New research presented at this year's annual meeting of the European Association for the Study of Diabetes (EASD) reveals the factors that influence the rate of progression of type 2 diabetes (T2D) which may explain why it varies so much between individuals.
The research was conducted by Dr Xuan Wang, Dundee University, Dundee, UK and Uppsala University, Uppsala, Sweden, and colleagues. Their goal was to identify those factors associated with the rate of progression of T2D using data from the UK BioBank; an ongoing health study of over 500,000 British volunteers recruited from 2006 to 2010.
The UK BioBank population contains 25,290 diabetic patients, with participants self-reporting whether they had type 1 or type 2 diabetes. In order to exclude type 1 cases from the study, the team looked at the genetic risk score of the participants and selected a cut off value that would ensure that only 1% of the selected group had that form of the disease. The researchers studied a selection of 6,215 white European patients with T2D who had lived with the disease for no more than 10 years.
From this group they were able to choose two sets of 429 patients who could be matched into pairs by the length of time they had lived with T2D. Each pair consisted of a fast progressor who went on to require insulin within 10 years, and a slow progressor whose disease was still able to be controlled by diet. The team then studied clinical and biochemical factors linking the two groups to discover associations between them and the observed rate of disease progression.
The authors found that membership of the fast progression group was associated with a younger age at diagnosis, a higher body mass index (BMI), higher hip to waist ratio, and were more likely to be taking statins and fibrates -- drugs used to control cholesterol. When comparing the family histories of the two groups, the team also found that a history of diabetes on the maternal side of the family was associated with a greater risk of fast disease progression. There was no such association found with the occurrence of diabetes among siblings or on the paternal side of the family.
The authors conclude: "The higher prevalence of maternal history of diabetes in the fast progression group suggests an impact of maternal intrauterine environment on offspring diabetes progression which warrants further investigation."
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