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Diabetes: Nature or Nurture?

November 3, 2018


Genetic Factors in Blood Sugar Regulation

Nature or nurture? For type 2 diabetes, it appears to be a bit of both. There have been tremendous advances in gene research over the past decade, but a singular “diabetes gene” has not been uncovered. Instead, researchers have identified dozens of genes and gene variations that may each make small contributions to an increased risk for diabetes.

  However, studies conducted on identical twins show that genes alone are not enough to determine whether someone might develop diabetes. Identical twins have been thought to have identical genes, yet research shows that when one twin has type 2 diabetes, the risk for the other twin is about 75% — not 100%. Something else is going on.

  In an identical twin study conducted in 2014 at Lund University in Sweden, researchers found 1,400 sites on the twins’ DNA where there was a difference in DNA methylation (which modifies the DNA’s function) between the diabetic twin and the non-diabetic twin. According to Emma Nilsson, one of the researchers, “It is believed that these differences are due to differences in lifestyle and this confirms the theory that type 2 diabetes is strongly linked to lifestyle.”

  Human biology is complex, but to simplify what this means, our DNA contains our genes, which are inherited and cannot be altered. On the genes are things called methyl groups that can either turn a gene “on” or “off” — in other words, methyl groups affect the expression of a gene. The methyl groups are influenced in different ways by factors such as diet, exercise, stress and other lifestyle choices.

  So while genetics does play a role in type 2 diabetes, the dramatic increase in the number of cases over the last generation has less to do with heredity than with the interaction between our genes, the world we live in and the lifestyle choices we make.

  A helpful analogy is to think of your genetic risk for diabetes as a seed. On its own a seed won’t grow into a tree, but if you give it the right environment (soil, water, sunlight), it will. Our modern food environment of processed and refined grains and sugar, combined with inadequate movement, high stress, lack of sleep and environmental toxins, can make those tiny genetic seeds flourish into type 2 diabetes. It has been said that genes load the gun, environment pulls the trigger.


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