Mahsa Sadeghi Garmaroudi - Master of educational management, Islamic Azad University, Tonkabon Branch, Mazandaran, Iran,

Type ۲ diabetes (T۲D), formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, fatigue and unexplained weight loss. Symptoms may also include increased hunger, having a sensation of pins and needles, and sores (wounds) that do not heal. Often symptoms come on slowly. Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations. The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon. Type ۲ diabetes primarily occurs as a result of obesity and lack of exercise. Some people are genetically more at risk than others. Type ۲ diabetes makes up about ۹۰% of cases of diabetes, with the other ۱۰% due primarily to type ۱ diabetes and gestational diabetes. In type ۱ diabetes there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas. Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A۱C). Type ۲ diabetes is largely preventable by staying at a normal weight, exercising regularly, and eating a healthy diet (high in fruits and vegetables and low in sugar and saturated fats).Treatment involves exercise and dietary changes. If blood sugar levels are not adequately lowered, the medication metformin is typically recommended. Many people may eventually also require insulin injections. In those on insulin, routinely checking blood sugar levels (such as through a continuous glucose monitor) is advised; however, this may not be needed in those who are not on insulin therapy. Bariatric surgery often improves diabetes in those who are obese. Type ۲ diabetes (T۲D) results from a co-occurrence of genes and environmental factors. There are more than ۱۲۰ genetic loci suggested to be associated with T۲D, or with glucose and insulin levels in European and multi-ethnic populations. Risk of T۲D is higher in the offspring if the mother rather than the father has T۲D. In this article, we will review the genetics of type ۲ diabetes and answer the important question of which parents to inherit this risk from.

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