Can’t hide from diabetes?

Just finished reading two articles by Diamond* and McDermott* which provides an interesting view on the huge influx of Type II Diabetes.

The Thrifty Genotype Hypothesis was coined by James Neel in 1962 and in the most simplest terms goes like this: in early years when we were still foraging, and continually swung on a food pendulum of shortage to plentiful, our bodies became very “thrifty” aka efficient in utilizing the little food available at times.  But, now in our modern world of plenty and exported food – this efficiency is no longer a survival advantage but makes some more susceptible to obesity and diabetes.

These articles go into great length – and gives a genetically driven perspective to explain why diabetes continues to affect many when it has an adverse effect on reproduction, and they research includes: Much research has been completed on Australia’s indigenous people, and they have shown 2 major conclusions: as more people are exposed to the western lifestyle – sedentary lifestyle and high energy food, we see higher diagnosis of diabetes.  And secondly, it is hypothesized that diabetes is carried down the female line through “fuel-mediated teratogenesis” during pregnancy, where the uterus is exposed to hyperglycemia and this has lasting susceptibility effects.  McDermott attempts to discredit social factors, as this has also been seen in rhesus monkeys with a controlled diet and no issues of social justice.  As well in rats, where a low-protein diet in infancy led to impaired glucose tolerance and reduced insulin secretion.  This correlation was also seen in the “dutch famine” where there was a severe protein shortage at a critical stage in pregnancy and now as adults these people show higher rates of diabetes and cardiovascular disease compared to genetically similar controls.

If this is true, education for pregnant women and continual follow up on pregnant women with GDM (Gestational diabetes mellitus) could be the solution to preventing obesity and diabetes later in their children’s lives.  However, what else we could be seeing in communities such as the Australian Aboriginals is the physiological effect from past and continuing malnutrition.  And it is the social environment and lack of social justice that is leading to an overall lack of micro nutrients.  Which, explains why there is still no where near the influx in European communities, even though they were foragers once too!

References:

McDermott, R. (1998). Ethics, epidemiology and the thrifty gene: biological determinism as a health hazard. Social Science & Medicine, 47(9), 1189-1196. doi: 10.1016/S0277-9536(98)00191-9

Diamond, J. (2003). The double puzzle of diabetes. Nature, 423, 599-602. doi: 10.1016/S0277-9536(98)00191-9

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