Lifestyle interventions are better than genetic tests for preventing type 2 diabetes

May 20, 2014

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, according to new research published in this week's PLOS Medicine. This 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.

Diabetes is currently estimated to affect more than 380 million people and the epidemic is likely to increase to 592 million by 2035. Type 2 is thought to be caused by a combination of genetic and , such as overweight and physically 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. However, risk of developing type 2 diabetes was highest in people who were obese, whatever their level of genetic risk for diabetes. 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 ". He added that, "the high absolute risk associated with obesity at any level of highlights the importance of population-wide, rather than genetically targeted, approaches to promoting healthy lifestyles that minimise excess weight".

Explore further: Waist circumference linked to diabetes risk, independently of body mass index

More information: Langenberg C, Sharp SJ, Franks PW, Scott RA, Deloukas P, et al. (2014) Gene-Lifestyle Interaction and Type 2 Diabetes: The EPIC InterAct Case-Cohort Study. PLoS Med 11(5): e1001647. DOI: 10.1371/journal.pmed.1001647

Related Stories

Genetic risk score linked to increased risk of diabetes

July 30, 2013

(HealthDay)—A genetic risk score based on 46 gene variants linked to type 2 diabetes is associated with increases in the risk of type 2 diabetes and declines in glucose control and beta-cell function, according to a study ...

Recommended for you

Do germs cause type 1 diabetes?

May 16, 2016

Germs could play a role in the development of type 1 diabetes by triggering the body's immune system to destroy the cells that produce insulin, new research suggests.

Melatonin signaling is a risk factor for type 2 diabetes

May 12, 2016

A sleeping pancreas releases less insulin, but how much insulin drops each night may differ from person to person, suggests a study published May 12, 2016 in Cell Metabolism. Up to 30 percent of the population may be predisposed ...

New gene for familial high cholesterol

May 12, 2016

New research from Denmark reveals the gene that explains one quarter of all familial hypercholesterolemia with very high blood cholesterol. Familial hypercholesterolemia is the most common genetic disorder leading to premature ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.