Diabetes prevention: genetic tests affect parents' intentions.(CLINICAL ROUNDS)

BALTIMORE -- The results of predictive genetic testing can have a big impact on the intention of parents with type 2 diabetes to try to prevent the disease in their children, despite the independent effect of the child's weight on disease risk, according to the results of a study of 189 parents.

When faced with a hypothetical positive genetic test result that indicated an increased risk of type 2 diabetes for their child, 67% of parents were more likely to take preventive measures than When they had no genetic test results. However, when faced with a hypothetical negative genetic test result that indicated a decreased risk, 39% were less likely to take preventive measures, Dr. Beth A. Tarini reported in a poster at the annual meeting of the Pediatric Academic Societies.

She and her colleagues surveyed parents with type 2 diabetes as part of a larger prospective cohort study of diabetic adults. Using a 10-point scale, parents reported their intention to prevent type 2 diabetes in their youngest child at baseline, and after hypothetical vignettes of a positive and a negative type 2 diabetes genetic test result. The researchers calculated the change in parents" scores from their baseline preventive action to after receipt of a hypothetical positive and negative test result. They also evaluated the relationship between the child's weight status and the parents' self-reported likelihood of taking preventive action. The average child's age was 10 years.

Roughly a quarter of parents (28%) were equally likely to act to prevent type 2 diabetes as at baseline, and only 5% were less likely to act after a positive genetic test result. After a negative genetic test result, half of parents were just as likely to take preventive measures as at baseline, while only 11% were more likely to act, said Dr. Tarini, a pediatrician in the child health evaluation and research unit at the University of Michigan in Ann Arbor.

Nearly half (47%) of parents of overweight children (body mass index of at least 85% for age and sex) were less likely to act to prevent type 2 diabetes in their children after learning of a hypothetical negative genetic test result. "'Negative type 2 diabetes genetic test results may reduce diabetic parents" motivation to prevent type 2 diabetes in their overweight children, despite the independent effect of the children's weight on type 2 diabetes risk," the researchers wrote.

"Given that nearly half of parents of overweight children were less likely to act to prevent type 2 diabetes after a negative genetic test result, it appears that careful communication with parents about the implications of genetic testing is needed," they said.

The study was funded by the Clinical Science Scholars Program at the University of Michigan.

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