Pharmacogenomics in Diabetes Mellitus: Pathway to Personalized Medicine

Author Name(s): *Karuna Sree P, Mrs Haritha Yadav K C, Venkat Rao Y
Author Email: drpkarunasri@gmail.com

Abstract

Diabetes, growing global health burden is a Multifactorial, heterogeneous group of disorders characterized by deficiency or failure in maintaining normal glucose homeostasis. The prevalence of Diabetes is rising across the globe at an alarming rate with India and china facing the greatest challenges with worsening trend affecting younger age groups. Diabetes and its complications not only increase morbidity and mortality rates but also have impact on the nation’s economy and an urgent need for prevention and control of diabetes. Even though many drugs are available to maintain the normal glycaemic levels, many individuals are seen who does not respond to the therapy. In this scenario, personalized medicine for diabetes (PMFD) has come into light which makes the use of information about the genetic makeup of a person with diabetes to modify strategies for preventing, detecting, treating, or monitoring their diabetes. Many genetic variants (monogenic / polygenic) were identified which are determinants of Type 1(polygenic) / Type 2 Diabetes mellitus (HNF4A, HNF1A,IRS1 etc.) / other specific types of diabetes (MODY, Neonatal (KCNJ11, ABCC8)) and genetic variants which are responsible for the sensitivity / failure (TCF7L2, NOS1AP, AMPK, SLC22A1,SLC22A2,SLC47A1 etc.) of the Anti Diabetic drug therapy. Understanding the basis of this heterogeneity helps in personalizing the methodology of prevention and treatment strategies according to individual patient clinical and molecular characteristics. By the implication of pharmacogenomics in Diabetes mellitus we can identify the individuals at risk and suggest suitable anti diabetic therapy thereby reducing the social and economic burden on the society.

Keywords

Diabetes Mellitus, Pharmacogenomics, Neonatal Diabetes, MODY, Anti Diabetic Drugs

Introduction

Diabetes mellitus: Diabetes is a growing global health burden, which is a Multifactorial, heterogeneous group of disorder characterized by a deficiency or failure in maintaining normal glucose homeostasis. An International expert committee under the sponsorship of American Diabetes Association (ADA) has classified diabetes mellitus into 4 types, i.e., Type1 (ß-cell destruction). Type2 (may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance), Gestational Diabetes and other Specific Types (Genetic / Diseases of Pancreas / Endocrinopathies/Drug or Chemical Induced / Infections / Immune Mediated).

 

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