Using Gene Tests to Pinpoint Risk of Type 2 Diabetes Complications

With commentary by study researcher Joel Dudley, PhD, director of Biomedical Informatics at Mount Sinai in New York City.

People with type 2 diabetes face higher risks for a laundry list of serious health concerns ranging from heart attacks, strokes1 and cancer2,3 to dementia4 , Parkinson’s disease5 and damage to the eyes6 and kidneys.7 But not everyone with high blood sugar problems develops the same complications and conditions.

genetic testingNow, a recent study from Mount Sinai Medical Center in New York suggests genes help determine the risk – and that someday, a gene test could help you and your doctor pinpoint personal risks before trouble happens.

Researchers used “Big Data,” analyzing electronic medical records and genetic information from more than 11,200 people including 2,551 with type 2 diabetes. They found that study volunteers fell into three groups. One had high risk for kidney damage and vision problems; they were the most likely to be obese; a second group had the highest odds for tuberculosis and cancer while a third group was more likely to develop neurological diseases, allergies, high blood pressure and blood clots (they were also more likely to be HIV positive). People in groups two and three also had the highest risk for cardiovascular disease.

Scientists then looked at their genes, finding variants in hundreds common to each group – but that were not widely shared by the others. “These findings suggest that some of the clinical differences observed between the different type 2 diabetes subtypes are rooted in lifestyle or environment, and others may be influenced by inherited factors,” according to a report from the National Institutes of Health , which funded the study. The research was published the journal Science Translational Medicine.

"This project demonstrates the very real promise of precision medicine to improve healthcare by tailoring diagnosis and treatment to each patient, as well as by learning from each patient," noted researcher Joel Dudley, PhD, director of Biomedical Informatics at Mount Sinai in New York City. 

OnTrack Diabetes Medical Advisory Board Member Caroline Apovian MD, FACP, FACN, professor of medicine and pediatrics in the section of endocrinology, diabetes, and nutrition at Boston University School of Medicine, who was not involved in the study, says research like this could one day help people with type 2 diabetes understand their unique health risks and take steps to protect their health sooner. “This is an area of research which is important,” she says. “We need to know beforehand who will develop certain diseases and certain kinds of complications so we can target surveillance and preventive treatment towards them. It can lead to more personalized care.”

Dr. Apovian adds that the techniques deployed in the study might also answer a bigger question about diabetes: Why obesity raises risk for blood sugar problems in some people, but not in everyone. About 80% of people with type 2 are overweight or obese. But while obesity boosts odds for diabetes seven times higher than it is for people at a healthy weight, not everyone with obesity develops it. “Who is predisposed to type 2? Why do some people with excess fat tissue develop it and others don't? That’s the main question,” she says.

Updated on: August 8, 2017
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