Hjelt grant holder 2015, Lund university
A step towards customised treatment for type 2 diabetes
How we react to a medicine may depend on our genes. Petter Storm, a bioinformatician at Lund University Diabetes Centre, is searching for new markers that show which medicine is most suitable for individual patients.The overall objective of the research for which Petter Storm was granted EUR 50,000 by the Hjelt Foundation is to identify genetic markers that can be used to understand or explain responses to pharmaceutical treatment of type 2 diabetes.
“One response, for example, is the absence of any blood-sugar lowering effect of a medicine. Another might be adverse reactions,” says Petter Storm. There are currently around ten different pharmaceutical classes for diabetes with completely different mechanisms of action. The ability to use a simple test to decide which medicine will be most beneficial for a patient would save the patient a lot of suffering.
The most common medicine for type 2 diabetes, metformin, is one example. Nearly a quarter of patients suffer adverse reactions such as vomiting and diarrhoea. The group of sulphonylurea preparations are another example, where certain diabetics have an excellent response because they have mutations in a particular gene.
Doctors and patients currently have to work towards the right dose and the right medicine by trial and error.
“However, we believe that are genetic explanations for intolerance to a specific medicine,” says Petter Storm.
This would imply a completely new approach to prescribing diabetes medicines and is one of the objectives of customised treatment of diabetes for the research project ANDIS (Alla Nya diabetiker i Skåne – All New Diabetics in Skåne). ANDIS started in 2008 and monitors just over 10,000 people who have contracted diabetes in Skåne.
Analysing genetic material
In ANDIS, the researchers will now analyse the genetic material, the DNA, of all participants.
“We will also extract all the prescription data, i.e. information on the diabetes and diabetes-related medicines (for example for complications such as cardiovascular disease) they have been prescribed in the past five years,” says Petter Storm.
Using information on HbA1C (the long-term average blood sugar level) for each participant, the researchers can monitor the progression of the disease.
“By comparing those who have had adverse reactions with those who had none, and those who responded well to treatment with those who did not, we hope to be able to find genetic markers to explain the differences.”
Before the entire ANDIS puzzle has been completed, the ANDIS researchers also hope to find genetic markers for complications such as cardiovascular disease or damage to eyes, nerves and kidneys.
“As the participants in ANDIS will be monitored for a long period of time, they will gradually develop various complications. This will allow us to compare those who suffer a certain complication with those who do not,” says Petter Storm.
Markers that indicate the risk of developing a specific complication will allow preventive treatment to be started in good time.
“The great thing about ANDIS is that the longer it lasts, the more data we will collect, giving us an even better basis for future research,” says Petter Storm.