My friend is a 30 year old male. He is physically feeling fine, but is worried about his health. Diabetes is quite common on both his mother’s and his father’s sides. Several of his relatives have suffered from strokes or cardiac infarction, and most of them are overweight. Lately, he has gained a little weight himself.

What is the connection between diabetes/fatness/cardiac infarction?

What types of diabetes are there, and how do they differ (hereditary etc.)?

How do you judge the risk for hereditary diseases?

Can you get diabetes without having any hereditary disposition?

What is hereditary and what is caused by environmental factors (diabetes, fatness, cardiac infarction, stroke).

What do you think about my friend?

Your answers are as follows:

Excess weight is associated with decreased insulin sensitivity. It is also associated with hypertension and elevated lipids. Diabetes is a very strong risk factor for heart disease, so are hypertension and elevated lipids. In fact, there is a continuum of risk from obesity to diabetes and heart disease. Many people who are insulin resistant, but have not developed diabetes are also at risk for heart disease. This is part of what people refer to as the metabolic syndrome. These factors tend to cluster together in affected patients.

Please refer to our Basics page.

For type 2 diabetes, there is roughly a 50 percent risk for offspring of people with type 2 diabetes.

You can get diabetes without having a family history of diabetes. This may occur because a relative may not have been diagnosed as having diabetes during their lifetime. Individuals with type 1 diabetes often do not have any family history of the disease.

Clearly, there are interactions between genetics and environment. For instance, a person may have a genetic predisposition for type 2 diabetes. However, they may live a healthy lifestyle and diabetes may not develop. On the other hand, individuals with a genetic predisposition may suffer an injury, gain weight as a result of inactivity, and then develop type 2 diabetes.

I would think it would be wise for him to work on lifestyle changes. He sounds like he is at increased risk for both type 2 diabetes and vascular disease. I would also add that he should receive regular follow-up from his physician so that risk factors can be addressed as they are identified.

JTL