**7. Host genetics**

Genetics can affect many areas of human physiology that can affect the progression of diabetic foot ulcers. There are genes that can affect not just obesity but also diabetes. As many as 20 different genes have been associated with type I diabetes [100]. It is usually an autoimmune disease passed on from parents to offspring. However, there is a greater chance of parents having children who also have Type 1 Diabetes however there is no evidence that it's not simply due to similar diets and living conditions since they are likely to live all in the same place. For type two diabetic patients the atypical types have been directly linked to mutations in certain genes but that only accounts for a small percentage of diabetic patients. MODY type diabetes is all the result of a single mutation causing a lack of glycemic control [12]. Nevertheless, some investigators believe that genes only predispose an individual to obesity and do not guarantee the condition and that environment plays just as important a role in diabetes/obesity phenotype. Now, there is also evidence that *Firmicute* family *Christensenellaceae* increased in numbers in lean non-diabetic individuals and is directly associated with the host genome [101]. It was demonstrated that in identical twins, the microbiota was more similar than twins that were not identical [102] which suggests genetics has an important role in determining correct balance of microbiota and therefore maintenance of energy balance, proper weight, and glycemic control.
