Does Your Genetic Background Result In Your Diabetes or Weight Struggles being Unmodifiable?

In my post last week, I discussed the large and important contribution of genetic background towards the tendency to develop type 2 diabetes or obesity.  Since that time, I've had a couple of people ask me whether there is any point to undertaking lifestyle intervention (ie changes in eating patters and/or activity) if their genetics have already dictated that they are going to have a lifelong struggle with these conditions. 


As I noted last week: 


While it is true that eating well and exercising are the cornerstones of the management of type 2 diabetes, and can certainly improve diabetes control, it is not possible for most people with diabetes to make it go away with these lifestyle changes.


This week I would like to bring the focus to the first part of this statement - ie, that lifestyle changes can certainly improve diabetes control, and improve obesity as well.  Just about everyone with type 2 diabetes or weight struggles can see some improvement with permanent lifestyle change.  How much improvement that is seen is going to depend on several factors, including: 

• For those who struggle with their weight or eating patters: Have the root causes of that  struggle been addressed? (emotional eating, depression, medications causing weight gain, untreated sleep apnea.... the list of possibile contributors is long)
• What is the degree of motivation to change? 
• What permanent lifestyle interventions have been undertaken, and are they in line with the genetically determined tendencies and ethnic/cultural considerations of the patient? 

On the last two points - yes, it's true - our genetic makeup plays a part in determining which lifestyle changes will work best for us, and may even play a role in our levels of motivation to do so.  For example, studies have shown genetic differences in the natural tendency to exercise than others, so for some, exercise will play a greater part in the success of their permanent lifestyle changes than for others. As another example, each of us has our own unique balance point of hunger and satiety hormones, such that some of us need more food or a higher body weight to feel full than others.  For those people, medications that are directed towards modifying these hormone balances may be a great leap forward in helping them lose weight (such medications are available to treat type 2 diabetes, but not to treat obesity per se).  

Again on the line of genetics, it is important that practical goals are set, with regards to controlling type 2 diabetes or managing obesity with lifestyle changes.  For diabetics, there may be only a certain amount of glucose control that can be obtained by making lifestyle change - the pancreas gets tired over time (genetics and stress on the pancreas caused by overweight both play a role here), and for many, medications need to be started despite the very best efforts on the part of the patient. 

From a weight stance, the goals must be practical as well.  Remember that even a 5% body weight reduction (in those who are overweight or obese) decreases the risk of a whole host of complications associated with excess body weight. 

The key in maximizing lifestyle success is in finding the form, or forms, of permanent lifestyle change that work for you - the bulk of this blog is dedicated to just that, in an attempt to help provide you lots of different lifestyle options to try on your journey towards permanent lifestyle change.   And don't be afraid to ask your healthcare providers for help - remember, there is no shame. 




Dr Sue Pedersen www.drsue.ca © 2011 drsuetalks@gmail.com

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There Should Be No Shame in Having Diabetes

I came across this excellent article online yesterday on msnbc.com, which discusses the stigma often associated with having diabetes.  The personal stories made me sad, then made me mad, and then I decided to take matters into my own hands and discuss this very important topic as this week's blog.

Mary's story is one that I hear from my patients on a regular basis - there is often a feeling of shame associated with having type 2 diabetes.   Because type 2 diabetes is often seen in association with overweight, there is a stigma upheld by many members of the general public that people who have diabetes are lazy, eat too much, don't exercise, and are not interested in their health.

What people need to realize, is that it is not the fault of the individual that they have diabetes.   There is a very strong genetic basis for developing diabetes (as blogged previously), and a very strong genetic basis for obesity as well (read more here), which we are learning more about every day as new genes involved are continuously being discovered.  Furthermore, there are many people out there with type 2 diabetes who are not overweight or obese - this speaks to the very strong genetic tendency towards developing diabetes in these individuals.   While it is true that eating well and exercising are the cornerstones of the management of type 2 diabetes, and can certainly improve diabetes control, it is not possible for most people with diabetes to make it go away with these lifestyle changes.

When I am discussing optimization of diabetes control with my patients, they often tell me that they feel embarrassed to check their blood sugars in public, or to administer medications or insulin in front of other people.  As a result, they may choose to forgo checking sugars or administering medications at times like lunch, when they are often out in public.   It breaks my heart each time I hear this - how can our society be so cruel and judgemental?

It's high time that our society gets a grip on what it actually means to have type 2 diabetes.  This disease has a strong genetic predisposition; our extremely toxic, fast food, sedentary enviroment is conducive to bringing it out in many people who are genetically prone.

People with diabetes who are seen checking blood sugars or administering insulin in public are showing committment and motivation to watch their numbers, and to do everything they can to optimize their glycemic control and their health - they deserve a HIGH FIVE! from all of us!


And a High Five to msnbc.com for writing this fabulous article - I hope their far reach will do well to get this message out to many.  Feel free to pass on this article as well, to everyone you know!


Dr Sue Pedersen www.drsue.ca © 2011 drsuetalks@gmail.com

Follow me on Twitter for daily tips! @drsuepedersen

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