Diabetes Basics.
Last updated Thursday, February 10, 2005
Incidence and risk factorsWho gets diabetes basics and why? For type 2 diabetes, which is the most common form, the gene or
genes responsible have not yet been identified. Certainly, obese
individuals are more at risk. For reasons not entirely understood, many
of the ethnic minorities in the US have a disproportionate risk of type
2 diabetes: African Americans, American Indians, Hispanic Americans,
and Asian Americans all have a high risk for type 2 diabetes. Recently,
there has been an epidemic of type 2 diabetes in young adults and even
adolescents. Obesity has been the primary reason for this. Other risks
for type 2 diabetes include a history of gestational diabetes (diabetes
during pregnancy), hypertension (high blood pressure), a family history
of type 2 diabetes, a sedentary lifestyle, and high triglyceride levels
(a type of blood fat). One exciting research study showed that by
strict diet and exercise someone with a high risk of getting type 2
diabetes can reduce that risk by 58%.
Type 1 diabetes is a completely different disease. We are now
learning more about the genetic risks, and can also predict who will
get the disease by measuring "antibodies" which are markers in the
blood for type 1 diabetes. We don't understand why some people get this
and others don't, but there are appears to be an environmental insult
(perhaps a virus) that attacks the cells in the pancreas, which makes
insulin. Although type 1 diabetes often presents in childhood, we now
know it can occur at any age. How is diabetes basics acquired (contagion, genetics, injury, lifestyle, etc)? For type 2 diabetes, besides having a genetic predisposition, most
people are also obese, especially those less than 60 years of age. It
is also clear that not everyone who is obese gets diabetes, as a
additional genetic risk must be present.
For type 1 diabetes, besides having a genetic risk, there appears to
be an environmental "trigger", most likely a virus, which seems to
cause the body to attack the cells in the pancreas that makes insulin.
What is the role of genetics in acquiring or developing diabetes basics? As noted above, genetics plays a large role for both type 1 and type 2 diabetes.
The majority of people with type 2 diabetes have a family member
with the disease. If an identical twin gets type 2 diabetes, the risk
for the second twin to get it exceeds 95%. For type 1 diabetes, the
risk of a school-age child to get the disease is only 0.3%. However, if
the mother has type 1 diabetes the risk of the child getting it is 2-3%
while the father gives a 5-6% risk to the child. No one knows why the
father gives a greater risk to the offspring. If one identical twin has
type 1 diabetes, the risk of the other twin getting it is only about
35%. So there are obviously huge differences between the genetics of
type 1 and type 2 diabetes.
Is diabetes basics contagious? Neither type 1 nor type 2 diabetes appears to be contagious.Is probability for acquiring diabetes basics affected by diet, metabolism, lifestyle, etc? For type 1 diabetes, there are no known risks for acquiring the
disease although a recent study from Europe suggested that ingesting
cod liver oil may prevent type 1 diabetes in children. Much more
research on this topic is now needed.
For type 2 diabetes, obesity is a major risk factor and as noted
above, weight loss with diet and exercise can reduce the risk of
developing type 2 diabetes by 58% over a 3-year period. Is diabetes basics likely to result from injury or trauma? Neither type 1 nor type 2 diabetes can result from injury or trauma.
However, a more rare form of diabetes, called "pancreatic diabetes,"
occurs when injury or surgical removal of the pancreas occurs. Since
insulin is made in the pancreas, the lack of a functioning pancreas
leads to insulin deficiency and diabetes.Can diabetes basics be prevented? The prevention of both type 1 and type 2 diabetes are major research goals.
Animal studies and early human studies in children suggested that
low doses of insulin could prevent type 1 diabetes in high-risk
children. A large study funded by the U.S. government, presented in
summer 2001, showed that insulin did not prevent type 1 diabetes, at
least in the doses of insulin used in the study. Studies are now
underway to see if other therapies may be of benefit for high-risk
individuals.
For type 2 diabetes, the Diabetes Prevention Program
was announced in August of 2001. This study showed that for high-risk
people with "impaired glucose tolerance" (a two hour blood glucose
between 140 and 200 mg/dL after a sugary drink) a strict diet and
vigorous exercise, mostly walking, could reduce the risk of type 2
diabetes by 58%. Another group in this study received the drug
metformin (glucophage) and even without additional diet or exercise
their risk of diabetes was reduced by 31%. It is now expected that
there will be new public health policies directing doctors and their
patients as we try to translate this research to clinical practice.
How useful was this page or article?
|
|