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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:
September 06, 2007
Content source: National Center on Birth Defects and Developmental
Disabilities
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