Sign up for our complimentary
weekly e-journal

Main Newsletter
Mastery Series
Therapy Series
 
Bookmark and Share | Print Article | Items for the Week Previous | All Articles This Week | Next
This article originally posted and appeared in  ObesityType 2 DiabetesPreventionGenetics of DiabetesIssue 731

Lifestyle Interventions vs. Genetic Testing in Preventing Type 2

Targeted interventions based on genetic risk may not be the best approach for preventing type 2 diabetes and instead universal strategies to prevent obesity should be prioritized.... 

Advertisement

The analysis, led by Claudia Langenberg from the MRC Epidemiology Unit at the University of Cambridge, UK, suggests that the contribution of genetics to the risk of developing type 2 diabetes is greatest in those who are younger and leaner. However, in this group, the absolute risk of developing type 2 diabetes is low and the number of people who would have to be screened in order to guide targeted prevention would be impractically large.

Type 2 diabetes is thought to be caused by a combination of genetic and lifestyle factors, such as overweight and physical inactivity. While progress has been made in understanding the genetic basis of type 2 diabetes, the details of how adverse lifestyles combine with genetic risk to determine risk of developing type 2 diabetes are uncertain.

The authors quantified the association of genetic and lifestyle factors with the risk of developing type 2 diabetes in a large cohort of 340,234 people in 8 European countries followed for 11.7 years. In this EPIC-InterAct study, 12,403 people developed type 2 diabetes. The researchers identified an individual's genetic risk by determining how many of a list of 49 known type 2 diabetes genetic variants each study participant carried. They then assessed how this genetic risk contributed to each individual's overall risk of developing type 2 diabetes after several risk factors (such as age, waist circumference, physical activity and Mediterranean diet) were taken into account.

They found that the relative increase in risk of type 2 diabetes for each additional adverse gene carried was greatest in participants who were younger and thinner at baseline. The 10-year cumulative incidence of type 2 diabetes was substantially greater for those with the lowest genetic risk who were overweight (1.29%) or obese (4.22%) compared to normal weight individuals with the highest genetic risk (0.89%).

Professor Nick Wareham, who led the EPIC-InterAct study said, "This is the largest study to date examining the impact of genetic susceptibility and lifestyle factors on the risk of developing type 2 diabetes." He added that, "The high absolute risk associated with obesity at any level of genetic risk highlights the importance of population-wide, rather than genetically targeted, approaches to promoting healthy lifestyles that minimize excess weight."

Practice Pearls:
  • The contribution of genetics to the risk of developing type 2 diabetes is greatest in those who are younger and leaner
  • Relative increase in risk of type 2 diabetes for each additional adverse gene carried was greatest in participants who were younger and thinner at baseline
  • Risk of developing type 2 diabetes was highest in people who were obese, whatever their level of genetic risk for diabetes

Gene-Lifestyle Interaction and Type 2 Diabetes: The EPIC InterAct Case-Cohort Study, Langenberg C, Sharp SJ, Franks PW, Scott RA, Deloukas P, et al. PLoS Med, DOI:10.1371/journal.pmed.1001647, published 20 May 2014. 

Advertisement


 

Bookmark and Share | Print | Category | Home

This article originally posted 29 May, 2014 and appeared in  ObesityType 2 DiabetesPreventionGenetics of DiabetesIssue 731

Past five issues: Issue 778 | Diabetes Clinical Mastery Series Issue 237 | GLP-1 Special Editions April 2015 | Issue 777 | Diabetes Clinical Mastery Series Issue 236 |

2015 Most Popular Articles:

A Potential New Type 2 Diabetes Indicator
Posted April 02, 2015
Glyburide Used for Gestational Diabetes May Increase Risk of Birth Complications
Posted April 02, 2015
A Third Treatment Option in Uncontrolled Type 2 Diabetes
Posted April 02, 2015
Gastric Electrical Stimulation an Alternative to Insulin Injections?
Posted April 02, 2015
A Novel Scale May Indicate Glycemic Progression to Type 1 Diabetes
Posted April 02, 2015
Women Retain Insulin Sensitivity Better than Men
Posted April 02, 2015
Artificial Pancreas Software Algorithm Receives Approval in Europe
Posted April 02, 2015
Glycemic Control and Medications in T2DM Elderly with Dementia
Posted April 02, 2015
HbA1c and OGTT Performance in Prediabetic Obese Adolescents
Posted April 02, 2015
Type 2 Diabetes and Other Diseases Risk Related to Increase in Artificial Light?
Posted April 02, 2015


Browse by Feature Writer & Article Category.
A. Lee Dellon, MD | Aaron I. Vinik, MD, PhD, FCP, MACP | Beverly Price | Charles W Martin, DD | Derek Lowe, PhD | Dr. Brian Jakes, Jr. | Dr. Fred Pescatore | Dr. Tom Burke, Ph.D | Eric S. Freedland | Evan D. Rosen | Ginger Kanzer-Lewis | Greg Milliger | Kristina Sandstedt | Laura Plunkett | Leonard Lipson, M.A. | Louis H. Philipson | Maria Emanuel Ryan, DDS, PhD | Marilyn Porter, RD, CDE | Melissa Diane Smith | Michael R. Cohen, RPh, MS, ScD, FASHP | Paul Chous, M.A., OD | Philip A. Wood PhD | R. Keith Campbell, Professor, B.Pharm, MBA, CDE | Richard K. Bernstein, MD | Sheri R. Colberg PhD | Sherri Shafer | Stanley Schwartz, MD, FACP, FACE | Steve Pohlit | Steven V. Edelman, M.D. | Timothy S. Hollingshead |

Cast Your Vote
What percent of your patients have reached their A1c target?
CME/CE of the Week
Vickie Driver, DPM, MS, FACFAS

Category: Wound Care
Credits: 1.0



Search Articles On Diabetes In Control