Understanding the effect of familial diabetes history is one step towards managing type 2 diabetes in young people.
Type 2 diabetes is common among individuals aged 45 years and older, but there is an emerging trend of the disease among younger people. However, there is little information concerning the cause of the increasing trend of youth with type 2 diabetes mellitus, and very few previous studies concerning familial history of type 2 diabetes. The current study aims to understand the origin of the disease and assess the impact of family history of paternal vs. maternal type 2 diabetes.
The hypothesis guiding the study is that epigenetic factors may be the driving cause for a greater impact of maternal type 2 diabetes on children’s subsequent diabetes risk. The study was carried out using data from Royal Prince Alfred Hospital. The hospital contains a detailed database of the history of patients with diabetes.
Familial diabetes history data from 11,467 patients with type 2 diabetes were considered for the study. Parental histories of diabetes were compared across a range of age of diagnosis strata (15-<30, 30-<40, 40-<50, 50-<60 and 60-<70 years). Data were analyzed using Statistical Package for Social Sciences and Number Cruncher Statistical System software. The analysis also involved the use of Pearson X2 to examine differences in the reporting by maternal and paternal history. Also, in the analysis, one-way analysis of variance was utilized to establish the difference between parental history groups based on different age groups.
The study provides exciting findings on type 2 diabetes and patients with paternal and maternal diabetes history. From the study, a more significant percentage of patients reported having a maternal history of diabetes. In this case, 21.1% reported maternal history, 12.1% reported paternal history, while only 6.15% reported both parents’ history of diabetes. Based on the study, a Cochrane-Armitage trend test played an essential role in confirming that there are more cases of type 2 diabetes relating to maternal history. The analysis of variance confirmed that there is a significant difference concerning the onset of diabetes between different age groups based on parental history. The young-onset group (diagnosed between 15 and 30 years of age) demonstrated the highest prevalence of any parental history of diabetes (60.7%), the highest combined maternal and paternal history (15.8%) and the smallest differential between maternal (25.1%) and paternal (19.7%) history of diabetes. Within the young-onset group, no significant association between parental history and cardio-metabolic risk factors or diabetic complications were identified after a median of 15.0 years of diabetes exposure.
The study results demonstrate a consistent maternal excess of diabetes, which could support the hypothesis of an underlying epigenetic effect. However, since the differential between maternal and paternal history is significantly lower in the young-onset group, the earlier emergence of type 2 diabetes may reflect a different interaction and impact of genetic and environmental factors.
Even though the study findings provide a relevant answer to the hypothesis, the study also suffers from some forms of biases. For instance, the study is based on observational design, hence the probability of reporting bias. Also, there is bias in sample selection and in explaining the difference between paternal and maternal diabetes history.
- People with young-onset diabetes had the highest prevalence of parental history of diabetes and the smallest differential between maternal and paternal diabetes.
- The earlier emergence of type 2 diabetes in young-onset patients may be due to the impact of both genetic and environmental factors.
- Understanding parental diabetes history is relevant because it contributes to a better formulation of prevention and treatment strategies.
Middleton, Timothy L., et al. “Maternal vs. paternal diabetes: The parental history is different in younger–onset versus older onset type 2 diabetes.” Journal of Diabetes and it‘s Complications 33.12 (2019): 107440.
Sandra Zaki, PharmD Candidate, Florida A&M University