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Family History as a Tool for Detecting Children at Risk for
Diabetes and Cardiovascular Disease
Diabetes and most types of cardiovascular disease typically emerge
in adulthood, but studies have shown that the risk for these
diseases might be apparent in childhood. Family history might be a
useful tool in assessing and reducing that risk.
- In the United States, about 21 million adults (older than 20
years of age) and 180,000 young people have diabetes. About 1.5
million individuals with diabetes are newly diagnosed each year.
- Cardiovascular disease (CVD)—which includes heart disease
and stroke—affects about 71 million adults. Heart disease is the
leading cause of death overall; stroke is the third leading
cause. About 10% of adolescents 12–19 years of age have a high
overall cholesterol level, a risk factor for CVD.
- Several studies show that risk factors for type 2 diabetes
or CVD can be found in childhood, even though these disorders
usually do not emerge until adulthood. The number of children
with type 2 diabetes and distinctly elevated risk factors for
CVD is rising.
- Diabetes and CVD share risk factors. So, increased risk for
one disease might mean higher risk for the other. Shared risk
factors such as overweight and impaired glucose metabolism are
growing more and more common among children and adolescents.
- For both diseases, among adults, onset might be prevented or
delayed with changes in diet and physical activity and use of
medication. Among children, several programs have changed
knowledge, attitudes, and behaviors that might reduce risk
factors for diabetes and CVD.
- Guidelines from the American Diabetes Association, American
Heart Association, and National Cholesterol Education Program
include family history among the factors to consider in
assessing disease risk and deciding about screening and
treatment.
- Several studies have shown family history to be an
independent risk factor for diabetes. People who have one or
more parents, siblings, or children with diabetes are 2 to 6
times more likely to have the disease than are people with no
affected relatives.
- Family history is also an established risk factor for CVD.
In one large study, the 14% of families that had a known family
history for heart disease accounted for 72% of cases of early
heart disease (before age 55).
- Strong evidence shows that youth with a family history of
CVD and diabetes already show signs of the diseases. Family
history can be part of the approach to screening for children at
risk of CVD and diabetes and should be part of prevention
campaigns aimed at reducing the burden of these diseases and
their risk factors in children.
- Much research is needed to find the most effective ways to
use family history in strategies to screen for and prevent
diabetes and CVD, particularly among children and young adults.
Questions remain about practical, ethical, and legal aspects of
screening for diseases that, in children, might take many years
to emerge. If family history improves risk assessment, and if
studies show that screening and early intervention can prevent
these diseases, clinicians and parents might be more willing to
view family history as an important risk factor in children and
start intervening earlier.
For more
information, please see the following Pediatrics supplement article:
Is Family History a Useful Tool for Detecting Children at Risk for
Diabetes and Cardiovascular Diseases? A Public Health Perspective
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Date:
March 11, 2009
Content source: National Center on Birth Defects and Developmental
Disabilities
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