Sunday, January 15, 2006

Another article on diabetes

The New York Times has another article on type 2 diabetes, this time on the finding of a gene that makes people more susceptible to the disease. Even though I am a type 1 diabetic, I found the article interesting, and wanted to post it for my readers.

The thing that makes this article so interesting is how completely different type 1 and type 2 diabetes are. They are completely different diseases, they just have the same end results: the buildup of sugar in the bloodstream due to an inability to process it. The difference is in how that result is met.

Type 1 diabetes is clearly a genetic disease. It is an autoimmune disease, which means that the person's immune system was programmed to destroy their own pancreatic, insulin-producing cells. The autoimmune response can start at any time: many type 1 diabetics are diagnosed as children, whereas I was 21 or possibly even 20 when my autoimmune response kicked in (22 when diagnosed). Even middle-aged adults can be diagnosed as type 1 (although this is often misdiagnosed, since type 2 is usually the culprit at this age). The trigger for the autoimmune response is not known.

Also, an autoimmune diseased can be passed genetically as any autoimmune disease. For example, my mother has a hyper thyroid, an autoimmune disease which became diabetes in me. I also know of a family where the uncle was diabetic, but the nephew was diagnosed with leukemia, another disease with an autoimmune basis. However, my mother has a friend whose husband and children are diabetic, showing that diabetes can also be passed as itself.

Type 2 diabetes has long thought to be a very different sort of disease - a disease of indulgence, you might say. Type 2 diabetes seems to occur in elderly and overweight individuals; in fact, the condition can often be corrected with militant exercise and careful diet planning. The disease occurs when a person's body becomes resistant to their own insulin. That is, they still make insulin (which type 1 diabetics do not), but they are unable to use it. Ninety percent of diabetics have type 2, and the disease is usually attributed to the American culture of poor diet - fast food and unhealthy diets, combined with excessive eating. Because of this, it's been difficult to pin down any genetic link to type 2 diabetes - particularly because the doctors could never be sure if the diabetes was genetic, or just the tendency to be overweight, which is a factor in type 2 diabetes.

According to this New York Times article by Nicholas Wade, however, scientists have identified a gene that makes the risk of type 2 diabetes significantly higher. This doesn't mean that the gene causes type 2 diabetes, though, I should point out - just that it makes the disease much more likely in a person that carries the gene. Again, it's hard to say how exactly the gene makes the disease more likely; but once they develop a test for the gene, those who have it will have the forewarning and awareness necessary to be more careful with their diet and exercise habits.

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