The answer is complex and depends on the type of diabetes and frequently other factors such as diet, lifestyle, and environment. “For most people who have diabetes, it is not due to a straight genetic group of factors or to environmental ones, but rather it is a combination of both,” says Mónica Alvarado, a certified and licensed genetic counselor who is the regional administrator for genetic services at Kaiser Permanente in Pasadena, California.
Type 1 Diabetes
Yet the presence of these autoantibodies isn’t a guarantee that a person will develop the disorder.
“We know some of the autoantibodies involved in attacking the pancreas, and we can screen for them, but there are patients who have positive autoantibodies and never develop type 1 diabetes,” explains Joshua Miller, MD, assistant dean for clinical integration and medical director of diabetes care at Stony Brook Medicine in New York.
Gestational Diabetes
Monogenic Diabetes
MODY
At least 10 genes have been linked to forms of MODY, says Scott Weissman, a certified genetic counselor on the faculty of Northwestern Medicine’s Center for Genetic Medicine in Chicago and the founder of Chicago Genetic Consultants in Northbrook, Illinois.
NDM
“Based on a combination of what SNPs people have, researchers can provide a score of whether they are at low, average, or high risk of developing type 2 diabetes,” Weissman says, adding that in theory, that information will allow people to take action in terms of making changes to their diet or exercise routine, or potentially quitting smoking. Risk scoring could be used to assess lifestyle changes that will lessen their probability of developing type 2 diabetes. “The biggest challenge in that area of research that baffles most scientists is: Why do some patients who have demonstrated positive autoantibodies not go on to develop type 1 diabetes?” Miller says. “That’s the area of greatest interest because if you can identify some factor in those patients that is protective, that keeps individuals with positive autoantibodies from killing off their beta cells, then perhaps you could prevent them from developing type 1 diabetes.” In the meantime, even without genetic testing, it is wise to pay attention to your family history and risk factors for diabetes. Not every case of diabetes is preventable, but neither is your DNA your destiny in every instance.
