scholarly journals Developmental Origins of Type 2 Diabetes in Aboriginal Youth in Canada: It Is More Than Diet and Exercise

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Kyle Millar ◽  
Heather J. Dean
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Early Onset ◽  
Maternal Obesity ◽  
Rapid Change ◽  
Environment Interaction ◽  
The Past ◽  
Central Canada ◽  
Cree People

Type 2 diabetes mellitus (T2DM) is classically viewed as a disease of adults caused by poor nutrition, physical inactivity, and obesity. However, with increasing awareness of the heterogeneity of T2DM, new risk factors are being identified that add complexity. Some of these new risk factors have been identified in Canadian people with Aboriginal Oji-Cree heritage, a group that demonstrates one of the highest rates of T2DM in the world. This high prevalence may be due to the rapid change, over the past 50 years, away from their traditional way of life on the land. Another environmental change is the increased rate of pregnancies complicated by obesity, gestational diabetes, or T2DM, resulting in more children being exposed to an abnormal intrauterine environment. Furthermore, the Oji-Cree of central Canada possesses the unique HNF-1αG319S polymorphism associated with reduced insulin secretion. We propose that intrauterine exposure to maternal obesity and T2DM, associated with the HNF-1αG319S polymorphism, results in fetal programming that accelerates the progression of early-onset T2DM. This paper describes the evolution of T2DM in children with a focus on the Oji-Cree people over the past 25 years and the unique prenatal and postnatal gene-environment interaction causing early-onset T2DM.

Risk of Incident Heart Failure in Individuals With Early-Onset Type 2 Diabetes

2021 ◽  
Author(s):  
Jian-Jun Liu ◽  
Sylvia Liu ◽  
Jiexun Wang ◽  
Janus Lee ◽  
Justin I-Shing Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Early Onset ◽  
Absolute Risk ◽  
Diabetes Duration ◽  
Adjusted Relative Risk ◽  
Onset Type ◽  
Onset Diabetes

Abstract Context Early-onset diabetes has been associated with unfavorable cardiovascular risk but data on heart failure (HF) in this subpopulation are scarce. Objective We aimed to study the risk of, and risk factors for, incident HF in individuals with early-onset type 2 diabetes. Methods We studied 606 individuals with type 2 diabetes diagnosed before 40 years of age (early-onset) and 1258 counterparts with diabetes diagnosed from 41 to 65 years of age (usual-onset) with no HF history, at a regional hospital, over a median follow-up period of 7.1 years. Incident HF by European Cardiology Society criteria was determined. Results A total of 62 and 108 HF events were identified in the early- and usual-onset groups (1.55 and 1.29 per 100 patient-years), respectively. Compared with usual-onset counterparts, individuals with early-onset diabetes had a 1.20-fold unadjusted (95% CI, 0.88-1.63; P = 0.26) and 1.91-fold age-adjusted (95% CI, 1.37-2.66; P < 0.001) hazard ratio (HR) for incident HF. Adjustment for traditional cardiometabolic risk factors only moderately mitigated the hazards (adjusted HR 1.69; 95% CI, 1.19-2.40; P = 0.003). However, additional adjustment for estimated glomerular filtration rate and albuminuria markedly attenuated the association of early-onset age with incident HF (adjusted HR 1.24; 95% CI, 0.87-1.77; P = 0.24). Notably, a long diabetes duration was not significantly associated with HF risk after accounting for kidney measures. Conclusion Individuals with early-onset diabetes have at least the same absolute risk and a 2-fold age-adjusted relative risk for incident HF. Excess cardiorenal risk factors but not a long diabetes duration are main drivers for HF development in this diabetic population.

Genetic variants associated with the early onset of type 2 diabetes in the Hungarian population

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N Werissa ◽  
P Pikó ◽  
S Fiatal ◽  
J Sándor ◽  
R Ádány
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Correlation Analysis ◽  
Risk Score ◽  
Genetic Risk ◽  
Early Onset ◽  
Genetic Risk Score ◽  
Age At Onset ◽  
Hungarian Population

Abstract Background It is generally accepted that early detection of type 2 diabetes mellitus (T2DM) is important to prevent the development of complications and comorbidities, as well as premature death. In addition to the environmental risk factors, genetic factors may also contribute to the development of T2DM. The aim of our study is to identify single nucleotide polymorphisms (SNPs) which have an effect on the early onset of T2DM in the Hungarian population. Methods This study included 891 T2DM patients (438 males and 453 females). The onset of T2DM varied between 25 and 90 years of age. Pearson correlation analysis was carried out for 16 SNPs to define how they are associated with the patient's age at onset of T2DM and genetic risk score was calculated for each patient by computation of alleles identified as risk ones. Linear regression analyses were used to estimate the effect of GRS on the early onset of T2DM independently of conventional risk factors (sex, BMI and TG/HDL-C ratio). Results Six SNPs (rs111875 in HHEX gene, rs560887 in G6PC2 gene, rs11071657 in the C2CD4B gene, rs5219 in KCNJ11 gene, rs10830963 in MTNR1B gene and rs11671664 in GIPR gene) were identified as risk polymorphism in the correlation analysis and GRS was calculated by defining their number/subject. The GRS showed significant association (β=-0.486, p = 0.008) with younger age at onset of T2DM. The correlation of GRS with the risk of earlier onset of T2DM was significant in the male population (β= -0.581, p = 0.024) and close to significant in female one (β= -0.471, p = 0.068). Conclusions Our findings indicate a considerable genetic predisposition for early onset of T2DM, which is mainly attributed to the cumulative effect of 6 SNPs presently known to be susceptible alleles. This set of SNPs and the genetic risk score calculated can be used for estimating the risk of earlier onset of T2DM on individual and population levels. Key messages SNPs were identified to play a role in the early onset of T2DM in the Hungarian population. The genetic risk score calculated by computation of susceptible alleles can be used for risk estimation of early onset of T2DM.

scholarly journals Association of ACE I/D Gene Polymorphism and Related Risk Factors in Impaired Fasting Glucose and Type 2 Diabetes: A Study Among Two Tribal Populations of North-East India.

2021 ◽  
Author(s):  
SUNANDA RAJKUMARI ◽  
SOMORJIT SINGH NINGOMBAM ◽  
VARHLUN CHHUNGI ◽  
MASAN KAMBO NEWMEI ◽  
NAOREM KIRANMALA DEVI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Health Concern ◽  
Environment Interaction ◽  
Hilly Terrain ◽  
North East India ◽  
Physiological Variables ◽  
North East ◽  
Tribal Populations

Abstract AIMType 2 diabetes is a serious public health concern in India, even the indigenous tribal populations are not felt unaffected. The present study aims to understand the association of major risk factors i.e obesity, hypertension, dyslipidemia, ACE I/D polymorphism with impaired (IFG) and type 2 diabetes (T2D) among two different Mendelian populations of North East India. METHODDemographic, somatometric and physiological variables along with fasting blood samples were collected from 609 individuals. ACE I/D polymorphism was screened. RESULTACE I/D polymorphism was found to follow HWE among Liangmai tribe but not among Mizo tribe. Distribution of DD genotype/D allele was found to be significantly higher for T2D among Mizo (OR 2.10; 95% CI 1.10-4.39, OR 2.10;1.16-4.09 respectively ).Significant association between DD genotype/D allele of ACE I/D polymorphism and TC in both IFG (OR 2.22; 95% CI 1.14-4.32) and T2D (OR 2.53;95%CI 1.51-4.23) were observed . LDL was also found to posed significant risk for IFG (OR 2.10;95% CI 1.10-3.91) and T2D (OR 1.04; 95%CI 1.02-1.06). CONCLUSIONThe present study is an example of gene-environment interaction where DD genotype or D allele and dyslipidemia (high TC and high LDL) are posing risk for IFG and T2D both independently and in combination only among Mizo tribe with relatively less physical activity attributed to their residence in less hilly terrain, but Liangmai tribe which resides in high hilly terrain shows no such association.

P28 Early onset type 2 diabetes and associated risk factors

2014 ◽  
Vol 103 ◽  
pp. S40-S41
Author(s):  
G. Kiraka ◽  
N. Kunyiha ◽  
P. Ojwang ◽  
R. Easmus
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Early Onset ◽  
Onset Type ◽  
Associated Risk Factors

scholarly journals Short-term progression of cardiometabolic risk factors in relation to age at type 2 diabetes diagnosis: a longitudinal observational study of 100,606 individuals from the Swedish National Diabetes Register

Diabetologia ◽  
2018 ◽  
Vol 61 (3) ◽  
pp. 599-606 ◽  
Author(s):  
Andri O. Steinarsson ◽  
Araz Rawshani ◽  
Soffia Gudbjörnsdottir ◽  
Stefan Franzén ◽  
Ann-Marie Svensson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Early Onset ◽  
Cardiometabolic Risk ◽  
Late Onset ◽  
Cardiometabolic Risk Factors ◽  
Diabetes Diagnosis ◽  
Diabetes Register

Abstract Aims/hypothesis The reasons underlying a greater association of premature mortality with early-onset type 2 diabetes relative to late-onset disease are unclear. We evaluated the clinical characteristics at type 2 diabetes diagnosis and the broad trajectories in cardiometabolic risk factors over the initial years following diagnosis in relation to age at diagnosis. Methods Our cohort consisted of 100,606 individuals with newly diagnosed type 2 diabetes enrolled in the Swedish National Diabetes Register from 2002 to 2012. The average follow-up time was 2.8 years. Analyses were performed using a linear mixed-effects model for continuous risk factors and a mixed generalised linear model with a logistic link function for dichotomous risk factors. Results The individuals diagnosed at the youngest age (18–44 years) were more often male and had the highest BMI (mean of 33.4 kg/m2) at diagnosis and during follow-up compared with all other groups (those diagnosed at 45–59 years, 60–74 years and ≥75 years; p < 0.05), being ~5 kg/m2 higher than the oldest group. Although HbA1c patterns were similar between all age groups, there was a difference of about 5 mmol/mol (0.45%) between the two groups at 8 years post-diagnosis (p < 0.05). Additionally, individuals diagnosed younger had ~0.7 mmol/l higher triacylglycerol, and ~0.2 mmol/l lower HDL-cholesterol levels at diagnosis relative to the oldest group. Such differences continued for several years post diagnosis. Yet, although more of these younger individuals were receiving oral glucose-lowering agents, other cardioprotective therapies were prescribed less often in this group. Differences in BMI, blood glucose and lipid levels remained with adjustment for potential confounders, including marital status, education and country of birth, and, where relevant, differential treatments by age, and in those with at least 5 years of follow-up. Conclusions/interpretation Individuals who develop type 2 diabetes at a younger age are more frequently obese, display a more adverse lipid profile, have higher HbA1c and a faster deterioration in glycaemic control compared with individuals who develop diabetes later in life. These differences largely remain for several years after diagnosis and support the notion that early-onset type 2 diabetes may be a more pathogenic condition than late-onset disease.

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