NOVEL research from Queen Mary University of London, UK, has revealed that genetic predispositions to lower insulin production and unhealthy fat distribution are major factors behind the early onset of Type 2 diabetes (T2D) in British Asians. These genetic traits also lead to faster progression of complications, earlier need for insulin treatment, and reduced effectiveness of some medications.
The findings, based on data from the Genes & Health cohort, emphasise the importance of understanding genetic variation across different populations to tailor disease prevention and treatment strategies. The study involved over 60,000 British-Bangladeshi and British-Pakistani volunteers who generously contributed their DNA for genetic research. Health records from 9,771 individuals with T2D and 34,073 diabetes-free controls were analysed to identify why South Asians often develop diabetes at a younger age and with a lower body mass index compared to White Europeans.
Using advanced genetic analysis, researchers pinpointed specific genetic signatures linked to T2D in South Asians. These included reduced pancreatic beta cell function, which limits insulin production, and patterns of fat distribution that elevate obesity-related risks. One significant genetic signature also increased the likelihood of gestational diabetes and its progression to T2D.
The study also highlighted the need for personalised treatments. Those with a genetic predisposition to lower insulin production responded poorly to common medications like sodium-glucose co-transporter 2 inhibitors and were more likely to require insulin therapy.
“This work shows how essential it is to move beyond a ‘one-size-fits-all’ approach to managing T2D. Understanding these genetic factors could help deliver precise treatments, improving effectiveness and reducing complications,” commented the team. The researchers noted the importance of extending the use of simple tests like C-peptide in precision diabetes care for South Asian populations.
This study, a significant contribution to the underrepresented genetic studies of South Asians, continues to advance healthcare outcomes for these communities, promising a future of more tailored and effective treatments.
Victoria Antoniou, EMJ
Reference
Hodgson S et al. Genetic basis of early onset and progression of type 2 diabetes in South Asians. Nat Med. 2024;DOI:10.1038/s41591-024-03317-8.
