A new way of using genetics to diagnose diabetes could pave the way for better diagnosis and treatment as features of diabetes among Indians might vary from standard Western textbooks.
Until recently, it was widely believed that Type 1 diabetes appeared in children and adolescents, and Type 2 in obese and older people, typically over 45 years of age.
However, recent findings have shown that Type 1 diabetes can occur later in life, while Type 2 diabetes is on the rise among younger and thinner Indians. Distinguishing between these two types of diabetes has, therefore, become more complex. The two types follow different treatment regime with Type 1 diabetes needing lifelong insulin injections but Type 2 diabetes often being managed with diet or tablet treatment. Misclassification of the type of diabetes may lead to complications.
A new publication conducted by researchers at KEM Hospital, Pune; CSIR-Centre for Cellular and Molecular Biology (CCMB), Hyderabad and the University of Exeter in the UK shows that a genetic risk score is effective in diagnosing Type 1 diabetes in Indians. The genetic risk score, developed by the University of Exeter, considers detailed genetic information known to increase the chance of developing Type 1 diabetes at the diagnosis.
So far, most research in this field was conducted among European populations. Now, in a paper published in Scientific Reports, researchers have analysed whether the European risk score is effective in diagnosing Type 1 diabetes in Indians too. For this, the team studied 262 people from Pune with Type 1 diabetes, 352 people with Type 2 diabetes, and 334 people without diabetes.
The research found that the test is effective in diagnosing the right type of diabetes in Indians, even in its current form, which is based on European data, yet the test could be further improved to enhance outcomes for Indians due to the genetic differences.
“Diagnosing the right diabetes type is an increasingly difficult challenge as Type 1 diabetes can occur at any age. This task is even harder in India, as more cases of Type 2 diabetes occur in people with low BMI. We now know that our genetic risk score is an effective tool for Indians to help get people get the right treatment avoiding life threatening complications like diabetic ketoacidosis,” said University of Exeter Medical School’s Richard Oram.
KEM Hospital & Research Centre’s Chittaranjan Yajnik agreed: “Escalating epidemic of diabetes in young Indians makes it imperative that we diagnose the type of diabetes correctly to avoid mistreatment. The new genetic tool will be a great help in this as physical characteristics of diabetic patients differ from the standard description”.
The authors found nine genetic areas or ‘SNPs’ that correlate with type 1 diabetes both in Indian and European populations, and can be used to predict the onset of Type 1 diabetes in Indians. “It’s interesting to note that different SNPs are more abundant among Indian and European patients. This opens up the possibility that environmental factors might be interacting with these SNPs to cause the disease,” said CSIR-CCMB chief scientist G.R. Chandok.
