Family History Assessment
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Family History Assessment
Family history assessment is a simple test which is performed by gathering enough family medical history to determine the pattern of heredity. It is essential to make extra inquiries about relatives who have been diagnosed with health condition for identifying the potential medical risk due to genetic reasons. In this Report, family history is assessed using U.S. Surgeon General Family History tool. It is observed form the collected data that Mercy and Sara are at the risk of developing type 1 diabetes. This document will try to describe the heredity patterns, risk of transmitting a disease to other family member and feasibility of using U.S. Surgeon General Family History tool. As most of the people are unaware of the diseases they have, it is important to be familiar with a family history to know the risk of getting a disease.
Type 1 diabetes is a medical condition in which pancreas fails to produce insulin. The illness can be transmitted by bone marrow transplantation. In type 1diabetes, pancreas fails to produce enough insulin. Sugar (glucose) enters the cells with the help of insulin to produce energy. Different components, including hereditary qualities and some infections, can add to Type 1 diabetes. Type 1 diabetes more often happens in youth or pre-adulthood ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"XyCr1Hjm","properties":{"formattedCitation":"(Ryan, Vega, & Drash, 1985)","plainCitation":"(Ryan, Vega, & Drash, 1985)","noteIndex":0},"citationItems":[{"id":401,"uris":["http://zotero.org/users/local/uHsb2Xzj/items/4K2TVURT"],"uri":["http://zotero.org/users/local/uHsb2Xzj/items/4K2TVURT"],"itemData":{"id":401,"type":"article-journal","title":"Cognitive Deficits in Adolescents Who Developed Diabetes Early in Life","container-title":"Pediatrics","page":"921-927","volume":"75","issue":"5","source":"pediatrics.aappublications.org","abstract":"A comprehensive battery of neuropsychological tests was administered to 125 adolescents with a history of insulin-dependent diabetes, and to 83 demographically similar nondiabetic control subjects. To test the hypothesis that developing this disease early in life greatly increases the risk of manifesting significant cognitive impairments, diabetic subjects were assigned to an \"early-onset\" (diagnosis before age 5 years) or a \"lateronset\" subgroup. Results showed that subjects with early onset of diabetes performed more poorly than either subjects with later onset of diabetes or nondiabetic control subjects on virtually all tests, including measures of intelligence, school achievement, visuospatial ability, memory, motor speed, and eye-hand coordination. Moreover, multiple regression analyses demonstrated that the age at onset and the duration of diabetes seem to affect neuropsychological functioning in very different ways. The duration of the disease best predicted performance on those tests requiring highly overlearned, primarily verbal, skills whereas the age at onset best predicted scores on tests requiring the ability to process relatively unfamiliar, typically nonverbal, information in novel ways. Although the etiology of these deficits remains unclear, there is a possibility that they are secondary to mild brain damage that develops as a consequence of multiple episodes of serious hypoglycemia early in life.","ISSN":"0031-4005, 1098-4275","note":"PMID: 3991281","language":"en","author":[{"family":"Ryan","given":"Christopher"},{"family":"Vega","given":"Arthur"},{"family":"Drash","given":"Allan"}],"issued":{"date-parts":[["1985",5,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ryan, Vega, & Drash, 1985). In spite of a lot of research, it doesn’t have any cure. Type1 diabetes is treated by controlling glucose level in blood using insulin. It effects can also be reduced by proper healthy diet and lifestyle.
Hereditary Patterns
Genes presents in the parents helps transfer some conditions to the kid, this phenomenon is call hereditary. If the history of certain disease is present in the family, it means that members of that family may have a chance of developing that disease. Risk of developing type 1 diabetes is 10 to 20 time more, if anyone in the immediate family (brother, sister, mother and father) has it ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6D71X1rm","properties":{"formattedCitation":"(Warram, Krolewski, Gottlieb, & Kahn, 1984)","plainCitation":"(Warram, Krolewski, Gottlieb, & Kahn, 1984)","noteIndex":0},"citationItems":[{"id":393,"uris":["http://zotero.org/users/local/uHsb2Xzj/items/HRJLTNGB"],"uri":["http://zotero.org/users/local/uHsb2Xzj/items/HRJLTNGB"],"itemData":{"id":393,"type":"article-journal","title":"Differences in Risk of Insulin-Dependent Diabetes in Offspring of Diabetic Mothers and Diabetic Fathers","container-title":"New England Journal of Medicine","page":"149-152","volume":"311","issue":"3","source":"Taylor and Francis+NEJM","abstract":"ALTHOUGH the association of insulin-dependent diabetes mellitus (IDDM) with certain histocompatibility antigens (HLA) demonstrates that genetic factors contribute to its causation, the exact role of heritable factors remains uncertain. A variety of single-locus models of inheritance have been considered, but none is completely consistent with the available data from both family and population studies.1 Although the inconsistencies can be resolved by the use of models involving two loci — one linked to HLA and one not1 2 3 4 — these more complicated models cannot be tested until there are some clues to the nature and location of the other locus. In addition, . . .","DOI":"10.1056/NEJM198407193110304","ISSN":"0028-4793","note":"PMID: 6738600","author":[{"family":"Warram","given":"James H."},{"family":"Krolewski","given":"Andrzej S."},{"family":"Gottlieb","given":"Marise S."},{"family":"Kahn","given":"C. Ronald"}],"issued":{"date-parts":[["1984",7,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Warram, Krolewski, Gottlieb, & Kahn, 1984). If one child in the family is diagnose with a type 1 diabetes, it is likely that other sibling also develops type 1 diabetes by the age of 50. Ratio of that happening is 0.1. If the father in the family has diabetes, there is 10 % chance that kids develops it too. Similarly if the mother has diabetes the chances of hereditary is dropped to 4 % ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"EWPNvy6M","properties":{"formattedCitation":"(Strojek et al., 1997)","plainCitation":"(Strojek et al., 1997)","noteIndex":0},"citationItems":[{"id":417,"uris":["http://zotero.org/users/local/uHsb2Xzj/items/RMM3KGHI"],"uri":["http://zotero.org/users/local/uHsb2Xzj/items/RMM3KGHI"],"itemData":{"id":417,"type":"article-journal","title":"Nephropathy of type II diabetes: Evidence for hereditary factors?","container-title":"Kidney International","page":"1602-1607","volume":"51","issue":"5","source":"ScienceDirect","abstract":"Nephropathy of type II diabetes: Evidence for hereditary factors? Family studies point to an important genetic element in the genesis of diabetic nephropathy, but it is not known whether renal abnormalities are present prior to the onset of diabetes. To address this issue we examined all consecutive patients suffering from type II diabetes with a duration of more than 10 years who attended a diabetes outpatient clinic. Ninety-four patients had nephropathy, 307 did not. All offspring who were phenotypically normal (no hypertension, normal oral glucose tolerance, nonsmoking) and agreed to participate were examined, 26 from nephropathic and 30 from non-nephropathic diabetic parents. They were compared with 30 offspring matched for age, gender and BMI from non-diabetic parents as controls. We measured urinary albumin excretion under baseline conditions and at several time points after ingestion of 300g cooked beef and submaximal treadmill exercise, respectively. In addition, casual blood pressure, ambulatory blood pressure, urinary albumin and urinary alpha-1-microglobulin were measured. Primary renal disease was excluded by clinical examination. Under baseline conditions, median urinary albumin excretion rate (AER; µg/min) was significantly (P < 0.005) higher in offspring of nephropathic type II diabetic patients (7.8; range 1.04 to 19.5) than in the offspring of non-nephropathic type II diabetic patients (4.8; 0.36 to 17.5) and controls (4.4; 0.16 to 18.4). Submaximal treadmill exercise caused a greater proportional increase of AER in offspring of nephropathic type II diabetics (median 16-fold) than in offspring of non-nephropathic diabetic patients (6.3-fold) or controls (4.8-fold). In offspring of nephropathic diabetic patients casual and particularly ambulatory systolic blood pressures were significantly higher, but AER was not correlated with blood pressure. In summary, higher values, albeit within the normal range, for baseline and postexercise albuminuria were noted in phenotypically normal offspring of parents with type II diabetes and nephropathy. The observation suggests that changes in transglomerular albumin traffic are demonstrable prior to the onset of diabetes and diabetic nephropathy in subjects with a potential genetic predisposition to these conditions.","DOI":"10.1038/ki.1997.220","ISSN":"0085-2538","shortTitle":"Nephropathy of type II diabetes","journalAbbreviation":"Kidney International","author":[{"family":"Strojek","given":"Krzysztof"},{"family":"Grzeszczak","given":"Władysław"},{"family":"Morawin","given":"Ewa"},{"family":"Adamski","given":"Miroslaw"},{"family":"Lacka","given":"Beata"},{"family":"Rudzki","given":"Henryk"},{"family":"Schmidt","given":"Susanne"},{"family":"Keller","given":"Christine"},{"family":"Ritz","given":"Eberhard"}],"issued":{"date-parts":[["1997",5,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Strojek et al., 1997)This chance also depends on the ages of the mother at the time of birth of that child. If the mother is older than 25, then the chance of developing type1 diabetes in the child is dropped to 1 percent ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"vhR3JWuv","properties":{"formattedCitation":"(Warram et al., 1984)","plainCitation":"(Warram et al., 1984)","noteIndex":0},"citationItems":[{"id":393,"uris":["http://zotero.org/users/local/uHsb2Xzj/items/HRJLTNGB"],"uri":["http://zotero.org/users/local/uHsb2Xzj/items/HRJLTNGB"],"itemData":{"id":393,"type":"article-journal","title":"Differences in Risk of Insulin-Dependent Diabetes in Offspring of Diabetic Mothers and Diabetic Fathers","container-title":"New England Journal of Medicine","page":"149-152","volume":"311","issue":"3","source":"Taylor and Francis+NEJM","abstract":"ALTHOUGH the association of insulin-dependent diabetes mellitus (IDDM) with certain histocompatibility antigens (HLA) demonstrates that genetic factors contribute to its causation, the exact role of heritable factors remains uncertain. A variety of single-locus models of inheritance have been considered, but none is completely consistent with the available data from both family and population studies.1 Although the inconsistencies can be resolved by the use of models involving two loci — one linked to HLA and one not1 2 3 4 — these more complicated models cannot be tested until there are some clues to the nature and location of the other locus. In addition, . . .","DOI":"10.1056/NEJM198407193110304","ISSN":"0028-4793","note":"PMID: 6738600","author":[{"family":"Warram","given":"James H."},{"family":"Krolewski","given":"Andrzej S."},{"family":"Gottlieb","given":"Marise S."},{"family":"Kahn","given":"C. Ronald"}],"issued":{"date-parts":[["1984",7,19]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Warram et al., 1984).
Knowing that certain disease is present in the family, one can simply take extra precautions against it. Like in the case of diabetes, proper precautions as advised by professional can delay the diabetes and I can even be reversed if the patient is in the prediabetic stage. Being aware that one has a chance of getting disease, one can simply adopt healthy life style and can completely avoid developing that disease. Development of diabetes can be delayed or avoided by maintaining a healthy weight, staying physically active and eating healthier.
After evaluating the complete family health history using the U.S. Surgeon General Family History tool, it is determine that there is pattern of Type 1 diabetes both in father and mother side of the family. Diabetes has developed in both parents approximately at the age of 40.
Risk of Transmission
Diabetes is not a contagious disease. It means it cannot be transferred through touch, living in the same environment, eating together or even having an intercourse. It can only be transferred genetically to one’s off-spring. Depending upon the region, it is observed that the chances of transferring type 1 diabetes to the next generation is greater as compared to the chances of getting it from our ancestors. It is determined through various studies that genes present in the males has ability to transfer type 1 diabetes to its offspring more likely as compared to genes in female. Risk of transferring type 1 diabetes from a father (with type1 diabetes) is 2.7 times greater than transferring it from mother (with type 1 diabetes) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1PxcIJs4","properties":{"formattedCitation":"(Harjutsalo, Reunanen, & Tuomilehto, 2006)","plainCitation":"(Harjutsalo, Reunanen, & Tuomilehto, 2006)","noteIndex":0},"citationItems":[{"id":395,"uris":["http://zotero.org/users/local/uHsb2Xzj/items/ZZRA9JM8"],"uri":["http://zotero.org/users/local/uHsb2Xzj/items/ZZRA9JM8"],"itemData":{"id":395,"type":"article-journal","title":"Differential Transmission of Type 1 Diabetes from Diabetic Fathers and Mothers to Their Offspring","container-title":"Diabetes","page":"1517-1524","volume":"55","issue":"5","source":"diabetes.diabetesjournals.org","abstract":"We studied the incidence of type 1 diabetes in the offspring of patients with childhood- and adolescent-onset type 1 diabetes and several risk factors predicting the risk. We defined the diabetes status in the offspring of all probands who were included in the nationwide register of Finnish type 1 diabetic patients diagnosed at the age of ≤17 years from 1965 to 1979. A total of 5,291 offspring at risk contributed 72,220 person-years of follow-up between 1970 and 2003. Of them, 259 offspring developed type 1 diabetes by the end of 2003, giving a cumulative incidence of 6.7% (95% CI 5.9–7.5) by the age of 20 years. The incidence of type 1 diabetes in the offspring between the years 1980 and 2003 was 35.3, 44.6, and 44.6 per 10,000 person-years for the age-groups 0–4, 5–9, and 10–14 years, respectively. Poisson regression analyses showed a marked increase in incidence of 5.3% per year from 1983 to 2003. The greatest increase occurred in the youngest offspring, aged 0–4 years. Of the offspring of male probands, 7.8% were affected by the age of 20 years compared with 5.3% of the offspring of female probands (relative risk 1.7 [95% CI 1.3–2.2]). The young age at onset of diabetes increased the risk of type 1 diabetes in the offspring of diabetic fathers but not in the offspring of diabetic mothers. In conclusion, our findings revealed that in the offspring of type 1 diabetic patients, the increase in the recurrence risk of type 1 diabetes was not more rapid compared with that in the background population. In the multivariate analyses, statistically significant predictors of type 1 diabetes in the offspring were male sex of the diabetic parent, young age at diagnosis in the male parent, and the more recent year of birth of the offspring.","DOI":"10.2337/db05-1296","ISSN":"0012-1797, 1939-327X","note":"PMID: 16644714","language":"en","author":[{"family":"Harjutsalo","given":"Valma"},{"family":"Reunanen","given":"Antti"},{"family":"Tuomilehto","given":"Jaakko"}],"issued":{"date-parts":[["2006",5,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Harjutsalo, Reunanen, & Tuomilehto, 2006). This shows that Probability of developing type 1 diabetes in a kid is high if the probound is male and kids can develop the disease at any early age. Similarly Probability of developing type1 diabetes in young age is three to ten times higher when both of the parents have diabetes ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"cdhu40YZ","properties":{"formattedCitation":"(Guo & Tuomilehto, 2002)","plainCitation":"(Guo & Tuomilehto, 2002)","noteIndex":0},"citationItems":[{"id":409,"uris":["http://zotero.org/users/local/uHsb2Xzj/items/ITAR6GI4"],"uri":["http://zotero.org/users/local/uHsb2Xzj/items/ITAR6GI4"],"itemData":{"id":409,"type":"article-journal","title":"Preferential transmission of type 1 diabetes from parents to offspring: fact or artifact?","container-title":"Genetic Epidemiology","page":"323-334","volume":"23","issue":"4","source":"Wiley Online Library","abstract":"It has been widely reported that men with type 1 diabetes (T1D) tend to be more likely to transmit the disease to their offspring than their female counterparts in Caucasoid populations. Several theories to explain this preferential transmission have been proposed, but so far none of them has been unequivocally proven. Whatever the mechanism, confirmation or refutation of this observation is nonetheless important and practical to the design of future genetic studies of T1D. We carried out some statistical modeling of the preferential transmission. The well-established fact that males have higher a prevalence of T1D than females, an apparent sex difference in fecundity, and a possible misclassification of gestational diabetes mellitus (GDM) as T1D in women have been considered. We demonstrated, first, that the ascertainment of study families through the affected offspring with T1D would generate a higher proportion of fathers than mothers having T1D, even though there was no preferential transmission at all. This can be explained by the male preponderance in T1D prevalence as compared with females, coupled with a greater likelihood of being selected and/or recruited for study in families with T1D fathers due to the fecundity difference. Second, when the study population is ascertained through affected parents, misclassification of mothers with GDM as T1D, and the existence of male/female difference in fecundity in conjunction with a birth order effect, can contribute to the observed preferential transmission, even though there was none. In light of the plausibility of assumptions employed in the analysis and, in particular, an apparent failure to critically examine the effects of these causes of bias in earlier studies, it is perhaps prudent to say that the jury for the existence of preferential transmission in T1D is still out. Genet. Epidemiol. 23:323–334, 2002. © 2002 Wiley-Liss, Inc.","DOI":"10.1002/gepi.10183","ISSN":"1098-2272","shortTitle":"Preferential transmission of type 1 diabetes from parents to offspring","language":"en","author":[{"family":"Guo","given":"Sun-Wei"},{"family":"Tuomilehto","given":"Jaakko"}],"issued":{"date-parts":[["2002"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Guo & Tuomilehto, 2002). In our case both father and mother have type 1 diabetes, so it is recommended that Mercy and Sara are checked frequently for diabetes. And they should also take precautions as both parents carries type 1 diabetic genes.
Conclusion
According to this report, it is recommended that everyone should have its family medical history evaluated. In our case we have used U.S. Surgeon General Family History tool. It is an online tool to evaluate medical history of a family. By using this tool, one can be aware of the potential of genetically transmitted diseases in his body and can take precautionary steps. Furthermore, foot-prints of heredity using the tool is observed and risk of transmitting the disease in future is also discussed
Reference
ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Guo, S.-W., & Tuomilehto, J. (2002). Preferential transmission of type 1 diabetes from parents to offspring: fact or artifact? Genetic Epidemiology, 23(4), 323–334. https://doi.org/10.1002/gepi.10183
Harjutsalo, V., Reunanen, A., & Tuomilehto, J. (2006). Differential Transmission of Type 1 Diabetes from Diabetic Fathers and Mothers to Their Offspring. Diabetes, 55(5), 1517–1524. https://doi.org/10.2337/db05-1296
Ryan, C., Vega, A., & Drash, A. (1985). Cognitive Deficits in Adolescents Who Developed Diabetes Early in Life. Pediatrics, 75(5), 921–927.
Strojek, K., Grzeszczak, W., Morawin, E., Adamski, M., Lacka, B., Rudzki, H., … Ritz, E. (1997). Nephropathy of type II diabetes: Evidence for hereditary factors? Kidney International, 51(5), 1602–1607. https://doi.org/10.1038/ki.1997.220
Warram, J. H., Krolewski, A. S., Gottlieb, M. S., & Kahn, C. R. (1984). Differences in Risk of Insulin-Dependent Diabetes in Offspring of Diabetic Mothers and Diabetic Fathers. New England Journal of Medicine, 311(3), 149–152. https://doi.org/10.1056/NEJM198407193110304
