Individuals with Type 2 diabetes are insulin resistance,
which means that the body does not use insulin properly. Patients with type 2
diabetes can now be grouped into five clusters based on their genetic
variations to specify the treatment for each individual. In a recent study
performed at Massachusetts General Hospital, an endocrinologist named Jose
Florez and his associates discovered five clusters from known diabetes risk
loci and related traits. Jose Florez and his associates used soft clusters in
the study because they take into account the fact that one genetic variation
may impact more than one trait and it provides a more broad framework.
The five
clusters identified included two marked by mechanism of pancreatic beta cell
dysfunction and three by mechanisms of insulin resistance. The five clusters
were proinsulin, beta cell, obesity, lipodystrophy, and the liver/lipid
cluster. For example, the obesity cluster was associated with an increased BMI,
waist circumference, and body fat percentage and it included the obesity-linked
FTO and MC4R loci. The findings obtained
from the study was backed up by data from the US National Institutes of Health’s
Roadmap Epigenomics Project. The genetically determined clusters can help patients
with specific disease characteristics. The next step in the study is to
determine how the clusters can make a difference in the prognosis of diseases
and the response to treatments for affected individuals.
I found this article interesting because Type 2 diabetes accounts for between 90-95 percent of all diabetes cases in the US. According
to the Centers for Disease Control, 30.3 million Americans have diabetes. If the
study advances, individuals with type 2 diabetes will have a more specific
treatment plan based on which type of diabetes they fit in instead of having a
trial and error medication plan.

I think this is a very important area of research. So many diabetics have difficulty sticking to the diet or respond badly to their insulin regimen. I worked at a group home in the past, and we had a resident with diabetes who was constantly having her insulin routine changed in hopes of finding one that would keep her sugar down without dropping her too low. A more targeted approach could help so many people.
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