Diabetes Type 2: Genetic and Lifestyle Interaction

With other risk factors like obesity and sedentary lifestyles, type 2 diabetes is a serious, protracted illness that has a complex interplay between genes and environment. This type of diabetes, along with its consequences, pose a serious global threat to public health. It has an almost universal impact on people in both developing and established countries. High rates of diabetes-related morbidity and mortality are the consequence of this. Additionally, over time, the prevalence rates for type 2 diabetes have been rising significantly. This has been the pattern in many “modernizing” emerging nations. As such, several factors have necessitated the development of better efficient therapy strategies, as well as appropriate prevention strategies aimed at controlling type 2 diabetes. Such factors include delayed diagnosis, complications, risk factors, and high financial costs incurred when treating this disease. In this article, I highlight the role of genes, lifestyle, as well as other issues that contribute to the increasing incidence of diabetes type 2.

Introduction

Diabetes is a serious condition that attacks a patient when the pancreas stops producing enough insulin or when the human body fails to utilize insulin efficiently produced (Franks 1). There are two types of diabetes. One such type of diabetes is known as type 1 diabetes and is mediated by the immune system. Consequently, it requires daily administration of insulin. Another common type is the type 2 diabetes which is the most prevalent among the population in the world. It is estimated that over 90% of the people who have diabetes in the world have this form of diabetes (Franks 299). The prevalence rate for diabetes type 2 has continued to increase in tandem with the increasing number of patients at risk of complications arising from diabetes. Suffering from diabetes type 2 twice enhances the risk of myocardial infarction as well as the risk of stroke (Joseph et al., 768). Besides, it is one of the leading causes of limb amputation, blindness, and failure of the kidneys.

Tests of secondary prevention after the occurrence of myocardial infection have shown that active short-term interventions in persons with diabetes are equally as effective in non-diabetic patients (Joseph et al., 769). Conversely, patients with diabetes have not experienced similar reductions in long-term case mortality rates of cardiovascular disease (Villegas et al., 6). Population studies conducted on patients to investigate cardiovascular disease risk factor trends in populations with and without diabetes have unveiled different patterns against those with diabetes.

Epidemiology of Type 2 diabetes

Diabetes type 2 has become a universal public health threat. From the analysis of recent statistical data, we can infer that this kind of diabetes has various new epidemiological characteristics (Wu et al., 1185). The prevalence of diabetes in developed countries is steady. As such, it has turned to be a serious issue at a worrying rate. Further, it is estimated that in the coming twenty years, diabetes type 2 will continue increasing by over 70 percent of this population being found in developing countries (Temelkova et al., 3). A majority of these individuals will be between the ages of 45-64 years. Moreover, seventy percent of states with the highest number of patients with diabetes are middle-income or low-GDP countries. Examples of these nations include Brazil, India, Bangladesh, Russia, and China. Still, age is the main standout factors influencing diabetes type 2, the increasing rates of childhood obesity have made diabetes type 2 a common ailment among children and adolescents (Wu et al., 1185). This is a critical emerging trend of the widespread and a public health concern.

Cross-sectional relationship studies seeking to assess interactions or associations with diseases associated with lifestyle are prone to be labeled as biased. Resultantly, this can somehow influence the precision of self-declared lifestyle in people with and without a disease label or diagnosis (Franks 301). For instance, since lifestyle is an obvious risk aspect associated with diabetes, individuals with new onset of diabetes type 2 may be inclined to over-report the consumption of healthy diets, as well as levels of activity when questioned about their food and physical activities (Franks 302). Similarly, persons who have not been diagnosed with the disease may declare such behaviors more precisely. Therefore, cross-sectional lifestyle studies and diabetes type 2 are susceptible to to bias, especially when lifestyle exposures are announced through the use self-report methods (Franks 302). This restriction applies in total disregard of whether the research concentrated on evaluating connotations between diabetes and lifestyle, or on diabetes and connections between genes and lifestyle (Villegas et al., 4).

Method

This study was case-controlled patterned to explain the connection between diabetes type 2, genetic characteristics, as well as lifestyle risk agents among the Qatari people between the ages of 25 and 65 (Bener et al., 303). Individuals were considered and classified as people with diabetes if the blood glucose values were7.0mmol/L. Also, those who were under diabetes medication were listed in this category.338 diabetic patient between ages 25-65 were selected using a simple random method from primary health care institutions (Bener et al., 303). The health conditions of these individuals was evaluated by noting down their previous medical state, family history, blood pressure, physical evaluation, blood sugar level, and cholesterol amounts. Control subjects of ages 25 to 65 years were singled out from the community and declared as healthy if their blood glucose levels were less than 6.1 mmol/L (Bener et al., 303). Also, this was subject to them never having administered any diabetic medication. Additionally, 344 healthy participants came to the primary health care centers for reasons other than chronic diseases. They were selected randomly from the list of daily appointments (Bener et al., 304). Consequently, their health statuses were analyzed by recording their previous medical state, physical examination, kin history, blood glucose, blood pressure, and cholesterol totals.

The study was taken for approval by the Research Ethics Group of Hamad General Hospital, as well as Hamad Medical Corporation. Informed assent was received from those who agreed to take part in this study according to the Declaration of Helsinki. The survey involved standardized interviews conducted by professionally trained nurses and officers. Participating individuals were categorized as physically inactive if they declared they had not been taking part in physical exercises such as walking or cycling for at least 30 minutes per day. Moreover, the height and weight of the subjects were assessed using standardized procedures. This required that the subjects put on light clothes without shoes. Subsequently, the BMI for each was calculated by taking their weight in kilograms and dividing it with their height in square meters. Nonetheless, one kilogram was subtracted from the weight of the subjects to allow for clothing. After that, subjects were classified into three categories. Those whose BMI values were less than 25 were classified as having acceptable weight (BMI < 25) (Bener et al., 304). The overweight group included those whose BMI range was 25-30. Obese individuals had a BMI reading of more than 30 (BMI> 30).

Blood pressure evaluation was conducted by qualified practical nurses based on the standards set by the World Health Organization. The average values obtained from the three readings were used to carry out the analysis. Hypertension was described based on the criteria proposed by WHO as diastolic blood pressure more or equivalent to 90 mm/Hg, as well as the use the use of antihypertensive drugs. Systolic blood pressure more or equivalent to 140 mm/Hg was also considered to be hypertension (Bener et al., 305). Mean blood pressure was described as 2/3 diastolic pressure and 1/3 systolic pressure. Pulse pressure was determined as the difference between systolic and diastolic pressure.

Results

From the findings, it was revealed that people with diabetes had low educational attainment levels and more than five children. Less diabetic participants resided in houses with more than five rooms with over five family members (Bener et al., 305). Also, obesity was more common among patients with diabetes. Subjects with diabetes consumed small amounts of fish and chicken since most of them were aware of their nutrition habits. Additionally, self-reported accounts of diabetes in first degree next of kin were found to be higher in diabetic participants as compared to non-diabetic participants.

Discussion

Previously, there were no studies based on the population that examined the prevalence of diabetes, together with its related risk factors in Qatar. In this study, the count of individuals living in the same household premise, smoking, count of children, and consanguineous marriages were positively related to diabetes (Bener et al., 306). Besides, many risk agents have been singled out that affect the incidence or prevalence of diabetes. Importance factors to consider are the age, history of diabetes type 2, increased amounts of fat in the abdomen, overweight, absence of physical exercise, hypertension, and tribal grouping (Garup et al., 423). In the study, smoking, low levels of education, systolic blood pressure, and obesity were classified as related risk factors (Bener et al., 306). This was in agreement with previous studies conducted. One of these studies reported a positive link between insulin resistance, obesity, and high prevalence of diabetes and cardiovascular hazards in South Asians. The high predominance statistics of diabetes among the Qatari populace seems to be connected to the activity of various environmental agents including obesity with a specific diabetic genotype (Midhet et al., 770). The outcomes affirm the potential adverse consequences of advancing nations on native individuals. Still, these discoveries agree with previous statements that suggest a link between the socio-economic status of diabetics, obesity, their lifestyle habits, as well as cardiovascular risk factors (Diabetes Prevention Program Research Group 399). For instance, diabetes type 2 is a typically significant problem as a disease related to the kind of lifestyle in Japan. Over seven million people of the population in Japan have diabetes.

In this study, most people with diabetes were discovered to be obese. This is in line with the findings of previous studies. Moreover, the relationship between diabetes type 2 and obesity is a consequence of various elements such as increases in fatty acids. In contemporary years, it has been observed that overall and central obesity were related to kin account of diabetes within the Indian population (InterAct 66). As such, a family account of diabetes may raise the possibility of hypertension, as well as hyperlipidemia albeit indirectly. This is through its relationship with BMI. Absence of physical exercises is also linked to diabetes mellitus, which resulted in the hypothesis that exercising boosts insulin activity (McCarthy 2345). Nevertheless, this was not confirmed by the study.

Conclusion

Diabetes type 2 affects all societies across the world from the developing to the developed nations. One of the significant risk factors for diabetes type 2 is abdominal obesity. Nonetheless, not all those who contract this condition are obese. Similarly, not all persons who lose weight are free from the risk of diabetic disease. This variation in vulnerability to diabetes considering the various lifestyles is believed to be the consequence of gene variants that are associated to other environmental factors. Still, there is little evidence to support this assertion. Since it remains highly likely that the interaction between genes and the environment can cause diabetes, one should carefully analyze why existing approaches to examining gene-lifestyle interactions have failed to provide significant support for such connections with human diabetes. This also includes the real examples of the interactions involving genes and the environment. One of the possible explanations may be the outcomes of the interplay could be small given the minimum level of accuracy with which risk factors associated with lifestyle changes are measured in epidemiology circles. Furthermore, the sizes of samples and mathematical formulas used in interaction studies bear unsatisfactory statistical capabilities. Moreover, these explanations have ignited a new form of gene-lifestyle association studies that concentrate on much more significant cohort collections, as well as highly sophisticated analytical approaches that have never been seen before. Consequently, it is a possibility that these studies will produce credible evidence of the interactions between genes and lifestyle associated with diabetes type 2 and provide clinical information that will be valuable in the prevention and treatment of this fatal disease.

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