Genetics and diabetes

Types of diabetes

Diabetes is a chronic metabolic disease that indicates that glucose levels in the blood are very high and, over time, erodes systems and organs such as kidneys or blood vessels (1). There are two types of diabetes:

Type I diabetes, in which the pancreas does not generate insulin, a hormone that helps absorb glucose by cells to provide them with energy. Without this hormone, insulin stays in the blood at a too high level and can cause problems in various body organs.

Type II diabetes is a condition in which the cells do not usually respond to insulin. Hence, the body needs more insulin to achieve the proper transfer of glucose into the cells. As a consequence, if not treated in time, the disease ends up generating hyperglycemia. Being overweight or obese, not doing physical exercise, and genetics contribute to the development of this disease. The prevalence is higher in men than in women (2).

Both types of diabetes are diagnosed through serological tests.

 

Diabetes and genetics

Diabetes is currently a fairly common disease in our society. However, it should not be underestimated, as it is the ninth leading cause of death worldwide. Type 2 diabetes, caused by our body’s resistance to insulin, is the most problematic worldwide, as its incidence has been increasing for several decades (1). Four years ago, in the United States alone, the health expenditure generated by this disease was estimated at more than 800 million dollars (3). This fact is compounded by the fact that it often goes undiagnosed.

Apart from immunological factors, the influence of genetic factors in the development of diabetes has been studied for many decades. It began with studies of the human leukocyte antigen (HLA), but later massive sequencing and new genetic analysis techniques have been the ones that have definitively yielded new and exciting genetic findings (4).

 

Genes involved

Among the great variety of genes that show influence in type I diabetes, we find the BACH2 gene, which exerts its function in the immune system and is related to the generation and conservation of different T cells or somatic hypermutation (5).

Regarding genetic susceptibility to type II diabetes, we find a great variety of variants in different genes. Part of them explains how this disease is inherited. WE estimated that genetic factors could explain about 10% of the reasons that cause the pathology.

In terms of specific genes in this type of diabetes, we find genes such as FTO, which is closely associated with obesity, which, in turn, is very directly related to this disease. In addition, it has recently been discovered how adipocytes, which are fat cells, secrete a molecule called resistin, named after insulin resistance, and which seems to relate diabetes to obesity (6) directly. Another gene of note in type II is the LPP gene, located on chromosome 3, which is present in the small intestine (7), and which seems to have great relevance in cell motility at cell adhesion sites (8).

 

Microbiota and feeding

The microbiota is another factor that also clearly influences the diabetic picture. A significant decrease in intestinal bacterial populations related to butyrate production has been observed, and increases in bacteria related to oxidative stress (9). All this invites us to think that the diet of diabetic persons (10) is an element to continue observing since it is one of the significant factors influencing the intestinal microbiota.

 

Diabetes, a risk factor for Covid-19

Although we are now in a more stable stage of the SARS-CoV-2 pandemic, we can say that people who have diabetes have been at the center of risk groups, together with people with respiratory difficulties, heart problems or obesity. In turn, people with diabetes are at increased risk of pneumonia or severe inflammatory responses (11).

 

Lifestyle or medication

As we have seen, a wide range of issues is affected by and influence diabetes. In terms of mental health, correlations have also been found between diabetes and the risk of depression (12).

It has also been shown that making lifestyle changes has a positive impact on reducing the incidence of diabetes in more than 50% of cases, even more so than the use of the popular drug Metformin (13, 14). In terms of prevention recommendations, screening also has a favourable impact on high-risk patients (15).

 

24Genetics and health

This pathology should not be understood without a preventive approach (16), and, of course, genetics in terms of prevention has a lot to say. At 24Genetics, we have applied this approach and, in various sections of our DNA test health report, you will be able to see what tendencies you may have towards both types of diabetes since we analyze a wide variety of genes distributed throughout the DNA. And, since diabetes has a robust nutritional component, you can also learn about your various vitamin and nutritional propensities in our report.

Knowing your genetic tendencies help you learn more about the big picture of your health. Stop by our store and learn more about yourself: https://24genetics.com/en/dna-shop

 

Bibliography:

  1. World Health Organization (WHO). (2021). https://www.who.int/health-topics/diabetes#tab=tab_1
  2. Wild, S.H., et al. (2004). Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes care, 27 5, 1047-53.
  3. Cho, N.H., et al. (2018). IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes research and clinical practice, 138, 271-281 .
  4. Noble, J.A., & Erlich, H.A. (2012). Genetics of type 1 diabetes. Cold Spring Harbor perspectives in medicine, 2 1, a007732 .
  5. Marroquí, L., et al. (2014). BACH2, a candidate risk gene for type 1 diabetes, regulates apoptosis in pancreatic β-cells via JNK1 modulation and crosstalk with the candidate gene PTPN2. 63(7):2516-27. doi: 10.2337/db13-1443. Epub 2014 Mar 7.
  6. Steppan, C., et al. (2001). The hormone resistin links obesity to diabetes. Nature, 409, 307-312.
  7. Kamura, Y., et al. (2016). FTO Gene Polymorphism Is Associated with Type 2 Diabetes through Its Effect on Increasing the Maximum BMI in Japanese Men. PloS one, 11(11), e0165523. https://doi.org/10.1371/journal.pone.0165523
  8. Garner, C. P., et al. (2009). Replication of celiac disease UK genome-wide association study results in a US population. Human molecular genetics, 18(21), 4219–4225. https://doi.org/10.1093/hmg/ddp364
  9. Qin, J., et al. (2012). A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature, 490, 55-60.
  10. Evert, A.B., et al. (2019). Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report. Diabetes Care, 42, 731 – 754.
  11. Guo, W., et al. diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020 Mar 31:e3319. doi: 10.1002/dmrr.3319. Epub ahead of print.
  12. Anderson, R.J., et al. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001 Jun;24(6):1069-78. doi: 10.2337/diacare.24.6.1069.
  13. Knowler, W.C., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. The New England journal of medicine, 346 6, 393-403 .
  14. Tuomilehto, J., et al. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England journal of medicine, 344 18, 1343-50 .
  15. Un gran Basevi, V. (2011). Standards of Medical Care in Diabetes—2012. Diabetes Care, 35, S11 – S63.
  16. Danaei, G., et al. (2011). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participants. The Lancet, 378, 31-40.

Written by Manuel de la Mata

Geneticist

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