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Temporal changes and genetic susceptibility to type 2 diabetes (1984-2019; HUNT): a longitudinal, population-based
Vera Vik Bjarkø1, Brooke N Wolford2, Eirin B Haug2
1HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway; Department of Endocrinology, Clinic of Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
The Lancet. Diabetes & Endocrinology
|January 31, 2026
Summary
Societal changes are widening the gap in type 2 diabetes prevalence. Individuals with high genetic susceptibility are disproportionately affected, highlighting the need for public health interventions.
Area of Science:
- Epidemiology
- Genetics
- Public Health
Background:
- Global type 2 diabetes prevalence has nearly doubled from 1990 to 2020.
- Genetic susceptibility increases type 2 diabetes risk, but environmental factors may modify this.
- Societal changes may influence type 2 diabetes prevalence across genetic risk groups.
Purpose of the Study:
- Investigate how societal changes impact type 2 diabetes prevalence in individuals with varying genetic susceptibility.
- Examine the interaction between chronological time, genetic risk, and age on diabetes prevalence.
- Explore underlying mechanisms by analyzing diabetes incidence and mortality.
Main Methods:
- Longitudinal, population-based study using four HUNT study surveys (1984-2019).
- Included 86,194 participants aged 20-79 years; diabetes assessed via self-report and glucose/HbA1c.
- Utilized a polygenic score (PGS) for type 2 diabetes with >1.1 million variants to define genetic susceptibility.
Main Results:
- Diabetes prevalence increased significantly more in the top genetic susceptibility decile (9.1 pp) compared to the bottom (0.4 pp) from the mid-1980s to late 2010s.
- The disparity in diabetes prevalence between high and low genetic susceptibility groups widened over time across all age groups.
- Increasing diabetes incidence was observed in younger adults (20-39 years) with high genetic susceptibility.
Conclusions:
- An increasing gap in type 2 diabetes prevalence exists between genetically susceptible and less susceptible individuals.
- Highly genetically susceptible individuals may be more vulnerable to diabetogenic environments.
- Public health strategies are crucial to address the growing disparities in type 2 diabetes prevalence.
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