Type 2 Diabetes Risk: Is genetic profiling the answer? A doctor’s opinion on that DNA study.
by James Hubbard, M.D., M.P.H.
The CDC says we’re having a big problem with type 2 diabetes. It reported a whopping 90-percent increase in new cases from 2005 to 2007, compared to 10 years earlier.
What can we do? Perhaps genetic treatment is the answer!(?)
The current New England Journal of Medicine published two studies on whether we can better predict type 2 diabetes risk by looking at DNA variations on genes. If we could, we might also be able to individualize treatment, they thought. A double whammy.
Alas, they found that it doesn’t help much more than knowing family history and weight. They hypothesized the reason was scientists haven’t found all the DNA sequences that affect diabetes.
Although I have simplified these complicated studies, that’s the gist. But I looked at the results a different way.
To me, this is good news! It’s confirmation that the risk factors we use right now are good predictors—at least the best we know. It also reaffirms the idea that if one of your parents has diabetes, you’d better get that weight under control. Family history (genes) is a big risk factor.
As I said, the CDC published some big numbers this year, but here are some other big ones–with more positive outcomes.
- The American Diabetes Association reports that the recently released Diabetes Prevention Program study found you could decrease your risk of type 2 diabetes by 58 percent with 30 minutes of moderate exercise per day (I know, Dr. J, what is moderate?) and a weight loss of 5 to 10 percent if you’re overweight.
- The Harvard School of Public Health cites results from the large Nurses’ Health Initiative Study that found we can attribute 90 percent of type 2 diabetes in women to five lifestyle factors: excess weight, lack of exercise, less-than-healthy diet, smoking, abstaining from alcohol. Wow. 90 percent.
So much for genotypes. You can be master of your own destiny.
What do you think?
November 24th, 2008 at 7:50 am
“It’s confirmation that the risk factors we use right now are good predictors—at least the best we know. It also reaffirms the idea that if one of your parents has diabetes, you’d better get that weight under control. Family history (genes) is a big risk factor.” So true and knowledge is the first step. Thanks for sharing!
November 24th, 2008 at 7:53 am
Agreed! The five lifestyle factors are what we should pay attention to! Just b/c someone has the genetics doesn’t always mean they will get the disease. Negative lifestyle factors combined with the genes is what pushes the envelope.
Little things done consistently (movement everyday, good food choices) can make a big difference.
November 24th, 2008 at 8:21 am
I totally agree - what you eat and how much you exercise can make such an amazing difference. And if it can help you stay off meds, even better!
FatFighterTVs last blog post..News Nugget: Fast food ad ban could cut childhood obesity
November 24th, 2008 at 10:19 am
Thanks anonymous
November 24th, 2008 at 10:20 am
I agree Jolene, little changes can lead to big results.
Thanks
November 24th, 2008 at 10:21 am
And the sooner you start the better. Thanks FatfighterTV
November 24th, 2008 at 12:59 pm
Dr. Hubbard,
As one that has this disease, I’m a believer that it can be controlled by diet and exercise. The connections to genetics just help to make predictions a little easier, I’m sure a weather forecaster can get it right 50% of the time on an educated guess. All the risk factors just help the pros to get a little closer on diagnosis. With over 6 million undiagnosed cases of Type II in the US would seem to me that education should be pushed rather than genetics. The workload is already there.
Tom Rooneys last blog post..To Each Their Own Healthy Lifestyle
November 24th, 2008 at 5:00 pm
Sounds logical. Just as long as you monitor your blood sugar periodically.
November 24th, 2008 at 10:25 pm
Interesting spin on it! I like it.
But I’m a little confused. Is the idea here that there really would be genetic treatments? And at what point in the life stage would they be done?
Sagans last blog post..How to eat a pile of cookie dough
November 25th, 2008 at 11:07 am
Sagan,
They thought the earlier the treament intervention, probably the better (if they were able to predict better with genes). This is all still theoretical. From the study, they also speculated that unknown gene sites (loci) that affect lifestyle changes (such as obesity) probably complicate the issue.
This was a very preliminary study to see if certain treatments might be better with certain genetic tendencies. I don’t think they were even thinking about direct gene manipulation.
I think they wanted to know, with their current knowledge of gene loci that affect diabetes, could they predict who would become a diabetic, and could they predict it better than with the risk factors we already use for prediction?
If they could predict it better, then they would probably look at how those loci affect diabetes risk, find what these loci were doing to cause diabetes, and try to find medications that would specifically treat what those loci were doing.
However, they were unsuccessful in predicting diabetes better than known risk factors, so it is back to the drawing board.