Diabetes: Study Shows Influence of Family History

An analysis of the Tyrolean Diabetes Register has now shown an earlier onset and gender-specific complications for people with a familial burden. This is the result of the study published in the scientific journal Plos One.

"A family history of diabetes (FHD) is a strong risk factor for type 2 diabetes. But little is known about how this affects the outcome," wrote Clemens Plattner from the Innsbruck University Clinic (MedUni Innsbruck) and his co-authors in their publication (doi: 10.1371/journal.pone.0324696), which was published last week.

90 percent of diabetes cases are attributed to type 2 diabetes. The internationally observed high wave of the disease is particularly associated with the increasing prevalence of overweight and obesity. However, the disease, which begins with a resistance to the body's own insulin produced by the pancreas, also has a genetic background and therefore occurs more frequently in families.

Type 2 Diabetes: Heritability Estimated at 25 to 72 Percent

"Based on family and twin studies, the heritability of type 2 diabetes is estimated at 25 to 72 percent," the scientists wrote. However, there are around 250 different genome regions with potentially involved hereditary factors. They are likely to have varying degrees of impact.

Plattner and his co-authors from all diabetes clinics in Tyrol used data from the Tyrolean Diabetes Register in their work to epidemiologically investigate the associated questions: "7,866 patients with type 2 diabetes from the Tyrolean Diabetes Register were grouped according to their familial status regarding diabetes."

The first result: In individuals with a family history, this form of diabetes, formerly known as "adult-onset diabetes" and initially not usually associated with a need for insulin injections, manifested earlier: On average, the disease appeared at the age of 51.89 years. Type 2 diabetics without relatives with the disease received the diagnosis on average at 56.59 years. This statistically significant difference was observed in both women and men.

Prevention of Long-term Complications

In the context of the chronic disease, it is particularly important to prevent long-term complications. These include cardiovascular diseases such as heart attack and stroke, chronically progressive kidney diseases, neuropathies with severe pain conditions, and retinal damage. Here, the data analysis showed significant differences. "The risk for neuropathy was higher with a family history of diabetes (41 percent increase in frequency; note), while there was a lower risk from diseases of the large blood vessels ("macrovascular", 16 percent decrease; note)."

However, the latter did not apply to men with type 2 diabetes and a corresponding family burden. Here, a significantly greater risk was filtered out from the registry data than in women. Mortality due to cardiovascular diseases was also higher in diabetic men than in women. The researchers: "The risk for all macrovascular diseases combined, heart attack, necessary heart bypass operations, or peripheral artery disease ("window shopping disease"; note) was 73 to 156 percent higher in the compared groups." For heart attack alone, these men showed about twice the frequency.

"The family history in diabetes is not only associated with an earlier diagnosis of type 2 diabetes but also affects diabetes-related outcomes, with men being more susceptible to cardiovascular diseases, patients with FHD (family history; note) having an increased risk for neuropathy, but the risk for macrovascular diseases being reduced," the authors summarized their findings.

(APA/Red)

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