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Person with genetic or hereditary diabetes using finger stick blood sugar test

Is diabetes genetic or hereditary?

Written on December 13, 2022 by Amy Harris, MPH, RN. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


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Whether you have been diagnosed with diabetes yourself or if diabetes runs in your family, you might wonder whether diabetes is genetic or inherited. With the explosion of genetic medicine and gene therapy, you may feel like every day you hear that another disease is genetic. But what about diabetes? We all would like to do what we can to avoid diabetes. Understanding which diabetes risk factors are modifiable (you can do something about them) and which might be genetic (non-modifiable) will help you make healthier choices and live longer.

Do "genetic" and "hereditary" mean the same thing?

No. Although these two words are often used interchangeably, they are not the same. Genetic means anything having to do with your genes (building blocks of DNA found in every cell).

Some diseases are genetic. A genetic disease is any condition caused by one or many gene mutations, as opposed to a disease caused by an infection (like COVID) or a deficiency of nutrients (anemia) [1]. For genetic diseases, scientists have identified particular abnormal genes, called mutations. Genetic mutations can occur in one gene or multiple genes, or be caused by a combination of genetic, lifestyle, and environmental factors — spoiler alert, this is the case for diabetes.

Genes inside of your cells are passed down from parents to offspring. Some gene mutations can be inherited — they are hereditary.

Other gene mutations are acquired, meaning they occur during a person’s lifetime due to environmental factors. Examples of environmental factors that can cause gene mutations include smoking, UV sunlight, or toxic chemicals.

So, the difference between genetic and hereditary is that just because a disease is genetic, it does not mean it is hereditary. Just because your parents have diabetes does not mean you are also destined to have diabetes.

Is diabetes a genetic disease?

The simple answer is that yes, diabetes is a genetic disease. Scientists have identified several genes that impact your diabetes risk [2]. These genes play a role in blood sugar (glucose) control, controlling insulin release, pumping glucose into cells, and speeding up the breakdown of glucose.

But not all diabetes is caused by genes. And not everyone with a genetic predisposition (family history of diabetes) for diabetes will get the disease.

Is there a difference between type 1 and type 2 diabetes when it comes to genes?

Yes. Type 1 and type 2 diabetes have different causes. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well [3]. For both type 1 and type 2, you can inherit a predisposition to the disease (via genes from your parents), but something in your environment must trigger it.

Type 2 diabetes has a stronger link to family history and heritability [4]. Twin studies show that genetics play a more substantial role in who develops type 2 diabetes than for type 1 diabetes [5]. Some racial groups are at higher risk for developing type 2 diabetes, but not due to differences in their genes, according to recent research [6].

How do we know that diabetes is not only caused by genes?

One piece of evidence comes from identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease, at most, only half the time. When one twin has type 2 diabetes, the other's risk is three in four at most. If diabetes was controlled entirely by genes, then both identical twins would get diabetes.

Lifestyle also influences the development of diabetes, especially type 2. For example, obesity tends to run in families, and families often have similar eating and exercise habits. Similarly, families of the same racial and ethnic backgrounds face chronic stressors such as poverty and racism that can negatively affect health and diabetes risk factors for the entire family [6].

For type 1 diabetes, researchers are studying what environmental factors might trigger someone with a genetic risk for diabetes to develop diabetes. Possible environmental triggers under study include [2]:

  • Living in a cold climate
  • Being introduced to solid foods at an earlier age
  • Not being breastfed
  • Exposure to some viruses

So, although having a family history of either type 1 or type 2 diabetes does make your risk of developing diabetes higher, it does not doom you to diabetes. According to the American Diabetes Association (ADA), type 1 and 2 diabetes are caused by an interplay of genetic, environmental, and lifestyle factors [7].

Lowering your diabetes risk

Regardless of whether or not diabetes runs in your family, there are several steps you can take to lower your odds of developing either Type 1 or 2 diabetes [8]:

  • Eating a nutritious diet (healthy fats and plant foods)
  • Staying physically active
  • Protecting yourself from viruses with regular vaccines and wellness visits
  • Living in a safe environment (low in air pollution and other toxins)
  • Routine screening with diagnostic tests for type 2 diabetes

Routinely screening your blood sugar levels (glucose) cannot diagnose diabetes, but it is another way to monitor your risk for developing diabetes. There are several ways to test for diabetes, but with Everlywell’s convenient, at-home Hemoglobin A1C Test, you can get an idea of what your average blood sugar level has been for the past 90 days.

Hemoglobin A1C is not the same as the glucose result from a blood glucometer (or “glucose meter”). With Everlywell's Hemoglobin A1C Test, you monitor your blood sugar levels to better understand your glycemic control. As a result, you can reclaim control of your health and wellness with Everlywell by your side, committed to providing you with the information you need to make informed choices.

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References

  1. Genetic disorders. National Human Genome Research Institute, NIH. Updated May 18, 2018. Accessed December 7, 2022. URL
  2. Morwessel NJ. The genetic basis of diabetes mellitus. AACN Clin Issues. 1998;9(4):539-554. doi:10.1097/00044067-199811000-00009. URL
  3. Diabetes. MedlinePlus. Accessed December 8, 2022. Updated January 2, 2017. URL
  4. Florez JC, Udler MS, Hanson RL. Genetics of Type 2 Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., eds. Diabetes in America. 3rd ed. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US); August 2018. URL
  5. Avery AR, Duncan GE. Heritability of type 2 diabetes in the Washington state twin registry. Twin Res Hum Genet. 2019;22(2):95-98. doi:10.1017/thg.2019.11. URL
  6. Good to Know: Race and Type 2 Diabetes. Clin Diabetes 1 October 2020; 38 (4): 403–404. URL
  7. Learn the genetics of diabetes. American Diabetes Association. Accessed December 8, 2022. URL
  8. Diabetes prevention: 5 tips for taking control. Mayo Clinic. Updated June 25, 2021. Accessed December 7, 2022. URL
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