My first exposure to diabetes was while living in the UK during my teenage years. I remember a girl who used to leave class at a specific time everyday in order to inject herself with insulin. Obviously at that time I was completely ignorant and so were my classmates who made cruel comments about the daily event.

A number of years later my mother developed type 2 diabetes, which was treated by using medication and a diet. Unfortunately dieting was something that turned out really difficult for her, so the use of insulin became necessary.

Medication turned to a device to check sugar levels in the blood and a shot of insulin once a day. Elevations of blood glucose levels lead to damage of the blood vessels, which over the years affected her eyesight, her ability to heal fast from leg and foot wounds and her kidneys. She past away at 69.

The Internet and most recently the move to view it as a platform, brought about the development and evolution of web-based communities such as social-networking sites like “Tu Diabetes” that was founded by my friend Manny Hernandez on March 2007 and today has 5,394 members and going strong.

Both type 1 and type 2 diabetes are at least partly inherited. Type 1 diabetes appears to be triggered by some (mainly viral) infections, or less commonly, by stress or environmental exposure (such as exposure to certain chemicals or drugs). There is a genetic element in individual susceptibility to some of these triggers which has been traced to particular HLA genotypes (i.e., the genetic “self” identifiers relied upon by the immune system). However, even in those who have inherited the susceptibility, type 1 diabetes mellitus seems to require an environmental trigger. A small proportion of people with type 1 diabetes carry a mutated gene that causes maturity onset diabetes of the young (MODY).

There is a stronger inheritance pattern for type 2 diabetes. Those with first-degree relatives with type 2 have a much higher risk of developing type 2, increasing with the number of those relatives. Concordance among monozygotic twins is close to 100%, and about 25% of those with the disease have a family history of diabetes. Candidate genes include KCNJ11 (potassium inwardly rectifying channel, subfamily J, member 11), which encodes the islet ATP-sensitive potassium channel Kir6.2, and TCF7L2 (transcription factor 7–like 2), which regulates proglucagon gene expression and thus the production of glucagon-like peptide-1.^[3] Moreover, obesity (which is an independent risk factor for type 2 diabetes) is strongly inherited.^[17]

Various hereditary conditions may feature diabetes, for example myotonic dystrophy and Friedreich’s ataxia. Wolfram’s syndrome is an autosomal recessive neurodegenerative disorder that first becomes evident in childhood. It consists of diabetes insipidus, diabetes mellitus, optic atrophy, and deafness, hence the acronym DIDMOAD.^[18]

This is something that today I think I should probably look out for, and so my quest for information and prevention begins. 23andMe, a start-up company named after the numbered of paired chromosomes in humans, wants to help you understand what your genes mean by indexing them and highlighting significant findings and Type 2 Diabetes is one of the conditions that 23andMe analyzes.

For the price of $399 through their online store, they will mail you a kit with a test tube that you will send back with a sample of your saliva. After 4 to 6 weeks you will receive a report to better understand your ancestry, genealogy, and inherited traits.

Specifically for Type 2 Diabetes, you will get:

• An estimate, based on currently available information, on whether your genetic risk of Type 2 Diabetes is higher or lower than average.
• Your results at 9 markers.
• A look at how Type 2 Diabetes works, a history of the condition, and a list of counselors, links and support groups for Type 2 Diabetes in your area.

In the United States, almost 21 million children and adults have diabetes, but the rate of new diagnoses is increasing, so I will get going with a visit to the doctor and then order one of these kits.

[ad]