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Diabetes research We look at some of the research presented at the annual meeting of the European Association for the Study of Diabetes
56.1 (range 50-65)). Almost half (49.5%) of the participants developed type 2 diabetes during an average 14.7 years of follow-up. A favourable lifestyle was defined as having at least three of the following healthy lifestyle factors: no current smok- ing, moderate alcohol consumption, regular physical activity and a healthy diet. An unfa- vourable lifestyle was defined as zero or only one healthy lifestyle factor, while the remaining participants were defined as having an intermediate lifestyle. Genetic risk was assessed by a genetic risk score (GRS) comprising 193 genetic variants known to be strongly associated with type 2 diabetes. The GRS was stratified into low (lowest 20%), intermediate (middle 60%) and high risk (top 20%) groups. The researchers found that having an unfavourable lifestyle and obesity are asso- ciated with a greater risk of developing type 2 diabetes regardless of their genetic risk. Obesity (defined as a body mass index of 30kg/m 2 or higher) increased type 2 diabe- tes-risk by 5.8-fold compared to individuals with normal weight.The independent effects of high (versus low) genetic risk and unfa- vourable (versus favourable) lifestyle were relatively modest by comparison, with the highest genetic risk group having a two-fold increased risk of developing type 2 diabetes compared with the lowest group; and unfa- vourable lifestyle was associated with a 20% increased risk of developing type 2 diabetes compared with favourable lifestyle. The authors concluded that the effect of obesity on type 2 diabetes risk was dom- inant over other risk factors, highlighting the importance of weight management in type 2 diabetes prevention. Puberty, menopause and the pill Later puberty and later menopause associated with lower risk of type 2 diabe- tes in women, while use of contraceptive pill and longer time between periods
associated with higher risk. The study by Dr Sopio Tatulashvili, Avicenne Hospi- tal in Bobigny, France, also presented at EASD, suggests that in general longer exposure to sex hormones, but later in life, could reduce the risk of diabetes, and that women at high-risk of type 2 diabetes taking the contraceptive pill may require personalised advice. Early screening to detect poor blood sugar control could lower the risk of further com- plications. For this reason, it is important to identify the risk factors of type 2 diabe- tes. The aim of this study was to determine the association between various hormonal factors and the risk of developing type 2 dia- betes in the large prospective female cohort study (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Educa- tion Nationale). The authors observed that higher age at puberty (over 14 versus under 12 years) reduced type 2 diabetes risk by 12%, and increased age at menopause (52 years and over, compared to under 47 years) reduced risk by 30%. Breastfeeding (ever breastfed versus never breastfed) was also associ- ated with a 10% reduced risk of developing type 2 diabetes. Furthermore, an increased total lifetime number of menstrual cycles (over 470 in a woman’s lifetime versus under 390) was associated with a 25% reduced risk and longer duration of expo- sure to sex hormones (meaning the time between puberty and menopause) (over 38 years compared with under 31 years) was associated with a 34% decreased risk of developing type 2 diabetes. By contrast, the use of contraceptive pills (at least once during a woman’s lifetime compared with no use at all) was associ- ated with a 33% increased risk. Longer time between periods (menstrual cycle length) (32 days and over versus 24 days and under) was associated with a 23% increased risk.
Obesity is linked to a nearly six-fold increased risk of developing type 2 diabe- tes, with high genetic risk and unfavourable lifestyle also increasing risk but to a much lesser extent. These are the conclusions of new research presented at this year’s Annual Meeting of the European Associa- tion for the Study of Diabetes (EASD) held recently in Barcelona. The findings were presented by Hermina Jakupović from the University of Copenhagen, Novo Nord- isk Foundation Center for Basic Metabolic Research, Copenhagen, and colleagues. Genetic predisposition, obesity and unfavourable lifestyle have an important role in the development of type 2 diabetes, an increasingly common disorder that con- tributes significantly to the global burden of disease. According to the International Diabetes Federation, approximately 425 million adults (20-79 years) were living with diabetes in 2017; by 2045 this is expected rise above 600 million. The current strategy to prevent type 2 diabetes is underlined by the maintenance of normal body weight and the promotion of a healthy lifestyle. Lifestyle interven- tions designed for weight loss have been shown to delay the onset of type 2 dia- betes among high-risk subjects. However, the effects of lifestyle factors and obesity on type 2 diabetes risk may vary between individuals depending on genetic variation. Thus, it is important to understand the interplay between genetic predisposition, obesity and unfavourable lifestyle in the development of type 2 diabetes. In this new research, the authors aimed to study whether the genetic risk for type 2 diabetes is accentuated by obesity and unfavourable lifestyle. They applied statis- tical modelling to a case-cohort sample of 9,556 men and women from the Danish prospective Diet, Cancer and Health cohort (49.6% women, 50.4% men, mean age
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