Family ties raise risk of diabetes complications

By Will Boggs, MD

NEW YORK (Reuters Health) - The risk that a person with diabetes will develop "microvascular" complications of the disease such as eye, nerve, and kidney damage -- as many diabetics do -- appears to be higher in certain families and in women in general, new research suggests.

"To the extent that glucose control is important, it may be even more critical in those patients potentially at higher risk for complications, those being type 1 diabetic-affected siblings of type 1 diabetes patients with complications, and also women, who appear to be at higher risk for complications," Dr. David A. Greenberg from Columbia University, New York told Reuters Health.

Greenberg, along with Dr. Maria C. Monti and colleagues, analyzed long-term data on a large group of diabetic patients and their families.

They found that having a parent with type 2 diabetes, but not type 1 diabetes, was significantly associated with the development of diabetic eye disease, as well as diabetic kidney disease and nerve damage.

They also found that diabetic patients whose siblings had type 1 diabetes complications faced substantially higher risks of developing these complications themselves.

Diabetes-related eye and nerve damage were more common in female type 1 diabetes patients than in male type 1 diabetes patients, the researchers say, and the risk of second complications was higher in female patients than in male patients.

The risk of complications increased with increasing duration of type 1 diabetes, and diagnosis at a very young age (under 5 years) or past puberty (over 14 years) was associated with a lower likelihood of developing complications.

"These new findings tell us that the explanation for what causes complications must involve shared pathogenic mechanisms in the family (mechanisms that may be independent of the susceptibility to type 1 diabetes)," the investigators conclude.

SOURCE: Journal of Clinical Endocrinology and Metabolism, December 2007.