Featured Review Cellscience Reviews Vol.2 No.4 ISSN 1742-8130

The Genetic Basis of Type 2 Diabetes

Abstract

Type 2 Diabetes results from a complex physiologic process that includes the pancreatic beta cells, peripheral glucose uptake in muscle, the secretion of multiple cytokines and hormone-like molecules from adipocytes, hepatic glucose production, and likely the central nervous system. Consistent with the complex web of physiologic defects, the emerging picture of the genetics will involve a large number of risk susceptibility genes, each individually with relatively small effect (odds ratios below 1.2 in most cases). The challenge for the future will include cataloging and confirming the genetic risk factors, and understanding how these risk factors interact with each other and with the known environmental and lifestyle risk factors that increase the propensity to type 2 diabetes.

Type 2 Diabetes: A Prologue

Type 2 Diabetes Mellitus (T2DM) is a complex heterogeneous group of metabolic condition characterized by elevated levels of serum glucose, caused mainly by impairment in both insulin action and insulin secretion. T2DM exerts a huge toll in human suffering and economy. A recent evaluation using a computerized generic formal disease model (DisMod II) revealed that excess global mortality due to diabetes in the year 2000 was equivalent to 5.2% of all deaths and diabetes is likely to be the fifth leading cause of death, similar in magnitude to numbers reported for HIV/AIDS (1). The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and is projected to be 4.4% in 2030 (most of which will be T2DM). The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030, with India, China and USA being the top 3 countries estimated to have the highest numbers of people with diabetes (2). T2DM accounts for 5-10% of the total health care budget in many countries. In the United States, the American Diabetes Association estimated the total cost of diabetes management in 2002 at $132 billion, which is about 1.3% of US gross domestic product (3,4).

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