Diabetes can cause serious health problems if not properly managed, but the risk of developing complications from this disease appears to be greater in certain families, according to a new study. The study also indicates that the risk for complications is greater for women.
"Our research indicates that susceptibility to certain complications of type 1 diabetes, especially retinal damage, has a strong familial and probably genetic component, and women may be more susceptible to these complications than are men," said David A. Greenberg, Ph.D., of the Columbia-Presbyterian Medical Center in New York City and senior author of the study. Maria C. Monti, Ph.D., also of the Columbia-Presbyterian Medical Center and the University of Pavia in Italy, was the study’s lead author.
Type 1 diabetes occurs when the pancreas does not produce enough of the hormone insulin, which helps cells process glucose. Taking insulin is the treatment, but because insulin is injected only periodically, critical control of glucose levels can be difficult to achieve. Getting blood glucose levels under control is considered essential for preventing complications from diabetes.
For this research, Monti, Greenberg, and their colleagues analyzed 25 years’ worth of data on type 1 diabetes patients and families. These data were assembled by the Human Biological Data Interchange (HBDI), a program of the National Disease Research Interchange (NDRI). Among the information collected were details on the subjects’ microvascular complications from diabetes, which included retinopathy (eye damage), nephropathy (kidney damage), and neuropathy (nerve damage).
Prior to this study, it was known that certain kinds of kidney damage from type 1 diabetes had a genetic component, but it was not clear if there was a familial component to other complications.
In this latest study, the researchers’ results indicated that the susceptibility to other complications, especially to retinopathy, went beyond poor control of blood glucose levels, and was dependent on one or more familial, and probably inherited, biological components.
This also was the first demonstration that women may be at greater risk for complications than men. “This was a surprise to us,” said Monti, “especially since there is no known increased risk for type 1 diabetes in females. It suggests that, to the extent that good glucose control can delay complications' onset, women may need to be more diligent in keeping blood glucose under control.”
Other researchers involved in this study include John T. Lonsdale, Ph.D. of NDRI in Philadelphia; Cristina Montomoli Ph.D. of the University of Pavia, Italy; and Rebecca Montross, M.S. and Erin Schlag, M.S., both from NDRI.
A rapid release version of this paper has been published on-line and will appear in the December issue of the Journal of Clinical Endocrinology & Metabolism.
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