How Much Of Diabetes Is Genetic?
Paula Deen never said she was teaching us how to cook healthy food. But when she announced she’s had Type 2 diabetes for three years, all the while instructing America on the virtues of butter, critics couldn’t resist calling her a hypocrite.
But does poor eating lead to Type 2 diabetes, or is it all in the genes?
“We know you don’t inherit diabetes in a simple manner,” said Dr. Nolawit Tesfaye, an endocrinologist and diabetes specialist at Hennepin County Medical Center.
The research is quite complicated, according to Tesfaye. Clearly, there’s a correlation between obesity, inactivity and diabetes, but there also is a genetic predisposition to people with diabetes.
“Geners aren’t the only explanation, but environment is not necessarily the only explanation either. It’s a complex interaction between these two things,” she said.
According to the American Diabetes Association, about 20 million Americans have diabetes. Type 1 is an autoimmune disease, generally showing up in childhood or teenage years.
Is Diabetes Genetic? Many people who suffer from diabetes understandably worry that their children will therefore have it, although the reality is not quite as simple as that. Diabetes itself is not hereditary; although the risk factors that a person has are passed down through the genes, therefore making it more likely that the next generation will have it. An estimated 80% of those diagnosed with diabetes each year have at least one family member who already has diabetes.
A family history of diabetes is only one of the risk factors; other risk factors include having a blood sugar level of more than 200 soon after eating, having high triglycerides, smoking and low HDL (good) cholesterol. In general, in the United States, one in every three people will at some point in their lives suffer from diabetes, with women being more susceptible than men. And it’s estimated that by 2025, around 300 million people worldwide will suffer from diabetes.
It can be difficult to determine if you are going to get type 2 diabetes due to a family history of diabetes, as most people don’t develop any symptoms until middle age. Less than 1% of the population develops juvenile diabetes, while it is far more likely to affect people who are over 40 years old and who are also overweight or smoke, although in recent years it has begun to affect younger people more.
But the vast majority - in fact, 90 percent of cases - are Type 2 Diabetes. That’s when your body doesn’t make enough insulin, or it loses the ability to use it.
“Actually Type 2 has a stronger link to heredity than does Type 1,” said Tesfaye.
Again, according to the ADA, research on identical twins shows that when one twin has Type 1 Diabetes, the other twin has a 1 in 2 chance of coming down with the disease. When a twin has Type 2 diabetes, the other twin has a 3 in 4 chance of having it, too.
“I think disclosure can be your friend,” said Steph Shimp, a co-owner of Blue Plate restaurant group. She owns The Lowry in Uptown, which serves healthy food, but lots of fatty stuff as well.
“I don’t eat eggs Benedict with hollandaise every day. I think it’s all about the choices I make,” said Shimp.
Identifying Type 2 Diabetes Genes
Although researchers know from studying family histories that you can inherit a risk for Type 2 diabetes, they have had difficulty identifying specific gene mutations that cause the disease.
Some of the problems include:
Number of genes: Many genes are involved in controlling our fuel intake and regulation. A mutation in any one gene will probably not lead to diabetes, but mutations in several genes could add up to pose an increased risk. Any two people with Type 2 diabetes may have mutations in a different subset of genes, making it hard for researchers to pinpoint high-risk mutations.
Environmental influence: A person’s lifestyle and environment play a large role in whether or not they develop Type 2 diabetes. Two people may have the same risk and the same gene mutations, but if one person controls their weight and exercises regularly, that person may not develop diabetes. If two people have the same mutation but different outcomes, researchers have a hard time distinguishing which genes are important in the disease.
Inherited Lifestyle: We inherit more than just genes from our parents; we also inherit lifestyle. Poor eating habits and lack of exercise are learned behaviors that children can pick up from their parents. This type of inheritance has nothing to do with genes, and makes it hard for researchers to identify a genetic risk for diabetes.
Despite these problems, researchers have found a few gene mutations that influence diabetes risk in some families. One well studied gene is the Beta3-adrenergic receptor gene. For recent news about additional Type 2 diabetes genes, see related news below.
She said if she were diagnosed with Type 2 diabetes, she would probably be inspired to look at the menu options her company offers. But she stressed that Deen’s situation is more about how to manage her own brand.
“I think she could have let us in on what she was dealing with and done more good than not,” said Shimp.
“We don’t like to just blame it on genetics,” stressed Tesfaye, pointing out that “what you eat makes a significant difference.”
Research indicates that eating right and exercising can delay the onset of diabetes and even keep it away forever.
Plus, as doctors try to understand how factors like poor diet and exercise interact with genetics, they also acknowledge that a family history of diabetes may be influenced by the fact “a lot of families have shared eating habits,” according to Tesfaye.
The reality is: you can’t do anything about your genetics, but you can do something about your diet and exercise habits, she said.
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