Genetics have a major influence on whether someone develops type 2 diabetes, but DNA alone does not dictate what happens.
New research indicates, for the first time, that people who are genetically predisposed to diabetes may still be able to postpone the condition by adopting appropriate lifestyle habits.
Genes and type 2 diabetes: risk isn’t destiny
A 3-year intervention carried out in Finland has now found that eating well and exercising regularly can reduce the chance of type 2 diabetes in men considered to have a high genetic risk.
The scheme supported participants in improving blood sugar balance and losing weight. Notably, these benefits were also seen among men assessed as having low genetic risk factors for diabetes.
"These findings encourage everyone to make lifestyle changes that promote health. Furthermore, they demonstrate the effectiveness of group- and internet-based lifestyle guidance, which saves healthcare resources," says clinical nutritionist Maria Lankinen of the University of Eastern Finland.
This is not the first time research has shown that lifestyle interventions can bring down rates of type 2 diabetes.
Only recently, a 12-month diabetes programme in England reported that completely changing a person’s everyday diet can lead to remission for 32 percent of people with type 2 diabetes, meaning they no longer require medication.
Even so, this latest work helps to separate the respective contributions of genes and environment to the development of diabetes.
How the Finland intervention study was run
Scientists at the University of Eastern Finland and Kuopio University Hospital in Finland enrolled more than 600 male participants aged over 50 for the intervention.
Participants attended group sessions focused on the value of a healthy diet and physical activity. They also received personalised dietary feedback from clinical nutritionists, along with a diet and exercise guide intended for use over the following three years. During that period, participants completed an oral glucose tolerance test and had a physical examination twice.
Around half of the men in the intervention were categorised as having a high genetic risk for type 2 diabetes, while the remainder were classed as low genetic risk. Risk was calculated using a combined score based on 76 gene variants known to raise the likelihood of type 2 diabetes.
In addition, a control group of 345 men who did not take part in the intervention was included. Within this control group, 149 participants had high genetic risk and 196 had low genetic risk.
What the results showed for high and low genetic risk groups
When compared with men with high genetic risk in the control group, men with high genetic risk who joined the 3-year intervention were 6 percent less likely to go on to develop type 2 diabetes.
Among participants in the intervention who had low genetic risk, there was no statistically significant difference relative to low-risk men in the control group. However, they still experienced weight loss and metabolic improvements comparable to those seen in the high-risk intervention group.
With age, blood sugar regulation often deteriorates, yet these negative changes were markedly smaller in the intervention group than in the control group.
Taken together, the findings indicate that men with low genetic risk may also gain from the same lifestyle adjustments.
Further research will be needed to verify the effect in larger and more varied groups. Even so, the investigators argue that the trial demonstrates type 2 diabetes can be "prevented or delayed" using an approach that is broadly accessible.
Prioritising a healthy diet and physical activity in middle-aged and older men-particularly those with a high genetic risk for type 2 diabetes-may represent a practical, cost-effective way to reduce the incidence of this extremely common metabolic disease.
"Therefore," the team from Finland concludes, "our results suggest that all individuals at risk of type 2 diabetes should be encouraged to make lifestyle changes regardless of genetic risk."
The study was published in the Journal of Clinical Endocrinology & Metabolism.
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