Thread by @DUK_research

Really looking forward to this one: precision medicine. It’s all about tailoring treatments for the individual and moving away from a one size fits all approach. #dukpc

.@markmccarthyoxf explains precision medicine could help us answers questions like:
Who is at greatest risk of #diabetes?
Who will respond best to different treatments?
Who will progress quickly or slowly?
#dukpc

Looking at people’s genetic information can help us spot who is at highest risk of #Type2diabetes. There are lots of outstanding questions about these genetic risk scores, but the future potential is exciting. #dukpc

.@markmccarthyoxf raises the subtypes of #Type2diabetes question. Research published last year argued there were 5 distinct subgroups. But we don’t yet know if these clusters would have any use in practice. #dukpc

Lovely paint palette analogy 🎨
Prof McCarthy tells us there’s no single cause someone’s #Type2diabetes. Rather risk is a mix of different colours. #dukpc

Genetics can explain about 40% of our risk for #Type2diabetes. So it’s really important, but Prof McCarthy reminds us it’s not the whole story. For true personalisation we need to combine genetics with environmental and clinical information. #dukpc

Next up is Prof Ewan Pearson. He begins by shining a light on the success of personalised approaches in rare monogenic types of #diabetes. We heard from Prof @MaggieShepher13 this morning about how genetics can influence diagnosis and treatment, and improves lives. #dukpc

So we’re doing well in monogenic #diabetes. We need to catch up in #Type2diabetes. #dukpc

Prof @ezpearson describes how we’re learning about how our genes can influence how well treatments work by looking at responses to metformin in people with #Type2diabetes #dukpc

He’s shown that based on your genes, you need smaller or bigger doses of metformin to do the exact same job. #dukpc

But we don’t yet have a way to easily and cheaply read everyone’s genetic information. Once this becomes part of routine health care, precision medicine in #diabetes will really take off. #dukpc

Prof Max Nieuwdrop presents another possibility for the future of precision medicine: fecal transplants 😯
In people who can’t properly use the insulin they make, a fecal transplant from a donor who has high insulin sensitivity can help #DUKPC

Looking at the specific gut bacteria people have was found to help predict who would and wouldn’t respond well to fecal transplants. #dukpc

Rounding off the session is Prof @athattersley. He illustrates that simple clinical characteristics, like age and gender, can be enough to start to tailor #diabetes treatments and predict responses. #dukpc

So at its most simple level we can make use of precision medicine now. It’s already a reality. But to make it better, and make sure people with #diabetes benefit as much as possible, we need to combine all the factors we’ve heard about this afternoon. #dukpc