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Impact of Genetic Testing and Family Health History Based Risk Counseling on Behavior Change and Cognitive Precursors for Type 2 Diabetes

  • Original Research
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Journal of Genetic Counseling

Abstract

Family health history (FHH) in the context of risk assessment has been shown to positively impact risk perception and behavior change. The added value of genetic risk testing is less certain. The aim of this study was to determine the impact of Type 2 Diabetes (T2D) FHH and genetic risk counseling on behavior and its cognitive precursors. Subjects were non-diabetic patients randomized to counseling that included FHH +/− T2D genetic testing. Measurements included weight, BMI, fasting glucose at baseline and 12 months and behavioral and cognitive precursor (T2D risk perception and control over disease development) surveys at baseline, 3, and 12 months. 391 subjects enrolled of which 312 completed the study. Behavioral and clinical outcomes did not differ across FHH or genetic risk but cognitive precursors did. Higher FHH risk was associated with a stronger perceived T2D risk (pKendall < 0.001) and with a perception of “serious” risk (pKendall < 0.001). Genetic risk did not influence risk perception, but was correlated with an increase in perception of “serious” risk for moderate (pKendall = 0.04) and average FHH risk subjects (pKendall = 0.01), though not for the high FHH risk group. Perceived control over T2D risk was high and not affected by FHH or genetic risk. FHH appears to have a strong impact on cognitive precursors of behavior change, suggesting it could be leveraged to enhance risk counseling, particularly when lifestyle change is desirable. Genetic risk was able to alter perceptions about the seriousness of T2D risk in those with moderate and average FHH risk, suggesting that FHH could be used to selectively identify individuals who may benefit from genetic risk testing.

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Acknowledgments

The original study was supported by a grant from The Duke Endowment. Acknowledgement goes to all members of the original study team including: Ley Killeya-Jones, Julianne O’Daniel, Kensaku Kawamoto, Dana Baker, Patrick Gallagher, Susanne Haga, Joseph Lucas, Gloria Trujillo, Michael Scott and Scott Joy. A portion of the above data was presented at the Society of General Internal Medicine national meeting in April 2015.

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Authors and Affiliations

  1. Center for Applied Genomics and Precision Medicine, Duke University, Durham, NC, USA

    R. Ryanne Wu, Rachel A. Myers, Allison Vorderstrasse, Alex Cho, Geoffrey S. Ginsburg & Lori A. Orlando

  2. Department of Medicine, Duke University, 411 West Chapel Hill St., Suite 500, Durham, NC, 27701, USA

    R. Ryanne Wu, Elizabeth R. Hauser, Alex Cho, Geoffrey S. Ginsburg & Lori A. Orlando

  3. Molecular Physiology Institute, Duke University, Durham, NC, USA

    Elizabeth R. Hauser

  4. Cooperative Studies Program Epidemiology Center, VAMC, Durham, Durham, NC, USA

    Elizabeth R. Hauser

  5. School of Nursing, Duke University, Durham, NC, USA

    Allison Vorderstrasse

  6. Department of Pathology, Duke University, Durham, NC, USA

    Geoffrey S. Ginsburg

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  1. R. Ryanne Wu
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Correspondence to R. Ryanne Wu.

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Conflict of Interest

R. Ryanne Wu, Rachel A. Myers, Elizabeth R. Hauser, Allison Vorderstrasse, Alex Cho, Geoffrey S. Ginsburg and Lori A. Orlando declare they have no conflicts of interest.

Human Studies and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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No animal studies were carried out by the authors for this article.

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Wu, R.R., Myers, R.A., Hauser, E.R. et al. Impact of Genetic Testing and Family Health History Based Risk Counseling on Behavior Change and Cognitive Precursors for Type 2 Diabetes. J Genet Counsel 26, 133–140 (2017). https://doi.org/10.1007/s10897-016-9988-z

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  • DOI: https://doi.org/10.1007/s10897-016-9988-z

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