Lifestyle Responses to Genetic Susceptibility to Type 2 Diabetes


Type 2 diabetes is a serious condition that often leads to complications and increases the risk of a number of other diseases. The prevalence of type 2 diabetes is rising and is associated with western lifestyles; overconsumption of high calorie foods and predominantly sedentary daily routines. However, recent advances in genomic research has established that some individuals are more ‘at risk’ from behavioural risk factors than others. Type 2 diabetes therefore reflects multifactorial inheritance in which susceptibility is determined by the complex interaction of multiple genes with environmental and lifestyle factors. There has been considerable debate in the literature about whether genetic information could undermine healthy lifestyle decisions particularly for conditions like type 2 diabetes with multifactorial aetiology. The evidence that personalised genetic risk information engenders feelings of fatalism is mixed. Optimising lifestyle responses to genetic susceptibility to diabetes requires not only an appreciation of the complexity of disease aetiology by health professionals, but also an understanding of how individuals interpret and respond to this genetic risk.

Key Concepts:

  • Type 2 diabetes is a complex multifactorial disease.

  • Although type 2 diabetes is considered a ‘lifestyle’ disease it has a strong genetic component.

  • Information about genetic aetiology has the potential to influence lifestyle choices.

  • Understanding that type 2 diabetes has a genetic aetiology may increase fatalism in individuals.

  • Communication of genetic risk is important to ensure that healthy lifestyles are supported.

Keywords: Type 2 diabetes; genetic risk; Fatalism; family history; lifestyle change; perceived aetiology


Andrews RC, Cooper AR, Montgomery AA et al. (2011) Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the early ACTID randomised controlled trial. Lancet 378(9786): 129–139.

Care P (2012) Type 2 diabetes, genomics, and nursing. Annual Review of Nursing Research 29: 281–302.

Claassen L, Henneman L, De Vet R et al. (2010) Fatalistic responses to different types of genetic risk information: exploring the role of self‐malleability. Psychology and Health 25(2): 183–196.

Collins RE, Wright AJ and Marteau TM (2011) Impact of communicating personalized genetic risk information on perceived control over the risk: a systematic review. Genetics in Medicine 13: 273–277.

Davies LE and Thirlaway K (2013) The influence of genetic explanations of type 2 diabetes on patients' attitudes to prevention, treatment and personal responsibility for health. Public Health Genomics.

Department of Health [DoH] and Diabetes UK (2005) Structured Patient Education in Diabetes: A Report from the Patient Education Working Group. London: Department of Health.

Drong AW, Lindgren CM and McCarthy MI (2012) The genetic and epigenetic basis of type 2 diabetes and obesity. Clinical Pharmacology and Therapeutics 92(6): 707–715.

Frosch DL, Mello P and Lerman C (2005) Behavioural consequences of testing for obesity risk. Cancer Epidemiology Biomarkers and Prevention 14(6) :1485–1489.

Grant RW, Meigs JB, Florez JC et al. (2011) Design of a randomized trial of diabetes genetic risk testing to motivate behavior change: the Genetic Counseling/Lifestyle Change (GC/LC) study for diabetes prevention. Clinical Trials 8(5): 609–615.

Hale ED, Treharne GJ and Kitas GD (2007) The common‐sense model of self‐regulation and illness: how can we use it to understand and respond to our patients' needs? Rheumatology 46: 904–906.

Heideman WH, Middelkoop BJ, Nierkens V et al. (2011) Changing the odds. What do we learn from prevention studies targeted at people with a positive family history of type 2 diabetes? Primary Care Diabetes 5(4): 215–221.

Hunt K, Davison C, Emslie C and Ford G (2000) Are perceptions of a family history of heart disease related to health‐related attitudes and behaviour? Health Education Research. Theory and Practice 15(2): 131–143.

Janssens ACJ and van Duijn CM (2008) Genome‐based prediction of common diseases: advances and prospects. Human Molecular Genetics 17(R2): R166–R173.

Leventhal H, Meyer D and Nerenz DR (1980) The common sense representation of illness danger. In: Rachman S (ed.) Contributions to Medical Psychology, pp. 17–30. New York: Pergamon Press.

Markowitz SM, Park ER, Delahanty LM, O'Brien KE and Grant RW (2011) Perceived impact of diabetes genetic risk testing among patients at high phenotypic risk for type 2 diabetes. Diabetes Care 34(3): 568–573.

Marteau TM and Lerman C (2001) Genetic risk and behavioural change. British Medical Journal 322(7293): 1056.

McBride CM, Bryan AD, Bray MS, Swan GE and Green ED (2012) Health behavior change: can genomics improve behavioral adherence? American Journal of Public Health 102(3): 401–405.

Mikail C (2008) Public Health Genomics: The Essentials. San Francisco: Wiley.

Miller SM, McDaniel SH, Rolland JS and Feetham SL (2006) Individuals, Families, and the New Era of Genetics: Biopsychosocial Perspectives. London: WW Norton & Co.

Parry O, Peel E, Douglas M and Lawton J (2006) Issues of cause and control in patient accounts of type 2 diabetes. Health Education Research 21(1): 97–107.

Petronis A (2010) Epigenetics as a unifying principle in the aetiology of complex traits and diseases. Nature 465(7299): 721–727.

Pijl M, Henneman L, Claassen L et al. (2009a) Peer reviewed: family history of diabetes: exploring perceptions of people at risk in the Netherlands. Preventing Chronic Disease 6(2): 1–7.

Pijl M, Timmermans DRM, Claassen L et al. (2009b) Impact of communicating familial risk of diabetes on illness perceptions and self‐reported behavioural outcomes. Diabetes Care 32(4): 597–599.

Qureshi N and Kai J (2008) Informing patients of familial diabetes mellitus risk: how do they respond? A cross‐sectional survey. BMC Health Services Research 8(1): 37.

Qureshi N, Wilson B, Santaguida P et al. (2007) Collection and use of cancer family history in primary care. Evidence Report – Technology Assessment 159: 1–84.

Ruffin MT, Nease DE, Sen A et al. (2011) Effect of preventive messages tailored to family history on health behaviors: the Family Healthware Impact Trial. Annals of Family Medicine 9(1): 3–11.

Sanderson SC, Wardle J and Humphries SE (2008) Public health genomics and genetic test evaluation: the challenge of conducting behavioural research on the utility of lifestyle‐genetic tests. Journal of Nutrigenetics and Nutrigenomics 1(5): 224–231.

Senior V, Marteau T and Peters TJ (1999) Will genetic testing for predisposition for disease result in fatalism? A qualitative study of parents' responses to neonatal screening for familial hypercholesterolaemia. Social Science and Medicine 48: 1857–1860.

Shaw JE, Sicree RA and Zimmet PZ (2010) Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Research and Clinical Practice 87: 4–14.

Tuomilehto J, Lindstrom MS, Eriksson J et al. (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose intolerance. New England Journal of Medicine 18(344): 1343–1349.

Underwood PC (2012) Type 2 diabetes, genomics, and nursing: necessary steps to advance the science into improved, personalized care. Annual Review Nursing Research 29: 281–302.

Valdez R, Yoon PW, Liu T and Khoury MJ (2007) Family history and prevalence of diabetes in the US population. The 6‐year results from the National Health and Nutrition Examination Survey (1999–2004). Diabetes Care 30(10): 2517–2522.

Walter FM and Emery J (2006) Perceptions of family history across common diseases: a qualitative study in primary care. Family Practice 23:472–480.

Walter FM, Emery J, Sanderson S and Sutton S (2006) Determinants of familial risk perception of common diseases [Abstract]. European Journal Human Genetics 14: s408.

Weedon MN, McCarthy MI, Hitman G et al. (2006) Combining information from common type 2 diabetes risk polymorphisms improves disease prediction. PLoS Medicine 3(10): 1877–1882.

Wijdenes‐Pijl M, Dondorp W, Timmermans D, Cornel M and Henneman L (2011) Lay perceptions of predictive testing for diabetes based on DNA test results versus family history assessment: a focus group study. BMC Public Health 11(1): 535.

Wilson BJ, Qureshi N, Santaguida P et al. (2009) Systematic review: family history in risk assessment for common diseases. Annals of Internal Medicine 151(12): 878–885.

Yates T, Davies MJ, Sehmi S, Gorely T and Khunti K (2011) The pre‐diabetes risk education and physical activity recommendation and encouragement (PREPARE) programme study: are improvements in glucose regulation sustained at 2 years? Diabetic Medicine 28(10): 1268–1271.

Yoon PW, Chen B, Faucett A et al. (2001) Public health impact of genetic tests at the end of the 20th century. Genetics in Medicine 3(6): 405–410.

Yoon PW, Scheuner MT, Peterson‐Oehlke KL et al. (2002) Can family history be used as a tool for public health and preventive medicine? Genetics in Medicine 4(4): 304–310.

Further Reading

Berry D (2004) Risk, Communication and Health Psychology. Milton Keynes: Open University Press.

Scriven A (2010) Promoting Health: A practical guide ( 6th edn). London: Elsevier.

Thirlaway K and Upton D (2010) The Psychology of Lifestyle: Promoting Healthy Behaviour. London: Routledge.

Upton D and Thirlaway K (2014) Promoting Healthy Behaviour: A Practical Guide of Nursing and Healthcare Professionals ( 2nd edn). London: Routledge.

Contact Editor close
Submit a note to the editor about this article by filling in the form below.

* Required Field

How to Cite close
Thirlaway, Katie, and Davies, Lindsey(Apr 2014) Lifestyle Responses to Genetic Susceptibility to Type 2 Diabetes. In: eLS. John Wiley & Sons Ltd, Chichester. [doi: 10.1002/9780470015902.a0025377]