Diabetes Sensor

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Diabetes Sensor

Chapter 41
Diabetes and genetics

Training video

Spoken text of the video

Section 1: Intro

Chapter 41, diabetes and genetics. This is a specific training for the Diabetes Sensor, the genetic test for diabetes. You will find this test here in the overview. It is specific for diabetes mellitus type 2. People call it age-related diabetes. It has a number of functions. It is useful for prevention. It will help you prevent the disease. It is good for early diagnosis. It will help you diagnose it in time and get treatment in case it develops. It will help improve the treatment.

Section 2: Blood sugar regulation

Let us look at the concept of blood sugar regulation. Here we have the inside of an intestine where food ends up. Then, we have the blood stream and blood sugar is glucose. So, we have glucose, sugar in here. It is a very small type of sugar. Here, we have liver. Now, something with carbohydrates is eaten. Carbohydrate is broken down into small sugars like glucose. Then, glucose is then taken in by the intestine. This causes too much sugar to be in the blood stream. Sugar is very important, especially glucose, for the cells as fuel. Too little sugar in diet makes you run out of fuel. Too much of it is toxic.

So, the body has developed a system where excessive glucose is absorbed into the liver. When the body just recognizes there is too much glucose, it secretes insulin which causes the glucose to be absorbed into the liver. This lowers blood sugar again. So, even if you eat something with sugar, it goes into the blood but it is absorbed into the liver to keep blood sugar in the normal range. Then, we have not eaten for a long time and we are using up some sugar because we do some sports or the cells use them up through metabolism, this would cause blood sugar level to go down. This is also dangerous. So, the body has another hormone, the opposite of insulin called glucagon, which causes glucose from the liver to be secreted into the blood stream again. This is the normal process. Blood sugar regulation is when it goes too low you need to increase it and when it goes too high you need to decrease it. This regulation is very important to always keep blood sugar in the right range. This usually works quite well in most people, but with increasing age and with certain genetic variations, this regulation can get out of control, basically. This is when type 2 diabetes is generated. It is poor control of blood sugar.

Section 3: The diabetic and genetics

Here is what happens in a diabetic. Carbohydrates are converted into glucose. Glucose goes into the blood stream. Then, the body recognizes that there is too much glucose and it secretes insulin. However, insulin has very little effect because the body has become insulin-resistant. So, this does not work anymore. So, not enough glucose is absorbed into the liver and you have too high blood sugar, which is very unhealthy. These are the genes that are involved in this. There are nine genes that influence it. By the way, if this table does not mean anything to you, do check the training for simple disease risk statistics that would explain it to you in detail. Just to summarize it.

This is the gene. This is the catalogue number for the genetic variation. This is some scientific stuff. These are the actual genetic results. Both genes of this type have a C at this position. The odds ratio, which you will learn about it in the simple disease risk statistics, is 1.38. So, it is 38 % higher risk, 64 % higher risk. The lower risk means you are protected. This is all scientific. For the customer or the patient to understand it easily, we have created this bar here so you can be anywhere from protection, i.e. lower risk from the general population. Average risk means the same risk as everybody else. Increased risk means a higher risk of developing the disease. Specially, if you are here in the increased risk area, it is very important for the person to know that he has a much higher risk than the general population. This prevention is much more important for you than it is for everybody else. We find that this really motivates higher-risk individuals to follow their preventive advice to stay healthy much more rigorously.

This is the general risk of diabetes. Then, through genetics, we know a lot about how different therapies would work and some other things. For example, when they develop diabetes mellitus type 2, some people tend to require insulin earlier. Insulin is the hormone that you need to inject. This is the last stage of diabetes, before you can usually modify the blood sugar with certain drugs, if not the last intervention, but some people just respond less to those drugs and require insulin more quickly. In this case, it is normal. So, you would not expect this person to require insulin this quickly. Then, glibenclamide, a blood sugar reducer, is in this case effective. It could also be less effective due to genetic variations. So, tolbutamide is ineffective, then you choose between those two drugs. In this case, I would use one that is genetically expected to be more effective rather than the ineffective one. Glimepiride is less effective and metformin is less effective. Generally, sulfonyluria drugs would be more effective. So, what we can do here is you can check how effective you would expect the drug to be according to genetics and start with those drugs first. Thereby, you can really improve the effectiveness of the treatment and slow the disease’s progression. This here is the science behind the genes.

As I said, in case you do not know what this table means, do watch the simple disease risk statistics. Here you see two Cs. 55 % of the population have a C on every one of the copies of this gene. They have no increased risk and insulin is not required sooner. 10 % of the population have a T/T, with 2.77 fold risk, 177 higher risk than people with an optimal genetic type. Then, insulin substitution is required sooner. Here is the science behind it, in case you are interested. This is the next gene. So, 3 % have 1.94 percent risk and so on. There is another gene with 70 % have no increased risk, 51% have 1.21 percent risk and 3 % have 1.44 percent risk and so on. Here is actually protected. So, there is a lower risk in some people and a higher risk in other genetic types. This is something that you can look into. If you are interested in the report, you will find this kind of information for every one of the genes. There is the science behind it. So, if you are interested in how we come up with the claims of increased risk, this is where you can look.

That is the end of chapter 41, diabetes and genetics as a specific training for the Diabetes Sensor.

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