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Early signs of type 2 diabetes risk could be seen decades before a diagnosis

New research has revealed that signs of being at high risk of type 2 diabetes can be spotted in children as young as 8 years old, often decades before a diagnosis.

Changes to our genes can increase our chances of developing type 2 diabetes, with around 500 genes linked to a higher risk. A team at the University of Bristol, part funded by Diabetes UK, studied over 4,600 people to find out if having a high genetic risk score of type 2 diabetes was linked to changes inside the body early on in life.

The researchers found that it was: people with a high genetic risk had signs of problems with their metabolism (the process for turning food into energy) in their childhood and early adulthood.

Preventing progression

Although the majority of people with type 2 diabetes are diagnosed as older adults, changes in the body that lead to the condition could already have been long underway.

“We wanted to understand how Type 2 diabetes develops early on and to identify features of the condition that may appear years before it’s diagnosed. Knowing what these features look like might help us to intervene much earlier to prevent the progression of Type 2 diabetes and its debilitating complications.”

– Dr Emma Vincent, Diabetes UK researcher

The team used a genetic risk score, which combines information from 160 genetic differences linked to type 2 diabetes, to pinpoint participants who were at a higher risk of developing the condition.

They also tested blood samples to look for changes in over 220 different chemicals and processes involved in metabolism. They carried out tests at four stages: childhood (8 years), adolescence (16 years), young adulthood (18 years), and adulthood (25 years).

The first of the changes in those with a high genetic risk appeared as early as 8 years old, showing they had lower HDL cholesterol levels. This is usually known as ‘good’ cholesterol as it removes excess cholesterol from cells and takes it to the liver so it can be broken down.

Other later changes in adolescence and young adulthood included having higher VLDL cholesterol levels, or ‘bad’ cholesterol, and signs of inflammation.

While there’s more we need to understand about how Type 2 diabetes develops, this research could help scientists to develop new preventative treatments that start earlier in life.

“We know our genes play an important role in determining our risk of developing type 2 diabetes, and this study helps us to understand why, suggesting that a high genetic risk is linked to specific changes inside the body that take place potentially decades before diagnosis.

"This is important because, in the future, insights like this could mean we’re able to spot who is at a higher risk and – most importantly – find ways to intervene to reduce this risk much earlier in a person’s life than we’re able to today. This means we could potentially prevent more cases of type 2 diabetes from developing at all – which has become critical, given 12.3 million people in the UK are at risk of the condition.

“Type 2 diabetes is complex and, although we can’t do anything about our genetic risk, there are things you can do to help lower your risk of developing the condition that include maintaining a healthy weight, eating well and moving more.”

– Dr Elizabeth Roberston, our Director of Research

This research was presented at this European Association for the Study of Diabetes (EASD) Annual Meeting in Barcelona.

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