Genes vs Environment

Question 1

What is MODY?

Answer 1

= Maturity onset diabetes of young

• Family history of young-onset diabetes (< 25) in more than 1 generation
• Not markedly obese
• Not requiring insulin
• One abnormal gene

Question 2

Which diabetes has a higher genetic risk score?

Answer 2

T1D

Question 3

What do many of the genes involved in T1D overlap with?

Answer 3

Autoimmune diseases

Question 4

Which virus can increase your risk of developing diabetes?

Answer 4

Enterovirus
Infects pancreas
Need predisposing genes as well

Question 5

What is Type 1 1/2 diabetes?

Answer 5

• Latent autoimmune diabetes in adults
• • autoantibodies
• Not requiring insulin @ diagnosis
• Usually not overweight
• HLA types show genetic predisposition in T1 direction
• Reduces prevalence of metabolic syndrome as not overweight - have more T1 genes

Question 6

What are the clinical features of T2D?

Answer 6

• BMI > 25 - central obesity
• Family history
• S asian/ Afrocarribean
• Asymptomatic
• Can be reversed by marked weight loss

Question 7

What causes T2D?

Answer 7

• B cell failure develops over time - need insulin resistance AND impaired insulin production
• Reduced physical activity + central obesity
• Genetic predisposition

Question 8

What are the genetics of T2D?

Answer 8

• Obesity/insulin resistance - FTO, PPARG

- Pancreas development/islet function - TCF7L2, KCNJ11, HHEX/IDE, CDKAL1, CDKN2, IGF2BP2, SLC30A8

Question 9

What is the link between obesity and T2D?

Answer 9

Fat in wrong pace

e.g. Partial lipodystrophy = increased risk diabetes as fat in liver + pancreas

Question 10

What is the link between mother & baby & risk of diabetes?

Answer 10

• Thin mother = small baby = increased risk diabetes

- Maternal malnutrition = baby has low fat cells > ovenutrition later in life = fat stores fill up + become inflames