Familial Clustering of Diabetic Nephropathy: Perceptions and Risk Recognition Among Mexican-American Patients With a Family History of Diabetes
- Nedal H. Arar, PhD,
- Helen P. Hazuda, PhD,
- Rosemarie Plaetke, PhD,
- Valeria Sartorio,
- Mazen Y. Arar, MD and
- Hanna E. Abboud, MD
- Address correspondence and reprint requests to Nedal Arar, PhD, Assistant Professor, Department of Medicine/Nephrology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229-3900, or e-mail him at ararn{at}uthscsa.edu.
Abstract
Abstract
Objective. Diabetic nephropathy (DN) clusters in families with type 2 diabetes, suggesting a genetic susceptibility for its development and progression. We investigated DN probands’ and relatives’: 1) perceptions of the causes and clustering of DN and 2) recognition of their genetic susceptibility and of other selected risk factors.
Research methods. Structured interviews were conducted with 246 Mexican-American participants in the Family Investigation of Nephropathy and Diabetes (FIND) study using the Contextual Assessment Approach Questionnaire (CAA-Q). A total of 105 (43%) DN probands and 141 (57%) first-degree relatives were enrolled. Subjects averaged 56 years of age (range: 33–76; SD: 9.04); 62% were females. Data analysis included both qualitative and quantitative methods using Atlas.ti and SPSS 9.0 software packages.
Results. Eighty-three percent of subjects recognized that type 2 diabetes clusters in their family, while 63% asserted that DN did not. Fifty-three percent of diabetic relatives presented with a high urinary albumin/creatinine ratio (≥0.03) and were unaware of having DN (P ≤0.05). All subjects viewed DN as a component of type 2 diabetes and not a separate disease entity. More than 80% of the subjects considered ethnicity but not age of onset or sex as risk factors for developing type 2 diabetes or DN.
Conclusion. Participants viewed type 2 diabetes and DN in the context of health behaviors related to their everyday activities. They considered DN to be part of diabetes with no direct genetic predisposition and not a separate entity. Diabetic relatives under-estimated their risks for developing DN and were not engaged in preventive measures to reduce these risks. We recommend that health professionals consider these findings when interacting with high-risk diabetic patients. DN is a serious complication of diabetes that requires special care, education, prevention, and management.
Footnotes
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Nedal H. Arar, PhD, is an assistant professor; Rosemarie Plaetke, PhD, is an assistant professor; Valeria Sartorio is research associate; and Hanna E. Abboud, MD, is a professor in the Department of Medicine/ Nephrology at the University of Texas Health Science Center in San Antonio, Texas. Helen P. Hazuda, PhD, is a professor in the Department of Medicine/Epidemiology, and Mazen Y. Arar, MD, is an associate in the Department of Medicine/Pediatrics at the same institution.
- American Diabetes Association
