Diabetes and Genetics: What the Future Holds
Genetics is “the study of inherited variation, and it is instructive to view the history of the discipline in the context of insights into the source and nature of the variation…Mendel, known as the father of genetics, established the basic laws of inheritance, including the laws of segregation and independent assortment” (Battle, 2009). Common disorders, such as diabetes, do not follow simple, predictable patterns. Instead, they cluster or aggregate in complex combinations from both environmental and genetic factors. Through the years of medical and science advancements, evidence has shown that there are genetic and environmental factors that contribute to diabetes. The mixture of a genetic background and a Western lifestyle (dietary supplements, obesity, exposure to organic pollutants, and glycemic control), leads to people having diabetes (Murea et. al, 2012).
It is important to use genetics with public health because all diseases have a genetic basis (Battle, 2009). Like stated before, there is evidence that genetic factors, as well as environmental factors, play a role to determine if an individual has diabetes or not. Most cases of diabetes result in a combination of both environmental and genetic factors, which come from type 2 diabetes. Four environmental factors that affect the prevalence of diabetes are the following: unhealthful food, such as refined carbohydrates, lack of physical activity, stress, and chemical pollution exposure. Humans were not designed to each large amount of refined carbohydrates, which is seen in sweets, breads, pasta, and more today because they do not occur in nature; these carbohydrates do not digest or absorb normally within the body. These types of carbohydrates are so readily seen because the bran and germ layer, which contains a majority of the nutrients and fiber, has been removed. Thus, they can be produced in large quantities with cheap price tags. Not only are these products cheap, but they also taste good, which can become addictive because they raise serotonin and dopamine levels. After a while the blood glucose levels drop, making an individual miserable, needing their next “fix” of the carbohydrate.
This is added with a lack of physical activity; people used to exercise and move their body throughout the day through food gathering, transportation, and recreation. Today machines have been built to operate these tasks, so people have to go out of their way to seek physical activity. This can become challenging with a lack of support, other demands, and no motivation. Stress, which is association with our bodies’ “fight-or flight” response, is the body’s response to perceived threats. This can be seen through raised blood pressure, raised glucose levels, a release of the hormone cortisol, and more. It is through stress that certain cells close off, becoming insulin resistant; this is done to save the glucose for future energy needed. It is also through stress that the liver gives off more glucose into the system, causing the problem to only become worse. Although this system is great for real-life threats, it is only designed to last a few minutes; it is not designed to last days or years.
Finally, studies have shown that chemicals in food, water, cleaning and beauty care products, and plastic packaging increase insulin resistance and diabetes. Those whose incomes are lower, along with those who have less education have less access to healthful foods. It is because of this that they not only have barriers to exercise and stress-free lives, but they often are exposed to more chemicals (Spero, 2014). Although not everyone can fix their environment, several items can be done to help reduce the risk of diabetes. Physical activity is key, and there are exercises one can do even if they can not walk. However, reducing stress might be the most important step one can do to reduce the risk of diabetes. This could be accomplished through relaxation, yoga, prayer, meditation, social support, and more.
When it comes to diabetes itself there are two types: type 1 and type 2. These two types of diabetes have very different causes, but two factors remain the same. One inherits predisposition to a disease, and then it can become triggered from the environment. In order for a person to have type 1diabetes they need to inherit the risk factors from both of their parents. Certain environmental factors can trigger type 1diabetes; studies have shown links to type 1 diabetes and the cold, viruses, diet, race, and breastfeeding. If a man has diabetes the likelihood of child having type 1diabetes is 1 in 17. If a women has diabetes and has a child before they are 25 the likelihood that the baby would have diabetes would be 1 in 25. After a women is 25 the likelihood of the baby having diabetes becomes 1 in 100. If both parents have type 1 diabetes the chance that the child will have diabetes becomes 1 in 10 to 1 in 4. Type 2 diabetes, however, shows a strong link to family history, where genetics play a strong role in the development of the disease. Lifestyle choices also greatly influence the development of type 2 diabetes due to similar eating and exercise habits (Genetics of Diabetes, 2017).
There are several genetic testing options that could take place as it relates to diabetes. The first test would most likely be family history, which looks at the biological relationship between first, second, and third-degree relatives. Genetic testing may also take place, which is used to rule our or confirm genetic disorder(s) in an individual (Battle, 2009). Today genetic policies and ethics are being debated due to the growing use of genetics testing. Questions that are being debated on are the following: how should the tests be regulated, what level of validity and utility should be required for tests offered to the public, what counseling should be provided, who should provide guidance, who will pay for the genetic testing, how will the government protect against genetics discrimination, and more.
If insurance companies and Medicare will not pay for the genetic testing the progress of genomic medicine will be stalled. Tests have been created to predict the likelihood of a drug response, assess disease risk, and more. If companies will not pay for these tests progress in medicine can not move forward. Today several government agencies are working together to develop regulatory standards for genetic testing for routine medical care, but this is still in the distant future. The Centers for Disease Control currently has an advisory group that specialized in CLIA regulations. Many also fear of possible discrimination that could occur from genetic testing, which could result in a lack of volunteers in research experiments. In 2008 the Genetic Information Nondiscrimination Act was passed, where the goal was to prohibit discrimination in the workplace and by insurance issuers (Policy and Ethics Issues, 2012).
As one can see, diabetes is a disease that is complex through genetic and environmental factors. Policies and procedures have been created to help move this disease forward, but unless everyone is on board this will not occur. Many issues still arise today due to ethic issues; it will be up to today’s rising generation to decide what the future will hold for genetics and diabetes.
References:
Battle, C. U. (2009). Essentials of public health biology: a guide for the study of
pathophysiology. Sudbury, MA: Jones and Bartlett.
Genetics of Diabetes. (2017). Retrieved April 03, 2017, from https://www.diabetes.org/diabetes-basics/genetics-of-diabetes.html
Murea, M., Ma, L., & Freedman, B. I. (2012). Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications. Retrieved April 03, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448170/
Policy and Ethics Issues. (2012, May 02). Retrieved April 03, 2017, from https://www.genome.gov/27527638/
Spero, D. (2014, March 19). Five Environmental Causes of Diabetes. Retrieved April 03, 2017, from https://www.diabetesselfmanagement.com/blog/five-environmental-causes-of-diabetes/