease and may lead to obesity, oxidative stress, and insulin resistance. A person can reduce or avoid the following to try and lower their risk for developing type 2 diabetes:
- alcohol intake
Americans can also join a National Diabetes Prevention Program to learn how to make changes to help reverse prediabetes and prevent type 2 diabetes. People can also access the ADA’s Living With Type 2 Diabetes program online.