Hello, I'm Andrew Hattersley from the University of Exeter.
What I'd like to do is to talk about how in
diabetes genetics has really made a dramatic difference for treatment,
and really to show how genetic technology and
genetic techniques have changed
treatment for a considerable number of people with diabetes.
I think for many diabetologists,
the idea that a genetic sequencer should be involved in the decisions about
what treatment a patient should have would seem ridiculous and far-fetched.
Indeed, if we think about treatment in diabetes in general,
many people would say that actually the approach that
most diabetes consultants take is a very simple one.
But it's basically the more severe the blood glucose,
the more treatment we give.
At one extreme, we're treating with diet and exercise,
and at the others we're treating with insulin.
But the key thing about this approach is it is all based on how
high the blood glucose is and not what is the cause of the blood glucose.
The big question is whether actually we can
start to make diabetes treatment be based on the cause.
Graeme Bell in 1998 said that he thought that one day physicians would be able to tailor
their treatment of diabetes depending on
the nature of the underlying molecular defect or defects.
Really, if you want to do that,
the place to do it is in monogenic diabetes,
where a single gene mutation results in the person having diabetes.
Because what that means is that if you can find that mutation,
you can make a diagnosis.
But crucially, you can then define
the etiology of what's wrong with the insulin produced in Beta cell.
I think the big question is whether this can
actually then be used to define the treatment response.