Diabetes Family History: A Metabolic Storm You Should Not Sit Out

  1. Paul W. Franks
  1. From the Department of Clinical Sciences, Lund University, Malmö, Sweden, and the Department of Public Health and Clinical Medicine, Section for Medicine, Umeå University Hospital, Umeå, Sweden.
  1. Corresponding author: Paul W. Franks, paul.franks{at}

First-degree relatives of people with type 2 diabetes are themselves at risk of developing the disease. While the transmission of genetic information from parents to offspring contributes to diabetes risk, there are other nongenetic risk factors that are shared by family members that can be amenable to intervention. These factors are likely to include sedentary behaviors such as television viewing and computer use. The extent to which family history influences the effects of sedentary behaviors on cellular energy metabolism and other markers of diabetes risk is poorly understood. An article by Højbjerre et al. (1) in this issue of Diabetes examines the impact of 10-days' bed rest on young, nondiseased adults with or without a first-degree family history of diabetes. This commentary summarizes the findings from that study, places them in context with the findings of earlier studies, describes mechanisms of action, and identifies key areas where future research is required.

Ecological comparisons (2), cohort studies (3), clinical trials (4), and government guidelines (5) tell us that a healthy lifestyle should include regular, moderately intense physical activity. Physically active people are at lower risk of type 2 diabetes (6), heart disease (7), specific cancers (8), and early death (9). Conversely, sedentary behaviors during leisure time and at work have been associated with cardiovascular morbidity (6,10) and mortality (11). While these epidemiological studies have received considerable media attention, many are prone to confounding and reverse causality. Intervention studies where participants are confined to bed (12,13) or in other ways discouraged from exercising (14) provide some of the strongest mechanistic evidence that sedentary behaviors are harmful to health. A study by Højbjerre et al. (1) in this issue of Diabetes is one such example.

Højbjerre et al. (1) examined the effects of 10 days' bed rest on energy …

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