Possible genetic risk factors

Patients with type 2 diabetes are more likely than those with type 1 to know of a relative with diabetes and, therefore, to believe that diabetes runs in the family. To some extent, the appearance of "clustering" of type 2 diabetes in families arises because type 2 is so much more common than type 1 diabetes in the general population: It accounts for 90 to 95 percent of the estimated 20.8 million cases in the country today. Moreover, the occurrence of multiple cases in a family may reflect shared environmental risk factors, such as obesity and sedentary lifestyle.

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Genetics does, however, play an important part in determining who develops type 2 diabetes. Studies show that if one parent has the disease, children have a 7 to 14 percent chance of developing it. If both parents have type 2 diabetes, this increases to a 45 percent chance. If an identical twin has type 2 diabetes, there's a 58 to 75 percent chance that the other twin will develop it, too. By contrast, a person with no diabetes in the family has an 11 percent chance of developing type 2 diabetes by age 70.

While type 2 diabetes may have a strong genetic basis in some patients, the development of the disease in most people is dependent upon the effects of such environmental and behavioral factors as obesity and a sedentary lifestyle or an underlying susceptibility that is poorly understood.

Susceptibility to certain complications of diabetes also seems to be linked to genetics. However, careful blood glucose control is still an important mitigating factor.