Figure 1. Interplay between genes and environmental/behavioral factors in the development of type 2 diabetes and related vascular complications.

Variability in diabetes and obesity-related genes predispose to type 2 diabetes (T2D) and diabetic vascular complications such as coronary artery disease (CAD), diabetic nephropathy (DN), and diabetic retinopathy (DR). Behavioral (e.g., sedentary lifestyle, high-fat diet) and environmental factors (e.g., organic pesticides, chemical exposures, and air pollutants) have complementary effects on the development of type 2 diabetes. Additional genes are associated with CAD and body mass index (BMI) in the general population, without demonstrable effects on the risk of T2D.