medwireNews: Family history of diabetes is associated with younger age at diagnosis of type 2 diabetes, but this could be delayed by following a healthy lifestyle, data from the Joint Asian Diabetes Assessment (JADE) Registry suggest .
The study, conducted by Juliana Chan (Chinese University of Hong Kong, Shatin) and colleagues, also found that self-monitoring, defined as a healthy lifestyle plus regular self-monitoring of blood glucose (SMBG) , was associated with better control of cardiometabolic activity. risk factors, particularly when there was a family history of diabetes.
Overall, 59.5% of 86,931 type 2 diabetes patients from 427 clinics in 11 Asian countries/regions between 2007 and 2021 had a parent or sibling affected by diabetes, but the prevalence ranged from 39.1% in Vietnam to 85.3% in Malaysia.
Mother alone was the most commonly affected relative (13.2%), followed by father alone (9.8%), siblings alone (11.5%), and then various combinations of the three.
The median age at diabetes diagnosis was 49.8 years, but the researchers found that people with a family history of diabetes were diagnosed significantly 4.6 years earlier than those without a family history (mean 47.9 vs. 52.5 years).
Within the family history group, patients with both affected parents with or without an affected sibling had the youngest mean age at diagnosis (44.6 years), followed by those with only one affected parent with or without an affected sibling. affected (47.7 years) and those with affected siblings only (51.5 years). The difference between the groups was statistically significant.
In addition to a significantly younger age at diagnosis, the researchers found that people with a family history of diabetes were more likely than those without a family history to have a middle school education or higher (82.0 vs. 71. 6%), having a job (48.1 vs 40.4%) and doing regular SMBG (73.5 vs 65.9%).
However, they were less likely to report aspects of a healthy lifestyle, such as eating a balanced diet, not using alcohol or tobacco, or engaging in regular physical activity.
Chan and his team then investigated whether family history interacts with unhealthy lifestyles to advance the age of diagnosis. They found that people with a family history who reported fewer than two healthy lifestyle behaviors were diagnosed earlier, at a median age of 46. Those with two or more healthy behaviors and no family history were the oldest at the time of diagnosis, with a mean age of 52.8 years.
Of note, the mean age at diagnosis was similar between people with a family history of diabetes who reported adhering to two or more healthy lifestyle behaviors and those with no family history but a less healthy lifestyle (48 .2 vs. 50.1 years).
For cardiometabolic risk factors, the researchers report that people who had two parents with diabetes were 12% more likely to have hypertension and 21% more likely to have dyslipidemia than those with no family history, after adjusting for possible risk factors. confounding factors. The risks were also significantly elevated for people with an affected parent, at 12% and 22%, respectively. In contrast, a family history of diabetes was not associated with a significantly increased risk of hyperglycemia.
The researchers also found that self-monitoring was associated with a significantly greater chance of achieving a glycated hemoglobin level below 7% (53 mmol/mol), blood pressure below 130/80 mmHg, and a lipoprotein cholesterol level. low-density below 2.6 mmol/L in all participants. However, the interactions were stronger among individuals with a family history of diabetes than among those without.
writing in BMC MedicineChan and co-authors conclude that having a family history of diabetes “advanced the age of diagnosis by almost 5 years, although this could be delayed with healthy lifestyles.”
They continue: “Similarly, although patients with [family history] had worse control of cardiometabolic risk factors than [non-family history] group, seemed to benefit more from self-management.
The team suggests that although biogenetic markers and algorithms may improve the prediction, diagnosis and treatment of patients with complex diseases such as type 2 diabetes, family history “is a simple indicator that can be used to identify people of high risk for intensive education and empowerment. to delay the onset of the disease and improve clinical outcomes”.
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