Patient awareness of genetic and environmental risk factors in non-insulin-dependent diabetes mellitus--relevance to first-degree relatives.

Abstract

Primary preventative strategies may be useful in non-insulin-dependent (Type 2) diabetes mellitus (NIDDM), where weight reduction and physical exercise may help to counteract the increased risk to first-degree relatives of affected patients. To assess the extent of patient's awareness of these and related issues, 100 NIDDM patients were selected to complete a questionnaire. Forty-four per cent had a family history of NIDDM. Forty per cent and 35%, respectively, were aware that the patient's siblings and children were at an increased risk of developing NIDDM. Sixty-three per cent and 35%, respectively, were aware that obesity and physical inactivity increased the risk of developing NIDDM. After appropriate counselling about these risk factors, all 100 patients claimed that they would be advising their first-degree relatives. However, at 4 months review, 53% of patients had informed their first-degree relatives of the increased genetic risk to them. Of these patients, 83%, 74%, and 23% had provided relevant advice on diet, weight reduction, and physical exercise, respectively, as a means of reducing the risk of first-degree relatives developing NIDDM. We conclude that only a small proportion of patients are aware of the increased genetic susceptibility of their first-degree relatives to develop NIDDM and that weight reduction and regular physical exercise can reduce this risk. But, after appropriate education, a significant proportion of NIDDM patients did inform their close relatives of these issues and this may prove to be a useful strategy in the primary prevention of NIDDM.