Precision medicine is at risk for the “rich” and Caucasians

There are different subtypes within diabetes, which in the future may be defined based on the genetics and physiology that lead to the development of the disease. This knowledge can help doctors develop more personalized treatments that target the root cause of a disease rather than just treating symptoms.

However, this promising personalized approach risks becoming in some ways discriminatory and classist, as pointed out by Prof. Josep Maria Mercader in XXXV Congress of the Spanish Diabetic Society.

Most genetic studies have been conducted, especially in populations of European ancestry. “Databases used to develop diagnostic and precision tools are biased and have lower accuracy in non-European populations,” points out an expert from Broad Institute of Massachusetts Institute of Technology (MIT) and Harvard

and researcher at the Faculty of Medicine Harvard and from Massachusetts General Hospital.

For Dealer“There is an urgent need to expand genetic research to include diverse populations in all areas, including the discovery of genetic susceptibility factors, identification of mutations associated with monogenic diabetes, and even pharmacogenetic studies.” In this context, the expert stated that “if this goal is not achieved, we risk that this medicine will become a medicine only for the rich and Caucasians.”

Explore the genetics of diabetes in different populations.

Investigation Dr. Jose Maria Mercader focuses on genetic variations in type 2 diabetes and related processes and their application to clinical practice.

At his conference, the specialist detailed how genetics is now used to better understand diabetes, predict risk and complications, and also showed how these advances in genetic knowledge can help diagnose different subtypes of monogenic diabetes or prescribe more appropriate treatment.

In this sense, studying the genetics of diabetes in different populations may be crucial. “Especially at the ancestral level (genetic variability of human populations in different geographical regions and throughout the genealogical history of their population,” he elaborates. Dealer. The goal is to be able to use precision medicine equitably, regardless of the background or background of patients.

Important contributions

Precision medicine is already a reality for some subtypes of monogenic diabetes. For example, it is already known that patients with neonatal diabetes caused by mutations in potassium channels, respond adequately to sulfonylureas. On the other hand, it has also been observed that some types of monogenic diabetesMODY (caused by mutations in the HNF1A and HNF4A genes) respond better to treatment with sulfonylureas.

In addition, patients with diabetes caused by mutations in the GCK gene They have mild hyperglycemia but do not require treatment because this type of diabetes does not cause long-term diabetic complications.

While these results represent a big step forward, the truth is that these types of diabetes account for only 0.4% of all diabetes cases. Thus, “there is still a lot to be done, mainly in relation to the types of polygenic diabetes that affect the majority of patients,” he concludes.

We will continue to inform…