Diabetes mellitus: heredity or lifestyle?

Diabetes mellitus is a complex disease; its neglected form is fraught with serious complications. Is heredity always to blame for the development of diabetes?

Every year, people with diabetes only arrive, and young people, and even children, are increasingly appearing among patients. The pathology is based on metabolic disorders that occur when insulin, the hormone responsible for the delivery of glucose to cells and its adaptation, is either not produced or not absorbed by the body. As a result, hyperglycemia develops – an increase in blood glucose levels.

Important questions: Is diabetes hereditary, or is it the result of lifestyle and any complications? And how much does a child’s risk of disease increase if one or both parents have diabetes?

There are various types of the disease, among the main ones:

• Type 1 diabetes mellitus, called insulin-dependent – the pancreas cannot secrete insulin due to the destruction or complete disappearance of ß-cells. To support the biological processes in the body, which are impossible without insulin, a person has to administer the hormone in the form of medications.
• In type 2 diabetes mellitus, called insulin resistance, the pancreas continues to produce insulin, unlike the first. Still, the sensitivity of tissues to it is either reduced, or insulin is produced in insufficient quantities for the body. To “fix” the situation, the gland produces excess insulin.

But in any case, glucose absorption by the body’s cells is disrupted; it ceases to be transported from the blood into the cells (this requires insulin), accumulating in the blood. The body’s cells, left without food, experience an energy deficit since glucose is the main energy supplier. All this leads to numerous disorders in the body.

Early signs of diabetes

Among the first symptoms of diabetes, to which a person pays attention and goes to the doctor, one can single out those that occur in both the first and second types of the disease:

• thirst and constant dry mouth;
• frequent urination, the amount of urine excreted increases;
• dry skin, itching, frequent pustular infections;
• muscle cramps;
• visual impairment, etc.

Of course, the clinical manifestations of diabetes are very diverse since almost all organs are involved in the pathological process. Therefore, it is better to consult a doctor to prevent complications when the first warning signs appear.

How justified is the anxiety of parents diagnosed with this disease if they plan to have children? As a result of numerous studies, it has been proven:

The hereditary factor in the development of diabetes is present. However, it is not the main one: the disease often develops in people with no one in their family with such pathology.

Diabetes and heredity – a bit of theory

As a result of the research, genes and their protein products, called genetic markers, were found that are responsible for the development of diabetes. But all people have the same set of chromosomes with genes responsible for producing different proteins. So why doesn’t everyone develop the disease?

As it turned out, the same gene can mutate in different people. So there were polymorphisms of genes, meaning diversity. In some cases, the mutation does not change the functional characteristics of the protein encoded in the gene. If the replacement turns out to be significant, the whole chain of biochemical reactions can change, and various diseases develop with certain combinations.

For example, some proteins’ function is to regulate glucose metabolism, but with polymorphism, its normal metabolism becomes impossible. Also, with polymorphisms of certain genes (for example, ADAMTS9, TCF7L2, KCNJ11, KCNQ1), insulin production and tissue sensitivity to it are reduced, which leads to an increase in blood glucose levels.

In addition, genes located in B-lymphocytes activated T-lymphocytes, and monocytes, whose function is the production of proteins involved in the regulation of recognition of foreign molecules, play a significant role in the development of diabetes. When these genes are mutated, immune processes are disrupted, so as a result of genetic disorders, the risk of not only diabetes but also autoimmune diseases increases.

Is disease always inevitable?

Type 1 diabetes

It has been established that the development of insulin-dependent type 1 diabetes mellitus is associated with a genetic predisposition and a malfunction of the immune system. The basis of the disease is a violation of the pancreatic ß-cells due to an autoimmune reaction and hereditary predisposition, which leads to absolute insulin deficiency.

Certain forms of genes, called genetic markers, are now associated with the disease. In the course of the research, it was found that in 70% of cases, type 1 diabetes is based on the genes of the tissue compatibility system (HLA – human leukocyte antigens), whose function is to recognize foreign tissue and form an immune response.

Autoimmune reactions can also be caused by a malfunction of the immune system with a predominant lesion of ß-cells by viral infections, inflammatory diseases, fibrosis or calcification of the pancreas, tumors in the body, and changes due to atherosclerosis. In childhood, diabetes most often develops in those who have had rubella, mumps, measles, rotavirus, and other viral infections.

According to statistics, mutated genes inherited from the father manifest in developing diabetes in a child in 6-9% of cases. If the predisposition is inherited through the maternal line, then the probability of the disease will be 3-5%. When both parents are diagnosed with diabetes, the chance is as high as 21%; in the presence of other close relatives with diabetes and diabetic parents, the risk increases by four times. However, a predisposition to the disease can be passed down through the generation when parents are only carriers of genetic information.

Type 2 diabetes

It turns out that genetic factors can be traced to type 2 diabetes. To date, about 20 genes have been discovered, with polymorphism of which there is a high risk of developing the disease. However, in this type of diabetes, the main cause is often a person’s lifestyle and past diseases. Factors that lead to the activation of various disorders:

• Infectious diseases are among the most dangerous: HIV, herpes, etc.
• Allergies to various allergens: the work of the immune system in emergency mode leads to a malfunction in the immune system.
• Frequent stress – can increase the risk by 5%; It is believed that adrenaline under stress has a detrimental effect on insulin.
• Inactivity – provokes obesity, which leads to metabolic disorders, and insulin susceptibility decreases.
• The predominance of simple carbohydrates and fats in the diet negatively affects insulin receptors and the pancreas and contributes to weight gain.
• Alcohol abuse – as a result, pancreatic cells that secrete insulin are affected.

Also, a person’s tendency to be overweight and endocrine diseases are often genetic. Still, obesity and metabolic disorders are included in the list of main risk factors for diabetes and increase the risk of its development by 10-15%.

Can the disease be prevented?

It should be remembered that it is not the disease that is genetically transmitted but the tendency to develop pathology. In addition, as it turned out, a huge role is assigned to the combination of hereditary predisposition, immunological disorders, and many adverse factors.

Is it possible to protect yourself from the development of the disease? In type 1 diabetes, the risk can be minimized with simple preventive measures, although it is not always possible to avoid the development of the disease. As for type 2 diabetes, the chances of preventing the development of pathology with the help of all the same preventive measures are quite high.

Basic Prevention Measures

• Diet correction: restriction of fast carbohydrates on the menu and refusal of alcohol.
• Fractional nutrition in small portions: 5 times a day with a portion weight of 300-400 gr.
• Compliance with the drinking regime: 2-2.5 liters per day.
• Physical activity that prevents excess weight.
• Hardening to prevent colds, vaccination aimed at preventing various diseases.
• Regular examinations.

Early diagnosis of diabetes

Of course, the above measures should become the norm of life and not a fleeting impulse. If, among close relatives, there are already patients with diabetes, then a timely examination will help to detect the threat long before the first signs appear. For example, a predisposition can be identified using a blood test for antibodies to GAD (glutamate decarboxylase). The presence of antibodies in the blood is considered a marker of type 1 diabetes, and they can appear up to five years before the first signs appear.

More recently, diabetes mellitus was considered a serious, incurable disease, dangerous for its complications. Today, patients, subject to medical recommendations, have every chance to meet old age cheerful and active. Moreover, it is not necessary to rely on chance: how lucky. Molecular biological diagnostics does not stand still; methods are constantly being improved. And turning to a geneticist can help prevent the development of the disease both in the patient himself and in future offspring.