All ETDs from UAB

Advisory Committee Chair

Jose R Fernandez

Advisory Committee Members

Brenda Bertrand

Paula Chandler-Laney

Anna C E Hurst

Fernando Ovalle

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


The prevalence of type 2 diabetes is increasing at an alarming rate in both children and adults worldwide. Timely identification of those at risk for type 2 diabetes is essential to reduce morbidity and mortality and to mitigate the toll on families and the healthcare system. Family history is an effective, universal tool that can be used to identify individuals at risk for type 2 diabetes before they acquire additional risk factors. Understanding how family history contributes to biomarkers associated with diabetes in healthy individuals could facilitate the creation of early screening and prevention strategies designed for this specific at-risk population. In addition, educational interventions with an accurate portrayal of the genetic and environmental contributions to type 2 diabetes could increase knowledge of diabetes development and motivation to engage in healthy lifestyle behaviors to prevent the diagnosis or progression of the disease. We utilized multiple regression models to investigate whether family history is a predictor of insulin and glucose biomarkers for type 2 diabetes after adjusting for relevant covariates in healthy weight children and adults. We also created and tested a genetics-focused educational intervention designed to increase knowledge of the multifactorial etiology of type 2 diabetes and motivation to engage in healthy lifestyle behaviors. Our multiple regression model found that family history was a significant predictor of fasting insulin in children (p=0.0372) in addition to waist circumference, sex, and grams of iv carbohydrate. In adults, family history was a significant predictor of fasting glucose (p=0.0193) in addition to age, gender, non-Hispanic Black ethnicity, waist circumference, and fat intake. The educational intervention increased knowledge of type 2 diabetes (p<0.0001) and motivation to engage in healthy lifestyle behaviors (p<0.0001). The findings from the multiple regression analyses contribute to the conflicting literature on how family history of diabetes affects diabetes development. Despite the limitations in understating the exact contributions of family history at a biomarker level, knowledge that type 2 diabetes is a multifactorial condition with both genetic and environmental influences can have positive effects on motivation to engage in lifestyle behaviors that reduce the risk for diabetes diagnosis and complications.



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