Jothydev Kesavadev, MD
Jothydev’s Diabetes Research Centre
Trivandrum
www.jothydev.net

The most popular complex endocrine disease, diabetes, is undoubtedly a hereditary disorder. There are two types of diabetes - the less common type 1 diabetes, which occurs in children and the more common type 2 diabetes which constitute 96% of the total patient population with diabetes. Type 1 diabetes is a sporadic disease which probably happen secondary to a viral infection or an auto immune disorder which destroys the beta cells in the pancreas which secretes insulin. Hence the genetic nature of type 1 diabetes is questionable. However it is not uncommon to observe siblings with type 1 diabetes. According to the American Diabetes Association, in general, if you are a man with type 1 diabetes, the chance of your child developing diabetes is 1 in 17. If you are a woman with type 1 diabetes and your child was born before you were 25, your child's risk is 1 in 25; if your child was born after you turned 25, your child's risk is 1 in 100. Your child's risk is doubled if you developed diabetes before age 11. If both you and your partner have type 1 diabetes, the risk is between 1 in 10 and 1 in 4.

Type 2 diabetes usually run in families. Type 2 diabetes has a stronger link to family history and lineage than type 1. If mother or father has got type 2 diabetes   chances are there for the children to develop the same. In general, if you have type 2 diabetes, the risk of your child getting diabetes is 1 in 7 if you were diagnosed before age 50 and 1 in 13 if you were diagnosed after age 50.Some scientists believe that a child's risk is greater when the parent with type 2 diabetes is the mother. If both the parents have diabetes, child's risk is about 1 in 2.

People with certain rare types of type 2 diabetes have different risks. If one parent is having the rare form called maturity-onset diabetes of the young (MODY), the child has almost a 1-in-2 chance of getting it.

Statistics has also shown an earlier onset of the disease in the offspring. In other words if the onset of diabetes used to be 65 years earlier, now the average onset of type 2 diabetes is 35 years in Kerala. With  the emergence of obesity among children across the globe,  there are children aged 15 or even 12 years developing type 2 diabetes which is secondary to consumption of high fat diet and lack of physical exercise. Though type 2 diabetes is polygenic in inheritance with no single gene identified, the good news is that its prevention in young individuals is possible with meticulous adherence to healthy food habits and daily physical activity or we can at least postpone the onset of diabetes.

So type 2 diabetes though widely recognised as a heredity disorder is a completely preventable disease. This is because though there is a genetic predisposition there is an environmental triggering factor as well for the onset of disease. This environmental triggering factor may either be obesity especially abdominal obesity, lack of physical exercise, high levels of cholesterol or untreated blood pressure. If onsets of risk factors are taken care of, diabetes is a preventable disease.