Each type 2 diabetes patient has their own physiological and genetic characteristics, although the treatment is basically the same for everyone. Doctors generally use the old method of trial and error until they find the therapy that works best for each patient, but that implies a lack of efficacy.
This ailment arises when the pancreas does not produce (or when the body does not use it correctly) insulin, a hormone that helps glucose to enter cells and provide them with energy. As a consequence, glucose accumulates in the blood and can cause serious problems in the eyes, kidneys, heart … Genetic inheritance, obesity and lack of exercise are triggers of the disease, but there are individual differences that would require a personalized treatment for each affected person.
The first step to achieving that precision medicine care could come from a study just published in PLoS Medicine by scientists at Massachusetts General Hospital and the Broad Institute at MIT and Harvard. Researchers have identified five differences in people’s DNA that appear to contribute to the development of the disease in unique ways.
This work could allow the identification of subtypes of type 2 diabetes, which would help doctors prescribe treatments aimed at the cause of the disease, and not its symptoms.
Fine-tuning the shot
Previous work has established subtypes of this disease based on variables such as insulin resistance (the body’s inability to use it well), body mass index or failures in the insulin-producing function of beta cells. But doing it from large-scale genetic analysis is more accurate, because genes are innate, while the variables mentioned above change over the years, often based on lifestyle.
The study authors found five types of genetic variants linked to different deficiencies that induce diabetes. For example, two of these variants cause beta cells to malfunction; the other three are related to insulin resistance: one of them has links with obesity, another with poor absorption of fat by the liver, and another with lipodystrophy (the incorrect distribution of fatty tissue throughout the body).
It was also observed that in almost a third of the patients, one of these five genetic variants predominated over the rest and caused the disease to develop in a particular way, which suggests that diabetes could be triggered predominantly from a single biological mechanism .
The results are consistent with clinical experience, because everyone affected by type 2 diabetes develops it in their own way. According to Jose Florez, one of the study authors, “the genetic variants that we have found seem to coincide with what we observe in hospitals. Now we have to determine if these differences in DNA translate into differences in the progression of the disease, the possible complications of this and the response to treatment ”.
If this were the case, precision medicine, based on the adaptation of medical treatment to the characteristics of each patient, would become a great weapon against type 2 diabetes.
