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Genetic Determinants Of Diabetes

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Genetic Determinants Of Type 2 Diabetes Mellitus.

Genetic determinants of type 2 diabetes mellitus. (1)John P. Robarts Research Institute, London, Ontario, Canada N6A 5K8. Type 2 diabetes refers to a group of disparate metabolic diseases, which aretypically characterized by insulin resistance in peripheral tissues, togetherwith impaired insulin secretion from pancreatic beta-cells. The complexity oftype 2 diabetes is related to factors such as genetic heterogeneity, interactionsbetween genes, and the modulating role played by the environment. Recent progresshas included defining the molecular basis of monogenic forms of type 2 diabetes, such as familial partial lipodystrophy and the subtypes of maturity-onsetdiabetes of the young (MODY), and also the identification of chromosomal regions that may harbor type 2 diabetes susceptibility genes. Many common variants infunctional and positional candidate genes, including ADRB3, PPARG, ENPP1, andCAPN10, have also been studied for their possible role as determinants of type 2 diabetes, with varying levels of agreement between studies. The availability of arelatively complete sequence of the human genome will increase the amount ofgenetic information that can be used to evaluate hypothese Continue reading >>

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Popular Questions

  1. still the same

    Is a steady A1c of 5.9 with no meds better than a lower a1c with meds?

    My $ 64,000 dollar question? The doctors can't seem to answer this question. Can anyone?

  2. furball64801

    It shows your average bgl is 122 so that means you have highs and lows which average out to 122 so that is one of those things you will not know. I think 5.9 is great but when you test do you see 140s and above or always below that.

  3. vpenning

    Long term studies do not follow a1cs that low. HOWVEVER, from my personal experience, I am going to tell you the truth. I have seen folks have complications that never had an a1c over 5%...one recently died from heart failure, and another had a major stroke. Two others that had ketogenic diets had neuropathy. Another retinopathy. All complications of diabetes.
    And, on the opposite side, I have seen folks with a1cs that have been over 8% for years, and have had no issues. Even on this site folks are always posting about some relative or another that doesn't pay attention to their diet, and they have no problems.
    STATISTICALLY, however, studies that have been done with complications of retinopathy and kidney failure (two that had long term studies against a1c vs complication rates), they say that it increases after 6.4% and with every full percentage point, the risks increase considerable. (I saw a chart in one of my books, and it increased pretty substantially beyond 7%.)
    Heart disease rates that I have seen double with a1cs over 7%, but under 6% I have not seen any studies tracking. Reminder that 5.9% is considered a prediabetic range, not a diabetic range...and, until recently, the medical community did not have a definition of prediabetes (some insurance companies still refuse to accept it as a disease, and will not cover it!!) It wasn't until about two years ago that the college of Endocrinolgy recommended lowering the a1c to be considered normal range, and add in the prediabetic range. When I was diagnosed, under 6.4% was considered just simply non-diabetic. (Some labs still have that on their forms!)
    In addition, a study was done that used medications to force folks to have tighter controls. They stopped the study when several people DIED. Because of that, it is not recommend that heart patients have such tight control. Their levels are monitored more closely, and they are told to keep their a1c below a target amount that is slightly higher than non heart patients.
    The college of Endocrinology recommends keeping your a1c under 6.5%. Though, they encourage doctors to work with patients on their own personal goals based on their health history, age, and quality of life.
    Because of this...some doctors would not even consider medication at such a low a1c. I had an a1c that went from 5% to 5.6% after surgery once (I also had a bout of pneumonia where I was on steroids...talk about high numbers!!!), and the doctor did not wish to add medication because she knew that even though I had had a big jump, I had also had medications that had caused high number. She just waited to see what would happen, and let me work it out. She was correct. The next a1c was back where it needed to be.
    So, in my OPINION, an a1c of 5.9% is PERFECT and fantastic! And, if is being achieved without medication...then, it should be commended, and kept going. It is possible that even a slight weight loss, or a diet change...or even the introduction of a new exercise could bring it down a little lower. BUT, it is a GREAT a1c!!!
    However, do not become complacent, and do continue to keep doctor appointments, and check your numbers. Watch for patterns, and if that a1c of 5.9% is just the stepping stone to a higher a1c...then, reevaluate your course of action.

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