A new genetic tool could pave the way for better diagnosis and treatment of diabetes among Indians, shows a study conducted by the CSIR-Centre for Cellular & Molecular Biology (CCMB), Hyderabad.
A new publication by researchers at the KEM Hospital, Pune, CSIR-CCMB, 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. The score may be used at the time of diabetes diagnosis to help decide if someone has type 1 diabetes.
The authors found nine genetic areas (called the 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 G.R. Chandak, the Chief Scientist leading the study at the CSIR-CCMB.
"Since more than 20 per cent of people with type 1 diabetes below the age of 15 years of age are in India, developing a genetic test kit to reliably detect type 1 from type 2 diabetes holds a lot of significance for the country," said Rakesh K. Mishra, Director at CSIR-CCMB.
Until recently, it was widely believed that type 1 diabetes appeared in children and adolescents, and type 2 diabetes in obese and older people (typically after 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 the two types of diabetes has become more complex. The two types follow different treatment regime with type 1 diabetes needing lifelong insulin injection but type 2 diabetes are often managed with proper diet or tablet treatment.
In a paper published in Scientific Reports, researchers have analysed whether the European risk score is effective in diagnosing type 1 diabetes in Indians.
The team studied people with diabetes from Pune. It analysed 262 people with type 1 diabetes, 352 people with type 2 diabetes, and 334 people without diabetes. All were of Indian (Indo-European) ancestry.
The outcomes from the Indian populations were compared to those of Europeans from the Wellcome Trust Case Control Consortium study.
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.
Authors also found genetic differences between the populations which mean the test could be further improved to enhance outcomes for Indian populations.
"Diagnosing the right diabetes type is an increasingly difficult challenge for clinicians, as we now know that 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, and can help get people on the treatment they need to avoid life threatening complications such as diabetic ketoacidosis and to achieve the best th outcomes," said Richard Oram of the University of Exeter Medical School.
"We look forward to using this test in diabetic patients from different parts of India where the physical characteristics of diabetic patients differ from the standard description," said Chittaranjan Yajnik of the KEM Hospital & Research Centre.
