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Family history of diabetes as a potential public health tool

  • Tabitha A Harrison
    Affiliations
    Department of Epidemiology (Harrison, Hindorff, Kim, Edwards), School of Public Health and Community Medicine, University of Washington, Seattle, WashingtonUSA
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  • Lucia A Hindorff
    Affiliations
    Department of Epidemiology (Harrison, Hindorff, Kim, Edwards), School of Public Health and Community Medicine, University of Washington, Seattle, WashingtonUSA
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  • Helen Kim
    Affiliations
    Department of Epidemiology (Harrison, Hindorff, Kim, Edwards), School of Public Health and Community Medicine, University of Washington, Seattle, WashingtonUSA
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  • Roberta C.M Wines
    Affiliations
    Institute for Public Health Genetics (Wines, Edwards),School of Public Health and Community Medicine, University of Washington, Seattle, WashingtonUSA
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  • Deborah J Bowen
    Affiliations
    Department of Health Services (Bowen), School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA

    Public Health Sciences Division, Fred Hutchinson Cancer Research Center (Bowen), Seattle, Washington, USA
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  • Barbara B McGrath
    Affiliations
    Psychosocial and Community Health, School of Nursing, University of Washington (McGrath), Seattle, Washington, USA
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  • Karen L Edwards
    Correspondence
    Address for correspondence and reprint requests to: Karen L. Edwards, PhD, Department of Epidemiology, Box 357236, School of Public Health and Community Medicine, University of Washington, Seattle WA 98195, USA.
    Affiliations
    Department of Epidemiology (Harrison, Hindorff, Kim, Edwards), School of Public Health and Community Medicine, University of Washington, Seattle, WashingtonUSA

    Institute for Public Health Genetics (Wines, Edwards),School of Public Health and Community Medicine, University of Washington, Seattle, WashingtonUSA
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      Abstract

      Given the substantial morbidity and mortality associated with type 2 diabetes, it is important that public health seek ways to delay or prevent the onset of this condition. Risk factors for type 2 diabetes are well established and include underlying genetic susceptibility. Despite this knowledge, as well as significant advances in understanding the human genome, the prevalence of type 2 diabetes continues to rise at an alarming rate. Because type 2 diabetes is a complex condition involving a combination of genetic and environmental factors, DNA testing for susceptibility genes is not yet warranted. However, because family history reflects genetic susceptibility in addition to other factors, it may be a useful public health tool for disease prevention. When evaluating family history as a public health tool, several important issues need to be considered, including the analytic and clinical validity and the clinical utility of using family history as a screening tool. These issues as well as a review of the epidemiologic evidence evaluating family history as a risk factor will be reviewed.
      Overall, a family history approach appears to be a promising new public health tool to fight the growing epidemic of diabetes in the United States. Adequate levels of funding to further evaluate this approach and to develop appropriate tools should be made available for research activities focused on this important area.
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