Abstract
Diabetes mellitus (DM) has become a significant health concern with an increasing rate of morbidity and mortality worldwide. India ranks second in the number of diabetes cases in the world. The increasing burden of DM can be explained by genetic predisposition of Indians to type 2 diabetes mellitus (T2DM) coupled with rapid urbanization and socio-economic development in the last 3 decades leading to drastic changes in lifestyle. Environment and lifestyle changes contribute to T2DM development by altering epigenetic processes such as DNA methylation, histone post-translational modifications, and long non-coding RNAs, all of which regulate chromatin structure and gene expression. Although the genetic predisposition of Indians to T2DM is well established, how environmental and genetic factors interact and lead to T2DM is not well understood. In this review, we discuss the prevalence of diabetes and its complications across different states in India and how various risk factors contribute to its pathogenesis. The review also highlights the role of genetic predisposition among the Indian population and epigenetic factors involved in the etiology of diabetes. Lastly, we review current treatments and emphasize the knowledge gap with respect to genetic and epigenetic factors in the Indian context. Further understanding of the genetic and epigenetic determinants will help in risk prediction and prevention as well as therapeutic interventions, which will improve the clinical management of diabetes and associated macro- and micro-vascular complications.
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Acknowledgements
This study was supported by grants from the DBT/Wellcome Trust India Alliance, IA/I/19/1/504271 and Science and Engineering Research Board (SRG/2022/001063) (to SD) and IISER—Mohali. SD is an Intermediate Fellow of the DBT/ Wellcome Trust India Alliance. AP is supported by the Council of Scientific and Industrial Research, Govt. of India and RM is supported by Indian Institute of Science Education and Research (IISER) Mohali. We are grateful to Dr. Parijat Senapati for her comments on the review.
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AP and RM wrote and edited the review and prepared the figures. S.D. conceptualized, wrote, edited the review, acquired funding, and supervised the study.
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Priyadarshini, A., Madan, R. & Das, S. Genetics and epigenetics of diabetes and its complications in India. Hum. Genet. 143, 1–17 (2024). https://doi.org/10.1007/s00439-023-02616-3
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DOI: https://doi.org/10.1007/s00439-023-02616-3