Tailored treatment for diabetics

16 October 2003

Professor Andrew Hattersley and Dr Ewan Pearson, and colleagues at the Peninsula Medical School, Exeter, have discovered that the genetic make-up of patients with type 2 (adult-onset) diabetes affects their sensitivity to drug treatments. The findings could lead to more tailored treatments for people with type 2 diabetes, and could be one of the first examples of a pharmacogenomic approach to medicine.

At present, people with type 2 (non-insulin-dependent) diabetes are typically treated with a variety of drugs that help to control blood sugar levels - most commonly the sulphonylureas. Type 2 diabetes is a poorly defined and variable condition, and guidelines for treatment assume that all patients respond similarly to treatment.

However, the Exeter group's findings suggest that this is not the case. The researchers assessed blood sugar responses to a sulphonylurea and metmorphin in patients with a specific form of diabetes caused by mutations in the HNF-1a gene and in other patients who had diabetes with no defined cause. Patients with HNF-1a diabetes were much more sensitive to sulphonylureas - they showed a fourfold greater response to sulphonylureas and therefore needed a much lower drug dose.

As the genetic basis of type 2 diabetes is untangled, it is likely that further different forms of the disease will be identified, each with a particular pattern of responses to diabetes drugs. If so, drug doses could then be refined according to a patient's genetic background.

The study was published in the Lancet (Vol. 362: 1275-80).

See also

• Trial leads to genetically tailored diabetes treatments for first time(Press release: 16 October 2003)

External links

• Professor Andrew Hattersley at the University of Exeter: Research interests
• Dr Ewan Pearson at the University of Exeter: Research interests
• The Lancet