MedicalResearch.com Interview with:
Wenpeng You, PhD student
Biological Anthropology and Comparative Anatomy Research Unit
University of Adelaide | School of Medicine
Maciej Henneberg, PhD, DSc, FAIBiol
Wood Jones Professor of Anthropological and Comparative Anatomy
University of Adelaide School of Medicine;
Institute for Evolutionary Medicine, University of Zurich
Editor in Chief, Journal of Comparative Human Biology HOMO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Type 1 diabetes disease has very strong genetic background. Prevalence of type 1 diabetes has been increasing globally. Previous studies focusing on regional genetics and environmental factors cannot fully explain this phenomenon. Due to insufficient medical knowledge up until early 20th century, people with type 1 diabetes disease would most commonly die during their teens or early 20s. Therefore, they did not have the opportunity to pass on their genes providing background for the development of type 1 diabetes to their next generations. Since discovery and introduction of insulin to modern medicine in early 1920s, more and more type 1 diabetes patients have been able to survive their reproduction cycle (up until and past 50 years of age). This has made more and more genes related to type 1 diabetes to accumulate in human populations.
We applied the Biological State Index which measures a probability to pass genes on to the next generation at population level. We found that the rapid increase in type 1 diabetes over the last few decades was correlated with increases of the Biological State Index and its proxy, human life expectancy, especially in more developed world in which natural selection has been relaxed most. This correlation was found after statistically excluding differences in countries income, levels of urbanization, sugar consumption and obesity prevalence.
MedicalResearch.com: What should readers take away from your report?
Response: Modern medicine is a double edged sword. It has made many heritable and partly heritable diseases, including type 1 diabetes curable in individual patients, but meantime, it has been accumulating the genes of these diseases in the population. Since compromised eugenic approaches that tried to limit individual reproductive performance have been shown to be ethically unacceptable and scientifically misguided, there is a need for gene therapy.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Gene therapy should be the focus of the research in medicine to cure type 1 diabetes. Insulin, other medicines and public health measures will not stop increase in the incidence of type 1 diabetes disease.
MedicalResearch.com: Is there anything else you would like to add?
Response: This is the first major disease we have shown that is accumulating due to the relaxation of natural selection over time. It is likely that situation is similar with other diseases that have genetic background.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Wen-Peng You, Maciej Henneberg. Type 1 diabetes prevalence increasing globally and regionally: the role of natural selection and life expectancy at birth. BMJ Open Diabetes Research & Care, 2016; 4 (1): e000161 DOI: 1136/bmjdrc-2015-000161
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