Could You Get Better Insulin From Your Ethnic Genes?
Medscape, a digital media company and publisher of advanced digital medical education, has teamed up with the American Diabetes Association to explore how ethnicity influences how people metabolize insulin. Combined with recent research about how genetics play a role in the precise timing of insulin-producing cells in our body, Medscape’s research shows that ethnic differences may provide a window to personalize insulin treatment for some patients.
Who is at risk for type 2 diabetes?
Type 2 diabetes is a relatively new condition on the American health scene. It is characterized by impaired kidney function, high blood pressure, and low levels of glucose (sugar) in the blood. If left untreated, type 2 diabetes can lead to serious complications, including cardiovascular disease and other conditions involving the blood vessels, nerve, and eyes.
Diabetes rates remain high in the United States. In 2016, according to CDC, 12.9 million people had diabetes, up from 10.6 million in 2014, and a staggering 49% of those with diabetes in 2016 didn’t know they had it.
One possible explanation for these high diabetes rates is the fact that many of the medications used to treat type 2 diabetes are chemically related to cholesterol, and many people cannot tolerate cholesterol-reducing medications on their own. With continued high rates of type 2 diabetes, patients are less likely to respond to others’ medications, leading to increased demand for insulin.
What do we know about the genes for type 2 diabetes?
In 2016, the American Diabetes Association released a statement in conjunction with researchers from the Wellcome Trust and the Oxford Diabetes and Endocrinology Centre in which they revealed a discovery about the role of insulin-producing cells in our body. Researchers have been finding that, on average, most people have about two-thirds of their insulin-producing cells in the neck region of the stomach called the small intestine.
Further research seems to show that the specific hormone insulin that is controlled by these cells is also encoded by small intestine cells, meaning that, as people’s insulin-producing cells age, they have lower levels of this particular hormone and more difficulty controlling blood sugar.
Numerous previous studies have investigated the genetic make-up of people with type 2 diabetes, mostly in Taiwan, where some people seem to have a more dominant sense of smell. Most studies have relied on blood samples, which may prove inaccurate, and others often cross-reference their findings with people from ethnic groups who had a less dominant sense of smell, a more common precursor to diabetes. With those limitations in mind, the ADA and Oxford team decided to conduct DNA analysis on individuals from all ethnic groups in the United States.
Why is it important for diabetes patients to be aware of these genetics?
A large proportion of the individuals who are at risk for type 2 diabetes are not aware that they have diabetes. Instead, they may believe that their health issues are minor, preventing them from seeking medical care. Although it may not be easy for many people to notice a case of type 2 diabetes, in the long run it can have serious consequences.
Diabetes is a chronic disease that is more prevalent in ethnic minorities. Its prevalence in African Americans, for example, is over 2 times that of white Americans. Although the genetic differences among ethnic groups play a role in type 2 diabetes, until now little has been known about how differences in the amount of insulin-producing cells may relate to the greater risk of the disease in certain groups.
This new research may be able to help us understand more about the genetic make-up of people who have type 2 diabetes, and identify potential strategies to prevent or treat the disease based on those differences. The research will be presented at 2018 National Diabetes and Obesity Summit in Washington, D.C. at 7:00 a.m. on Thursday, August 2nd, 2018.