Module 2: Diabetes Case Study

Recent discoveries in fetal origins can potentially decrease rates of chronic disease, and improve the health of populations with unusually high rates of certain long-term illnesses. One example is the Native American population, which has the highest rate of Type 2 diabetes in the world. Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) occurs when the human body becomes resistant to insulin or does not make enough. Specifically, the O’odham population in Arizona has seven times the national average rate of diabetes. A century ago, there were no cases of diabetes amongst the O’odham people; now, almost half of the population has it.(1) Type 2 diabetes is a worldwide epidemic that increases an individual’s susceptibility to numerous health complications such as heart disease and stroke.(2) Though diabetes can reduce life expectancy by five to ten years, there is currently no known cure.(3) Furthermore, diabetes disproportionately affects individuals living in poverty, as well as minorities and indigenous groups.

It was previously believed that the O’odham people were genetically predisposed to developing diabetes and that their risk was heightened by a poor diet and inactive lifestyle.(4) Despite numerous studies on the O’odham, however, researchers have not yet found an explanation for the high rates of diabetes among this population. The O'odham people have been taught “I just have bad sugar”.(5) Moreover, prevention strategies supporting healthy lifestyle choices have not proven to be successful in controlling diabetes in this community. Consequently, there has been rising skepticism as to whether genetics and lifestyle choices are truly the cause of this particularly high rate of diabetes.(6) Since researchers have consistently focused on genetic factors, there has been criticism that these studies reinforce the myth that diabetes is inevitable, and that there are no preventative steps available for the O’odham population.

While the O’odham are still commonly cited as having the highest rate of diabetes in the world due to a genetic predisposition, research has shown that a mother’s high blood sugar (that is circulated to the fetus) increases her baby’s risk of developing diabetes.(7) In fact, when a pregnant woman has diabetes, her child’s risk of developing the condition is 4 to 8 times higher than a child whose mother does not have Type 2 diabetes.(8) As diabetes is a widespread health concern that is particularly threatening to minority groups and developing countries, it will be crucial to promote awareness of the role and importance of in-utero health to encourage communities to actively strive to improve the health of future generations. In fact, when a pregnant woman has diabetes, her child’s risk of developing the condition is 4 to 8 times higher than a child whose mother does not have Type 2 diabetes.(9) As diabetes is a widespread health concern that is particularly threatening to minority groups and developing countries, it will be crucial to promote awareness of the role and importance of in-utero health to encourage communities to actively strive to improve the health of future generations.(10)

Footnotes

(1) Centers for Disease Control and Prevention. (2020). “National Diabetes Statistics Report” Center of Disease Control and Prevention”. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.Pdf.

(2) "Unnatural Causes.” Case Studies. Inequities in US Health. California Newsreel." https://www-tc.pbs.org/unnaturalcauses/assets/resources/badsugar_transcript.pdf.

(3) World Health Organization. (2020). “Diabetes.”https://www.who.int/health-topics/diabetes.

(4) WHO-WPRO Publication Office. (2007) "Plan of Action 2006-2010 for the Western Pacific Declaration on Diabetes: From Evidence to Action."

(5) The Human Genome Project and Diabetes: Genetics of Type II Diabetes. New Mexico State University. 1997.

(6) WHO-WPRO Publication Office. (2007) "Plan of Action 2006-2010 for the Western Pacific Declaration on Diabetes: From Evidence to Action."

(7) Ibid.

(8) Centers for Disease Control and Prevention. "CDC - Trends in Diabetes Prevalence Among American Indian Children - Factsheets."

(9) Canadian Medical Association Journal. “Maternal Gestational Diabetes Linked to Diabetes in Children.” ScienceDaily. April 15, 2019. https://www.sciencedaily.com/releases/2019/04/190415081822.htm.

(10) Hanson, M., Gluckman, P., Ma R., Matzen, P., Biesma-Blanco, R. (2012). Early life opportunities for prevention of diabetes in low and middle income countries. BMC public health. 12. 1025.