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Paul Franks

Paul Franks

Principal investigator

Paul Franks

Monogenic diabetes : From genetic insights to population-based precision in care. reflections from a diabetes care editors’ expert forum

Author

  • Matthew C. Riddle
  • Louis H. Philipson
  • Stephen S. Rich
  • Annelie Carlsson
  • Paul W. Franks
  • Siri Atma W. Greeley
  • John J. Nolan
  • Ewan R. Pearson
  • Philip S. Zeitler
  • Andrew T. Hattersley

Summary, in English

Individualization of therapy based on a person’s specific type of diabetes is one key element of a “precision medicine” approach to diabetes care. However, applying such an approach remains difficult because of barriers such as disease heterogeneity, difficulties in accurately diagnosing different types of diabetes, multiple genetic influences, incomplete understanding of pathophysiology, limitations of current therapies, and environmental, social, and psychological factors. Monogenic diabetes, for which single gene mutations are causal, is the category most suited to a precision approach. The pathophysiological mechanisms of monogenic diabetes are understood better than those of any other form of diabetes. Thus, this category offers the advantage of accurate diagnosis of nonoverlapping etiological subgroups for which specific interventions can be applied. Although representing a small proportion of all diabetes cases, monogenic forms present an opportunity to demonstrate the feasibility of precision medicine strategies. In June 2019, the editors of Diabetes Care convened a panel of experts to discuss this opportunity. This article summarizes the major themes that arose at that forum. It presents an overview of the common causes of monogenic diabetes, describes some challenges in identifying and treating these disorders, and reports experience with various approaches to screening, diagnosis, and management. This article complements a larger American Diabetes Association effort supporting implementation of precision medicine for monogenic diabetes, which could serve as a platform for a broader initiative to apply more precise tactics to treating the more common forms of diabetes.

Department/s

  • PediatricCeliaki/Diabetes
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • Genetic and Molecular Epidemiology
  • EpiHealth: Epidemiology for Health

Publishing year

2020

Language

English

Pages

3117-3128

Publication/Series

Diabetes Care

Volume

43

Issue

12

Document type

Journal article

Publisher

American Diabetes Association

Topic

  • Endocrinology and Diabetes

Status

Published

Research group

  • PediatricCeliaki/Diabetes
  • Genetic and Molecular Epidemiology

ISBN/ISSN/Other

  • ISSN: 0149-5992