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23andMe: New Genetic Test Option Predicts Diabetes Risk

The simple-to-use, at home genetic test, can provide insight into how your genes might impact your health but should you mail in your saliva?

Hispanic family walking together outsideThe ancestry and genetic-testing company, 23andMe, now offers a diabetes report that can predict your risk of getting type 2. Company says it hopes to raise awareness of the problem but critics have privacy concerns.(Photo: Unsplash, Luis Quintero)

One of the most popular ancestry service companies, 23andMe, is now offering not only to tell you where you came from but where you may be going, healthwise.

As of March 2019 the genetic-testing company now offers a reportto predict your risk of getting type 2 diabetes. The hope, company officials say, is to raise awareness about diabetes and a person's risk so they can address it and possibly improve their lifestyle to stop it in its tracks.

The use of the number 23 in the company's name refers to the fact that there are 23 pairs of chromosomes that make up our DNA. Within the DNA is information that can determine things like whether someone carries genetic mutations for serious diseases like cystic fibrosis which could be passed on to a child. 

According to the CDC, about 30 million people in the US have diabetes, and 1 in 4 do not know. More than 84 million have prediabetes, in which blood sugar is abnormal but not yet high enough to be diagnosed as diabetes, and 90% of them are unaware.2

How it Works

The 23andMe Type 2 Diabetes Report, is priced at $199 and based on data from more than 2.5 million 23andMe customers who have given permission to use their information for research.

Some who agreed to let the company use their genetic information have diabetes; others do not. Together, all this information helped the scientists there create what is known as a polygenic score. This score is based on a model that factors in more than a thousand genetic variants to evaluate an individual's likelihood of developing diabetes. The approach and score were reviewed by company scientists, medical and regulatory teams and by external experts.

The caveat: the analysis does not take into account lifestyle habits such as exercise, known to reduce risks.

"It is based on genetics and further calibrated by age, ethnicity, and gender," says Liza Crenshaw, a spokesperson for the company. "Although the estimated likelihood doesn’t take into account other risk factors, lifestyle factors are featured throughout the report as ways to take action."

To get the diabetes risk report, the process is the same as for learning your ancestry: simply spit in a tube, send it to the lab, and wait for results. The results tell if you are at  ''typical" or "increased" risk for diabetes. If it is increased, the report tells you what percent risk you have of getting diabetes in your lifetime—from your current age to age 80.

The report is meant as a screening tool, not a diagnosis. "The results can also aid in facilitating a conversation with your healthcare provider about how to manage your likelihood of developing diabetes," Crenshaw adds.

Second Opinion

Getting personal information on your diabetes risk ''can be both helpful and harmful," says Elena Christofides, MD, FACE, an endocrinologist and CEO of Endocrinology Associates in Columbus, Ohio. Dr. Christofides reviewed the information for OnTrack Diabetes.

She emphasizes that it is important to understand the data and what to do with it. For instance, she says, ''if you have average risk, what you do has a strong influence on the outcome. So, working hard to prevent it through lifestyle is going to be the correct option.''

On the other hand, if you have a higher than average risk, ''that means you really have to work hard at lifestyle'' and may mean you should consider medications as suggested by your doctor.

She urges people who do get the report to discuss the findings with a healthcare provider who understands personalized medicine such as this.

Other Ways to Calculate Risk

While the motto of 23andMe is ''A little spit can go a long way," not everyone is comfortable sharing their spit and other personal details fearing their genetic information can be used against them with regards to obtaining health insurance or becoming a target of pharmaceutical companies looking to market drugs.

If that's you, you can calculate diabetes risk using the American Diabetes Association's Type 2 Diabetes Risk Test.3 This questionnaire, which can be taken online, is free and takes just 60 seconds to complete.

It takes into account age, gender, physical activity, race/ethnicity, weight and family medical history. It scores you on a scale of 1-10 and tells you the degree of risk—low to high. You can even look back and see which answers gave you ''points" to make the total higher and increase your risk. Based on your risk, it suggests what to do next.

Focusing on What Can Be Changed

You can't change family history, your race or ethnic background or your age, nor a history of gestational diabetes (diabetes during pregnancy, which also ups your risk).

But you can change many risk factors, such as being overweight or sedentary. You can control high blood pressure and abnormal cholesterol, if you have those conditions. All of those changes will go a long way to reducing risk

Updated on: April 16, 2019
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