Changing lives: stratified medicine in monogenic diabetes

Published on January 19, 2015   41 min

Other Talks in the Series: Molecular Genetics of Human Disease

0:00
Hello. 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.
0:22
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.
0:35
Indeed, if we think about treatment in diabetes in general, many people would say that, actually, the approach that most that diabetes consultants take is a very simple one. But it's basically the more severe the blood glucose, the more treatment we give. And so at one extreme we're treating with diet and exercise, then 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.
1:09
So the big question is whether, actually, we can start to make diabetes treatment be based on the cause. And Graham 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. And 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 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-producing beta cell. I think the big question is whether this can actually then be used to define the treatment response.
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Changing lives: stratified medicine in monogenic diabetes

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