Family matters: A new approach to identify individuals at risk of type 2 diabetes
Identification of household clustering in T2D risk factors will lead to a novel understanding of the role that household relationships play in the risk of T2D and potentially to a new and innovative approach for T2D prevention where several individuals at risk of T2D can be targeted at once instead of the high-cost individual T2D prevention approaches currently used.
The project runs from November 2015 to October 2017 and is funded by The Danish Council for Independent Research | Medical Sciences.
Globally more than 382 million people have diabetes and though the potential of prevention is clearly established, estimates project that the number will increase to 592 million by year 2035.
Diabetes is a burden for the society as well as the individual: in a country like Denmark the treatment of one of the 320.545 patients with known diabetes (up to 200.000 Danes are unaware of their diabetes status) costs 45.000 d.kr per year (in total 15% of the public yearly health budget), and despite considerable public health efforts, daily three diabetes patients have a foot amputation.
Therefore, the purpose of this postdoc project is to identify new approaches to identify individuals at risk of T2D by investigating household clustering of T2D risks and health related behaviours and thus the importance of the household as a potential target for prevention and early detection of T2D under different conditions.
I hypothesise that at the onset of T2D in one individual, there is a clustering of T2D risk factors in individuals living in the same household as the person with T2D. As time goes by this clustering of risk factors will either increase the risk of the non-diabetic household members getting T2D or the household members will benefit from the potential dietary and exercise changes the patient undergoes as part of the diabetes treatment regime and thus improve their risk profile. Further, the household clustering effects are affected or modified by the degree of economic development, urbanisation, epidemiological transition, and the type of health system.
- To investigate the degree of household clustering of fixed (age, sex, ethnicity, chronic disease status) and modifiable risk factors (e.g. blood glycaemia, anthropometry, blood pressure, health service utility) related to T2D in different geographical settings at various stages of epidemiological transition, and in different health systems and welfare policies.
- To identify social determinants (e.g. income, education, social status, family structure) related to household clustering of T2D risk factors under different geographical and socio-economic conditions, at various stages of epidemiological transition, and in different welfare and health systems
To address the objectives and investigate clustering of T2D and related risk factors at household level, I will combine and harmonize extant cross-sectional and longitudinal data from registries and cohorts from four different countries: Denmark, United States, India, and Uganda.
Emory Global Diabetes Research Center, Emory University, Atlanta GA USA
Professor Daniel R. Witte, Department of Public Health, Aarhus University
Senior Researcher Bendix Carstensen, Steno Diabetes Center
Dr. Silver K Bahendeka, St. Francis Nsambya Hospital, Kampala, Uganda