Is diabetes hereditary or acquired? What are the major risk factors of diabetes? Learn about diabetes, how to test for the disease, and prevention strategies.
If you’ve ever taken a home DNA kit, it’s likely that you were told it can measure the risk of developing a particular disease, like diabetes. But in fact, there’s only so much DNA kits can tell you about whether or not diabetes is in your present or future, as risks of such diseases come from many sources, not just genetic changes. Although valid studies are necessary to prove these tests provide accurate results, there’s one thing we do know for certain — your understanding of disease and overall health plays a vital role the quality of your life.
In 2017, the Centers for Disease Control and Prevention (CDC) reported that diabetes and prediabetes affects more than 100 million U.S. adults. Although there is currently no cure for diabetes, there are treatments that can support people living with the disease.
Know Your Health: What Is Diabetes & Diabetes Risk Factors
Diabetes mellitus is more commonly known as diabetes and refers to the various groups of metabolic disorders, all of which affect how the body uses blood sugar, or glucose. There are multiple types of diabetes, but all involve excess sugar in the blood due to an abnormal metabolism of carbohydrates. When too much sugar remains in the blood, it causes multiple health complications. There are several types of diabetes, and while they all have similarities, they are also very different in terms of nuances, risk factors, and treatment options. Learn more about diabetes, prevention, and treatment by reading this guide.
- What is Diabetes?
- What Causes Diabetes?
- Diabetes Diagnosis — How to Test for Diabetes
What is Diabetes?
When you have diabetes, your blood sugar, or blood glucose, is too high. Blood sugar is the primary source of energy that comes directly from the foods we eat. The pancreas makes a hormone called insulin, which helps glucose get into cells so it can be used for energy. When the body doesn’t make enough insulin, glucose can’t reach your cells so it builds up in your blood. The causes of diabetes vary by types but they all result in excess sugar in the blood, which can lead to serious health problems if not corrected.
What Are the Different Types of Diabetes?
While there are several types of diabetes, the three that are most common are Type 1, Type 2, and gestational. Other less common types include monogenic and cystic fibrosis-related diabetes.
Type 1 Diabetes
Type 1 diabetes occurs when your body isn’t making insulin because your immune system is attacking and destroying the insulin-making cells in your pancreas. If you’re diagnosed with Type 1, you need to take insulin every day. While Type 1 diabetes is typically diagnosed at a younger age in children or young adults, it can onset at any age.
Type 2 Diabetes
Type 2 diabetes occurs when your body makes insulin, but it doesn’t make or use it well. This is the most common type of diabetes. When you have Type 2 diabetes, cells develop a resistance to the action of insulin, and as a result, your pancreas can’t keep up insulin production to keep your blood glucose level in a healthy range. Similarly to Type 1, sugar can’t move into cells and instead builds up in the bloodstream.
Type 2 diabetes can be diagnosed at any age. However, it is most often diagnosed during middle or older age.
Gestational diabetes can occur during pregnancy, but often will go away after giving birth. However, if you develop gestational diabetes while pregnant, you are more likely to develop Type 2 diabetes later in life.
Monogenic diabetes is a rare type of diabetes that is inherited and results from single gene mutations, as opposed to Types 1 and 2, which are caused by multiple genes. The gene mutations are often passed from parent to child, but they can occasionally occur spontaneously.
The two most common types of monogenic diabetes are neonatal and maturity-onset diabetes of the young (MODY).
What Causes Diabetes?
Diabetes is caused by various factors depending on the type you have. Yet, despite the different causes, there are two important factors in all diabetes diagnoses: an inherited predisposition to the disease and an environmental trigger.
Type 1 Diabetes — While the exact cause of Type 1 diabetes is unknown, it’s believed that a combination of environmental factors (like viruses) and genetic susceptibility come into play. What is known is that Type 1 occurs when your immune system attacks or destroys the cells that produce insulin in the pancreas. Being overweight does not appear to be a factor in Type 1 diabetes.
Type 2 Diabetes — The most common of all types, Type 2 diabetes is caused by genes and lifestyle factors, among other things. Family history, weight or obesity, and physical inactivity are also significant contributing factors. Most often, Type 2 diabetes starts with insulin resistance, which occurs when your body doesn’t process insulin well. The pancreas tries to make more insulin, but eventually cannot meet demand. Once this happens, your blood glucose levels rise.
Gestational Diabetes — Gestational diabetes is caused by hormonal changes that women experience throughout their pregnancy. Sometimes, these changes make cells more resistant to insulin. The pancreas tries to produce more insulin but is unable to do so adequately, and glucose stays in the blood rather than going to cells. Genetics and lifestyle can also play a role in whether or not a woman will develop diabetes during pregnancy.
Is Diabetes Genetic?
The genetic component of diabetes is complicated. With Type 1 diabetes, most people inherit risk factors from both of their parents. For example:
- A male with Type 1 diabetes has a 1 in 17 chance of his child developing the disease.
- A woman with Type 1 who has a child before age 25 will have a 1 in 25 chance of having a child with diabetes.
- A woman with Type 1 who has a child after age 25 will have a 1 in 100 chance of having a child with diabetes.
- If you were diagnosed before 11 years of age, your future child’s risk is doubled.
- If both you and your partner have Type 1 diabetes, your children will have between a 1 in 10 and 1 in 4 chance of developing the disease.
If you have Type 1 and are Caucasian, it is likely you have a gene called HLA-DR3 or HLA-DR4, and if you share these genes with your child, he or she is at greater risk. Research done for other ethnicity groups has had similar findings, but are not as well-studied. The HLA-DR7 and HLA-DR9 genes may put African Americans and Japanese, respectively, at greater risk. Current research is aimed at predicting and understanding the odds of a child developing diabetes in relation to race, gender, and other factors.
Type 2 diabetes has a stronger link to family history but environmental factors play more of a role in this type. Twin studies have shown a strong connection in the development of Type 2 but environmental factors, such as obesity and exercise habits, also tend to run in families. If you have Type 2 diabetes, most likely it is due to both lifestyle and genetic factors. However, studies show that by exercising and losing weight, you can delay or prevent onset of Type 2 diabetes.
Diabetes Risk Factors
While we’ve examined how some risk factors might be inherited, other risks can be avoided with the right care and precautionary measures taken. Some of the top risk factors to note include, in no order of importance:
- Poor diet
- Family history
- High blood pressure
- Previous history of gestational diabetes
How to Prevent Diabetes
While Type 1 diabetes cannot be prevented, there are multiple approaches that can be taken to reduce your risk of developing Type 2, with healthy lifestyle choices at the top of the list.
Eating healthy foods that are high in fiber and low in fat and calories is important. Whole grains, fruits, and vegetables are great snack choices. In addition to a healthy diet, being sure to get plenty of physical exercise and losing weight are both critical if you are high risk. Just 30 minutes a day, at least five days a week, of moderate activity like a brisk walk, bike ride, or swim can make a huge difference in reducing your risk of developing Type 2 diabetes.
Diabetes Diagnosis — How to Test for Diabetes
Multiple tests are used by a doctor to make a diagnosis of diabetes. A glycated hemoglobin, or A1C test, can indicate average blood sugar levels from the past several months. The A1C is a blood test that measures the percentage of blood sugar attached to hemoglobin, which is the protein that carries oxygen in red blood cells. A1C results can indicate the following:
- 6.5 percent or higher — indication of diabetes; must be in this range on two separate test results
- 5.7-6.4 percent — indication of prediabetes
- 5.6 percent or lower — considered normal; no indication of diabetes
Other tests include a random blood sugar test that doesn’t account for last meals (meaning, no fasting is necessary) or a fasting blood sugar test that’s administered after an overnight fast. Another test administered is an oral glucose tolerance test (OGTT), in which you fast overnight and your baseline blood sugar level is recorded in the morning, and again two hours after you ingest a sugary drink. The OGTT helps your doctor determine how your body processes sugar.
If a doctor suspects Type 1 diabetes, a urine test will be able to detect any presence of ketones, a byproduct that’s produced when fat breaks down. Another test that is used looks for destructive immune system cells called autoantibodies.
Common symptoms of diabetes include:
- Excessive and increased thirst
- Dry mouth
- Numbness or tingling in the hands or feet
- Extreme hunger, particularly after eating
- Unexplained weight loss despite regular eating
- Frequent urination
- Fatigue or feeling weak
- Blurred vision
- Sores that won’t heal or are slow-healing
- Gum or skin infections
What is the Treatment for Diabetes?
Managing a diabetes diagnosis is different depending on the type of diabetes you have. But in all cases, diet and exercise are important.
Monitoring blood sugar, carbohydrate counting, and taking insulin and oral medications may all play a role in treatment. All people with Type 1 diabetes and many people with Type 2 diabetes require insulin injections or an insulin pump. Although some people with Type 2 diabetes manage their condition through diet and exercise alone, many patients need diabetes medications as well.
For women diagnosed with gestational diabetes, keeping blood sugar levels under control is imperative to keeping the baby healthy and avoiding complications during delivery. Treatment during pregnancy might include monitoring blood sugar levels and possibly using oral medications or insulin. In most cases, gestational diabetes will resolve after a woman gives birth; however, the risk of developing Type 2 later in life increases after a gestational diabetes diagnosis. Women who are diagnosed with gestational diabetes should be screened for diabetes at least every three years after their blood sugar levels return to normal.
Diabetes, while not yet a curable disease, is treatable. And with over 2,000 clinical trials investigating new interventions, there are many possibilities on the horizon. While medication and lifestyle can play a significant role in treatment, continued genetic research and advancements in precision, or personalized, medicine offer amazing hope for those living with diabetes.
How To Get Involved In Diabetes Research
In December 2018, the U.S. Securities and Exchange Commission approved LunaDNATM to offer shares of ownership in the organization in return for health data. This made LunaDNA the first community-owned health and DNA data platform to exist. Our goal is to build a rich and robust health discovery platform dedicated to supporting research, advancing science, and accelerating medical breakthroughs.
Now, for the first time, people affected by diabetes can contribute their health data to LunaDNA’s secure platform. By uploading a personal DNA data file or even just taking a health survey, you can directly contribute to health research. The more people who come together to contribute health data for the greater good, the quicker and more efficiently research will scale, improving the quality of life for us all.
Luna is bringing together individuals, communities, and researchers to better understand life. Directly drive health discovery by joining the Tell Us About You study. The more we come together to contribute health data for the greater good, the quicker and more efficient research will scale, and improve the quality of life for us all.