The study, conducted by researchers from the Brigham and Women's Hospital in Boston, USA, is published December 19 in the open-access journal PLoS Genetics .

Diabetes is a leading cause of morbidity and mortality in both the developed and developing world. Because the main metabolic characteristic of diabetes is increased blood glucose concentration, the researchers sought to uncover the genetic determinants of glycated hemoglobin. Lead author Guillaume Par?© and his team analyzed glycated hemoglobin concentration in a subset of 14,618 women from the Women's Genome Health Study, a large-scale study seeking to identify patterns of genetic variations that predict future disease states in otherwise healthy American women.

Using new technologies to study genetic variation on a whole genome basis, the group found that variations at the hexokinase-1 gene are an important determinant of glycated hemoglobin concentrations. Hexokinase-1 encodes the enzyme hexokinase, responsible for the first metabolic step in glucose utilization and a likely candidate for the control of glucose metabolism.

While further work will be needed to fully understand the metabolic role of these genetic variants, it is hoped that this discovery could lead to a better understanding of the mechanisms underlying diabetes and its complications.

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Those at increased risk of developing the infection are people with a weakened immune system or chronic health problems such as diabetes, cancer, or liver or kidney disease.

Also at risk are those with surgical wounds from operations such as an episiotomy or a hernia repair, or with recent chickenpox or other viral infections that cause a rash - steroid medicines too can lower the body's resistance to infection.

The most common cause is infection by the bacteria which cause infections such as 'strep throat' and impetigo and while the infections caused by these bacteria are mild, in rare cases the bacteria produce toxins that can damage the soft tissue below the skin and cause a more dangerous infection that can spread quickly along the tissue covering the muscle - the bacteria also can travel through the blood to the lungs and other organs.

The disease also may be caused if wounds are exposed to ocean water or contact raw saltwater fish or oysters and from handling sea animals such as crabs - these infections are more common in people who have chronic liver diseases such as cirrhosis.

A break in the skin allows bacteria to infect the soft tissue, in some cases, infection can also occur at the site of a muscle strain or bruise, even if there is no break in the skin.

It may not always be obvious where the infection started, because the bacteria may travel through the bloodstream to other parts of the body.