Diabetes Mellitus Type Is A Multifactorial Disease With Strong Genetic Susceptibility

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Diabetes mellitus type 2 is the most common endocrine-metabolic disorder and affects at least 5% of Western society. According to the persisting trends for increasing obesity, the amount of newly diagnosed patients will increase dramatically over the next decades. Unfortunately, lifestyle in combination with affluent alimentation does not spare the young, and increasing obesity in this group is already observed. Usually diabetes mellitus occurs at ages over 40 but we now observe a shift in the age of onset towards younger patients. In Germany diabetes mellitus type 2 is the major cause for blindness, kidney failure and amputation of lower extremities. Patients with diabetes not only develop microangiographical vascular complications but also have a three to five times increased risk for cardiovascular complications. According to the expected long period of the disease duration especially within young patients, the diabetic complications must be treated with great efforts, and a fast diagnosis of the underlying diabetes sub-classification is necessary for best treatment.

The key to developing diabetes is the genetic predisposition. The concordance rate of monozygotic twins is over 75% for developing diabetes type 2 even when they grow up in different environmental and social backgrounds (1). Certain populations like the Pima Indians have a higher risk of developing diabetes (2). This indicates that in contrast to the general public opinion, diabetes is a complex genetic disorder with strong genetic predisposition. So in diabetes, like in every other complex multifactorial disease, e.g. cancer, the personal genetic predisposition determines whether a person would develop the syndrome or not. The individual life style determines the age and the severity of diabetes onset.

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