Type 2 Diabetes - The Role of Genes in Diabetic Complications

By Beverleigh H Piepers

Type 2 diabetes affects the whole body because it affects the heart and blood vessels, and blood travels through almost every living tissue. Why do some individuals develop particular complications, while others do not? Having specific genes makes people susceptible to certain conditions. As these genes are found and matched with complications to which they can contribute, it will someday become possible to predict which complications patients and their physicians need to watch out for and prevent.

In September of 2018, the journal Acta Ophthalmology reported on a genetic study performed at the University of Dundee in the United Kingdom and a number of other research institutions throughout the world. The work centred on retinopathy, the most common eye disease seen in those diagnosed with Type 2 diabetes...

• a total of 560 participants with Type 2 diabetes and severe diabetic retinopathy, and
• 4,106 Type 2 diabetic participants without retinopathy

were included in the study.


The participants diagnosed with retinopathy were found to have a gene called the NOX4. The investigators, therefore, concluded NOX4 is involved in causing diabetic retinopathy in those people who had been diagnosed with Type 2 diabetes.
Diabetic retinopathy affects the back of the eye, where light forms a picture which is sent to the brain via the optic nerve. Preventing or treating retinopathy can save the sufferer's vision.

In the same month, the retinopathy report was published in the journal Life Science and reported on a similar study on liver disease in people who had been diagnosed with Type 2 diabetes. Researchers at Zhejiang University in Hangzhou, China, compared which genes were turned on in Type 2 diabetes sufferers with and without non-alcoholic fatty liver disease (NAFLD). Four genes were found to be expressed in patients with NAFLD compared with those free of NAFLD. The scientists concluded the testing they used might help to detect people who had early NAFLD and treat them before serious complications could develop.

When too much fat is stored in the liver, inflammation can take place and lead to scarring, or fibrosis. When this happens, bilirubin can build up in the body. Bilirubin is the natural breakdown product of red blood cells at the end of their lives, about every 120 days. A build-up of bilirubin results in...

• jaundice (yellow eyes and skin),
• weakness,
• confusion,
• loss of appetite, and
• weight loss.

Ulcers can develop as blood unable to enter the liver becomes backed up in the stomach. Untreated the condition can lead to total liver failure. Loss of 10 percent of body weight through healthy diet and exercise are recommended as the first line of defence. Weight loss surgery is another option before liver transplantation is considered.

Although managing your disease can be very challenging, Type 2 diabetes is not a condition you must just live with. You can make simple changes to your daily routine and lower both your weight and your blood sugar levels. Hang in there, the longer you do it, the easier it gets.

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