Search

Aim To understand the knowledge and perceptions of type 2 diabetes and to explore preferable educational strategies in the non-diabetic offspring of patients with the disease. Background Type 2 diabetes is an increasingly prevalent disease with significant long-term consequences. Offspring of patients with type 2 diabetes have an increased risk of developing the disease compared with the general population. Previous studies have shown that offspring have a poor perception of their own risk. Design A qualitative study was carried out using semi-structured one-to-one interviews. Analysis was completed using a structured framework approach. Methods Research was carried out during January-March 2011 in the north east of UK. Six offspring of patients diagnosed with the disease were interviewed. Results Participants balanced positive and negative aspects of their lifestyle behaviours to estimate their own risk. They had adequate knowledge of healthy lifestyle behaviours, but were uncertain about the long-term effects and seriousness of the disease and the role of inheritance. Behavioural changes at an individual level would only be motivated by an event, which would impact on their own health. Participants believed that 'fear'-based strategies to health promotion would be most effective to encourage behaviour change. Conclusion Knowledge of individual risk and why diabetes was serious was limited and variable. The health behaviours of this at-risk group were complex. Nurses engaged in the care of at-risk individuals must take this complexity into account when developing and implementing multi-faceted strategies to improve awareness. [ABSTRACT FROM AUTHOR]

Background: Klotho has an important role in insulin signalling and the development of ageing-like phenotypes in mice. The common functional "KL-VS" variant in the KLOTHO (KL) gene is associated with longevity in humans but its role in type 2 diabetes is not known. We performed a large case-control and family-based study to test the hypothesis that KL-VS is associated with type 2 diabetes in a UK Caucasian population. Methods: We genotyped 1793 cases, 1619 controls and 1616 subjects from 509 families for the single nucleotide polymorphism (SNP) F352V (rs9536314) that defines the KL-VS variant. Allele and genotype frequencies were compared between cases and controls. Family-based analysis was used to test for over- or under-transmission of V352 to affected offspring. Results: Despite good power to detect odds ratios of 1.2, there were no significant associations between alleles or genotypes and type 2 diabetes (V352 allele: odds ratio = 0.96 (0.84-1.09)). Additional analysis of quantitative trait data in 1177 healthy control subjects showed no association of the variant with fasting insulin, glucose, triglycerides, HDL- or LDL-cholesterol (all P > 0.05). However, the HDL-cholesterol levels observed across the genotype groups showed a similar, but non-significant, pattern to previously reported data. Conclusion: This is the first large-scale study to examine the association between common functional variation in KL and type 2 diabetes risk. We have found no evidence that the functional KL-VS variant is a risk factor for type 2 diabetes in a large UK Caucasian case-control and family-based study. [ABSTRACT FROM AUTHOR]

Additional information on genetic susceptibility effects relevant to type 2 diabetes pathogenesis can be extracted from existing genome scans by extending examination to related phenotypes such as age at disease onset. In this study, we report the reanalysis of data from 573 U.K. sibships ascertained for multiplex type 2 diabetes, using age at onset (assessed by the proxy measure of age at diagnosis) as the phenotype of interest. Genome-wide evidence for linkage to age at diagnosis was evaluated using both variance components and Haseman-Elston (HECOM) regression approaches, with extensive simulations to derive empirical significance values. There was broad agreement across analyses with six regions of interest (logarithm of odds [LOD] >/==" BORDER="0">1.18) identified on chromosomes 1qter, 4p15-4q12, 5p15, 12p13-12q13, 12q24, and 14q12-14q21. The strongest empirically "suggestive" evidence for linkage comes from regions on chromosome 12. The first region (12p13-12q13), peaking at D12S310 (variance components LOD [LOD(VC)] = 2.08, empirical pointwise P = 0.0007; HECOM LOD [LOD(HECOM)] = 2.58, P = 0.0010) seems to be novel. The second (12q24) peaking between D12S324 and D12S1659 (LOD(VC) = 1.87, P = 0.0016; LOD(HECOM) = 1.93, P = 0.0027) overlaps a region showing substantial prior evidence for diabetes linkage. These data provide additional evidence that genes mapping to these chromosomal regions are involved in the susceptibility to, and/or development of, type 2 diabetes. [ABSTRACT FROM AUTHOR]

The BAIR consortium has been formed to provide insight into the biological processes underlying insulin resistance through multidisciplinary research combining various genomic/proteomic/metabolomic approaches in animal models, followed by haman genetic analysis. Based on previously described associations, function and on BAIR biological data, we selected 11 candidate genes (ARNT; RBP4; HIF1a; EIF2S1; AKT1; ONECUT1; RPS6KB1; TRB3; FOXA2; PCK1; FOXO3A) for investigation. Pairwise tags (r²>0.8) spanning these genes were selected based on HapMap phase II CEU data to exhaustively capture common variation (MAF>0.05). 103 SNPs were genotyped in 5,602 samples (935 UKT2D, 1927 UK-controls, 926 French T2D, 934 French obese and 880 French controls) by iPLEX & SNPlex methods. Single-point analyses on 92 SNPs were carried out after stringent quality control. Coverage of common variation remained high (74%-100% per gene). There was no significant association with T2D or obesity (at the p=0.01 level) in 9 of the strong candidate genes examined. In the UK population, rs11908628 of PCK1 (encoding phosphoenolpyruvate carboxykinase 1, the main control point for the regulation of gluconeogenesis) was found to be protective against diabetes (MAFs 2.7% v 4.3%, OR(95%CIs): 0.62 (0.44-0.86); p=0.003 additive). Mantel-Haenszel meta-analysis of rs11908628 across the UK and French T2D samples provided additional support for this finding (p=0.002), although further investigation, given low MAFs, is warranted. When comparing genotypes between T2D cases and controls in the French population, 2 independent associations were seen in RPS6KB1: rs180535 (MAFs 18% v 15%; OR 1.29 (1.07 -1.55); p=0.006) and rs180531 (24% v 28%; OR 0.81 (0.69-0.95) p=0.008) (r²=0.06 in controls). RPS6KB1 codes for ribosomal protein S6 kinase 70KD 1, which negatively regulates insulin signalling. Interestingly, rs180531 (23% v 28%; OR 0.80 (0.69-0.94) p=0.005) was also associated with protection against obesity in the French. In conclusion, our genetic data suggest modest effects of the BAIR insulin resistance candidates PEPCK and S6K1 gene variation in UK (T2D) and French (T2D and obese) samples, results that require replication in additional populations. [ABSTRACT FROM AUTHOR]

Determines the prevalence of cysteine at codon 282 (C282Y) mutation among patients with type 2 diabetes. The genetic susceptibility to haemochromatosis; Results of a test conducted in England.