Researchers at University of Exeter have developed a new test to help diagnoses diabetes, which they say will lead to more effective diagnosis and patient care.
Research published in the journal Diabetes Care, shows how a genetic test can help doctors to differentiate between type 1 and type 2 diabetes in young adults.
With rising obesity levels it is sometimes difficult for doctors to distinguish between type 1 diabetes, which requires treatment with insulin injections and type 2 diabetes, which can be controlled through diet and weight loss. The Exeter team has devised a genetic risk score which can help identify people between 20 and 40 who will require insulin treatment.
"This will be an important addition to correctly classifying individuals with diabetes and will improve the number of people who get the right treatment when they are first diagnosed, especially people who sit in the overlap between type 1 and type 2 diagnosis," said Dr Richard Oram, National Institute for Health Research Clinical Lecturer and specialist in Diabetes and Nephrology at the University of Exeter Medical School.
"There is often no going back once insulin treatment starts. This may save people with Type 2 diabetes from being treated with insulin unnecessarily, but also stop the rare but serious occurrence of people with Type 1 being initially treated with tablets inappropriately and running of the risk of severe illness."
In work supported by NIHR and the Wellcome Trust, the Exeter researchers devised a test which measures 30 genetic variants in DNA and combines all the risks associated with them in a single score, which can then act as a summary of genetic risk for type 1 diabetes. If a person's score is high they are likely to have type 1 diabetes, if it is low then it will be type 2.
The researchers believe this will provide important additional information for doctors when making a diagnosis and suggest that the test can be used in addition to an existing commonly used test which measures anti-bodies.
Dr Oram says it will also benefit patients understanding and attitude towards their condition. "Having this information about their diabetes and about their genetic risk will make a big difference to the way people feel about their care. If you speak to people with diabetes they often want to know why they have developed the disease and whether some of their risk for the disease is genetic."
The Exeter team is now working to develop a test that any clinical laboratory could run cheaply and quickly.
The University of Exeter is one of the world's leading centres in genome-wide association studies. This latest development has demonstrates how scientific understanding in this area can be translated into improved clinical care.
Dr Mike Weedon, of the University of Exeter Medical School, said: "We think this is a really good example of taking results from large-scale genetic studies and translating them into clinical practice and improved patient care."
About the University of Exeter Medical School
The University of Exeter Medical School is improving the health of the South West and beyond, through the development of high quality graduates and world-leading research that has international impact.
As part of a Russell Group university, we combine this world-class research with very high levels of student satisfaction. The University of Exeter Medical School's Medicine programme is ranked 11th in the Guardian University Guide 2016. Exeter has over 19,000 students and is one of the global top 100 universities according to the Times Higher Education World University Rankings 2015-16, positioned 93rd. Exeter is also ranked 7th in The Times and The Sunday Times Good University Guide 2016, 9th in the Guardian University Guide 2016 and 10th in The Complete University Guide 2016. In the 2014 Research Excellence Framework (REF), the University ranked 16th nationally, with 98% of its research rated as being of international quality. Exeter's Clinical Medicine research was ranked 3rd in the country, based on research outputs that were rated world-leading. Public Health, Health Services and Primary Care research also ranked in the top ten, in joint 9th for research outputs rated world-leading or internationally excellent. Exeter was named The Times and The Sunday Times Sports University of the Year 2015-16, in recognition of excellence in performance, education and research. Exeter was The Sunday Times University of the Year 2012-13.
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (http://www.
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