Are Inherent Genes or Inherent Lifestyles to Blame for the Rise in Diabetes

In my essay: I am addressing the issue of developing diabetes based off of genetic

predispositions versus inherent lifestyles from parents and social norms. I address how diabetes
can be prevented because of its overwhelming link to a poor lifestyle and not genetic factors.

Target audience: The audience is a broad newspaper audience, directed at anyone who needs to
improve their lifestyle in order to reduce their “inheritance” of diabetes. This entails a lot of
people, but the rationale is that we all need to be mindful that we risk developing diabetes when
we do not take care of our bodies with healthy food and exercise.

Thesis: For those with type 2 diabetes, the development of diabetes is more related to lifestyle
than genetic inheritance.

Word count: 1511

 Are Inherent Genes or Inherent Lifestyles to Blame for the Rise in Diabetes
Katie Angerhofer

Diabetes is a life changing disease. Although chronic, measures can be taken to

prevent and improve diabetic conditions. Preventative measures such as a healthy lifestyle and

improvements such as diet and exercise are some examples. However, consider those who are

not diabetic because of lifestyle choices, rather a risk of diabetes is in their genetic code. For

those people who have a strong genetic predisposition toward type 2 diabetes, how effective

are lifestyle changes in preventing and treating diabetes? In other words, is there any hope in

avoiding a chronic burden of diabetes or are people with “bad genes” destined to a life with

disease. Admittedly, there are many who live a healthy life and are still diagnosed with type 2

diabetes. We are also aware of ethnic and genetic variations causing a higher likelihood of

developing certain diseases, but we are learning how common treatments can be effective even

if genes are a cause. The inheritance of genes plays a large role in health outcome, however,

an even larger factor is the inheritance of lifestyle. Families often live similarly and have similar

health outcomes. For those with type 2 diabetes, the development of diabetes is more related to

lifestyle than genetic inheritance. Lifestyle changes such as diet and exercise are effective in

preventing the development of diabetes. Even among different ethnicities, lifestyle changes can

help improve diabetes. Diabetes has less to do with the genes inherited and more to do with the

lifestyle inherited.

Lifestyle changes to improve health are effective for many chronic conditions. For both

type 1 and type 2 diabetes changes in diet and exercise can help improve physical and mental

well being (1). Even with a genetic predisposition to diabetes, weight plays an important role in

the development of type 2 diabetes (3). Weight not only plays an important role in the

development of diabetes, it is the single most significant factor. Our genetic code does not see a

lot of variation from one generation to the next. Because of this, environmental factors and
behaviors account for more recent trends in increased obesity and diabetes. Coupled with this is

that diabetes runs in families and families tend to pass on similar lifestyle habits (2). In other

words, diabetes has less to do with whose you are and more to do with who you are and how

you live your life.

Another factor for obesity that is newer in research is the influence of gut microbiota. An

increase in certain gut microbiota organisms have shown to either promote or reduce weight

gain. With certain gut germs increasing susceptibility of obesity, it in turn raises a person's risk

for diabetes (4). Gut microbiota are easily transferred among family members, which contributes

to the explanation of families with “obesity” in their blood. Lifestyles of families are also very

similar and is another contributor to a families “inherent” obesity.

Lifestyle habits such as diet and activity levels have similar effects on different

ethnicities. Ethnicities have variation in their genetic code which can cause for different rates of

disease. In a study that evaluated different diabetic lifestyles, multiple ethnicities were looked at

(5). Among the different ethnicities were Caucasian, Japanese American, and Native Hawaiian.

Native Hawaiians had the highest incidence rates followed by Japanese Americans (5). They

discovered five different lifestyle choices that significantly increased risk of diabetes among

these ethnicities. First was being overweight/obese. Second was living an inactive life. Third

was a high amount of red meat intake. Fourth was no alcohol. Fifth and final was being a

current or former smoker (5). These are all lifestyle choices that can be modified and

subsequently reduce the risk of diabetes. For each ethnicity there was significant evidence to

suggest the correlation between these behaviors and diabetes risk (5). The only exception that

was not significant was a correlation between smoking for Caucasians (5). In a similar study,

African American diabetes rates were studied. They found that African Americans have on

average higher BMI and obesity rates, which were significantly higher among those diagnosed

with diabetes (6). The overall message of these studies is that a lifestyle leading to obesity also
increases risk of diabetes among all ethnicities. With that knowledge we can change how we

look at diabetes and focus on how it can affect each of us, instead of focussing on how it may

affect one group of people or ethnicity.

The opposite is also true among multiple ethnicities. If a healthy lifestyle is lived and

weight is maintained and managed with a healthy diet and adequate physical activity then risk

for diabetes is reduced (7). A study done with multiple treatments on a variety of ethnicities

showed the benefit of healthy lifestyles. Four groups of treatment were tested. The first group

was a low-intensity group where minimal physical activity was done and little education on

healthy habits was given. The second group was a high-intensity group where physical activity

was monitored and healthy living was taught. The third group received Metformin, a drug for

diabetes treatment. The final group received no treatment and acted as the control group (7).

The results showed those receiving high-intensity treatment saw greatest improvement to

symptoms from diabetes. Improvements were especially high among African Americans and

Hispanics. Although, we cannot change ethnicity or genetics at birth, from a very young age

healthy behaviors in diet and exercise can reduce the risk of diabetes.

Early lifestyle habits increase an individual's chance of developing diabetes, regardless of

genetic predisposition. Habits of eating and exercise early in life tend to stick with us for the rest

of our lives. It is harder to change our ways later on. When our bodies are conditioned to

unhealthy conditions it overworks our bodies and we accumulate a lot of sugar and ultimately,

our bodies cannot keep up. This results in insulin resistance and eventually diabetes (8).

Additionally, younger children who are offspring of an insulin resistant family member have a

higher risk of diabetes and are more likely to have a similar lifestyle leading to diabetes (9).

Among younger children in Asian countries, the children born with a diabetic parent are more

likely to take on similar lifestyle habits early on and develop diabetes (10).
 As compelling as the previous statements may be, what about the argument that

diabetes is not a matter of lifestyle choice and that people who are genetically more inclined to

get diabetes cannot prevent it with lifestyle changes. Or that you are what you inherit. Although

these arguments are true to an extent, the flawed thinking comes in when people argue that you

cannot change because of an inherent “gene” or “lifestyle”. Lifestyles are often inherited from

one generation to the next. However, the environment is constantly changing and influences our

decisions concerning our health (7). We may inherit something that is less than ideal, our family

history may be filled with obese members who lived sedentary lives, but we can be the change

and live an active life. To credit the arguments, genetics play a very large role in our health

outcome (11). It is hard to change or prevent a condition just by changing our lifestyle(11). But

the takeaway is that genetics play a very large role, yet change is possible. With early

prevention such as a good diet and exercise, diabetes can be prevented, even in those with a

higher genetic chance of getting diabetes.

We must also acknowledge that many people associate type 1 diabetes with genetics

and type 2 diabetes with lifestyle leading to obesity, however, the development of type 2

diabetes is linked more to genetics than type 1 (2). This is important to know for a couple of

reasons. First, it can help someone who has lived a healthy life and is diagnosed with type 2

diabetes understand how they got the disease. Second, this knowledge can help raise

awareness that type 2 diabetes is not just a disease caused by obesity, but rather a disease

caused by both controlled and uncontrolled factors. With all of that said, patterns of diet and

activity levels can affect our genes activity and the onset of diseases.

Diabetes is a very unpredictable and devastating disease, however, it can be prevented with

a healthy lifestyle. Even though genetics play a large role in disease development, those

predispositioned to get diabetes can change their condition with an improved lifestyle. Even for
those of us who do not have “diabetic inherited genes” we run the risk of inheriting diabetes with

our lifestyle. To prevent this, eating a balanced low-sugar and low-fat diet with regular exercise

can dramatically reduce the risk of developing diabetes. We must acknowledge that we play a

much larger role in our individual health outcome than the genes our parents passed down to

us. Acknowledging this could be the difference of living 20 years with diabetes or living 40 years

disease free. It is up to each of us to take charge of our health and live a life we are not afraid to

pass onto our children.

References:

1- McCulloch DK. Overview of medical care in adults with diabetes mellitus. In: UpToDate,
Nathan DM, Mulder JE. UpToDate, Waltham, MA. Accessed January 27, 2018.

2- Genetics of Diabetes. (n.d.). Retrieved March 16, 2018, from

http://www.diabetes.org/diabetes-basics/genetics-of-diabetes.html

3- Omar A. Genetics of type 2 diabetes. World Journal of Diabetes. 2013; 4: Pages: 114-123.

4- Komaroff AL. The Microbiome and Risk for Obesity and Diabetes. JAMA. 2017;317(4):355–
356. doi:10.1001/jama.2016.20099

5- Steinbrecher A, Morimoto Y, Heak S, Ollberding N, Geller KS, Grandinetti A, Kolonel LN,

Maskarinec G. NCBI. https://www.ncbi.nlm.nih.gov/pm
c/articles/PMC310 9209/. Accessed March 19, 2018.

6- Wuenstel W, Johnson J, Humphries J, Samuel C. Ethnicity, Obesity, and Type 2 Diabetes of

Adults in Urban Populations of Central America. International Journal of Public Health Science
(IJPHS). 2016; Vol.6: pp. 28-33.

7- Roberts S, Craig D, Adler A, McPherson K, Greenhalgh T. Economic evaluation of type 2

diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes
and metformin in participants with different categories of intermediate hyperglycaemia. BMC
Medicine. 2018; 16. 2-12.
8- Jiang X, Ma X, Wang Y, Liu Y. Early Life Factors and Type 2 Diabetes Mellitus. Journal of
Diabetes research. https://www.hindawi.com/journ als/jdr/201 3/485082/. Accessed March 19,
2018.

9- Natali A, Muscelli E, Maria A, Balkau B, Walker M, Tura A, Anderwald C, Golay A,

Ferrannini E. Insulin Sensitivity and β-Cell Function in the Offspring of Type 2 Diabetic Patients:
Impact of Line of Inheritance, The Journal of Clinical Endocrinology & Metabolism. 2010;
Volume 95: Issue 10, Pages 4703–4711.

10- Yajnik C.S. Early Life Origins of Insulin Resistance and Type 2 Diabetes in India and Other
Asian Countries. The Journal of Nutrition, 2004; Volume 134: Pages 205–210.

11- Zimmet P, Shaw A and B. Global and societal implications of the diabetes epidemic. Nature
International Journal of Science. https://ww w.nature.com/articles/414782a. Accessed March 20,
2018.