People with Type 2 diabetes who have variants of a certain gene respond better to the diabetes drugs known as sulphonylureas, and are over three times more likely to achieve good blood glucose level targets than people without the variants who take those drugs. This is the finding of new research funded by Diabetes UK.
The results of this observational study mean that people with Type 2 diabetes who have the gene variants and are taking sulphonylureas may be less likely to develop diabetes complications, such as heart disease, kidney disease and stroke.
The research, carried out at the Biomedical Research Institute at the University of Dundee, looked at 1,073 people with Type 2 diabetes who had been treated with sulphonylureas for up to 18 months.
The study found that the six people in every 100 people with two variants of the gene CYP2C9 were 3.4 times more likely to achieve their blood glucose target of less than 7 per cent, compared to people who did not have those variants.
Determining new treatments
“This research is important because it demonstrates the effect that genetic variations could have in determining treatments for people with Type 2 diabetes," said Dr Iain Frame, Director of Research at Diabetes UK.
“The CYP2C9 gene produces an enzyme which breaks down sulphonylureas in the liver. In people with variations in this gene the enzyme is less active, which could explain their improved response to sulphonylureas.
“This study adds to the pharmacogenetic field of research which may in time lead to better tailored prescriptions for people with Type 2 diabetes so that treatment is optimised in light of a person’s genetic make-up. This could in turn eventually lead to a reduction in the amount of money that is spent on ineffective diabetes drug treatments by the NHS.”
There are 2.25 million people with Type 2 diabetes in the UK and approximately 550,000 of them will take a sulphonylurea as a treatment.
Dr Ewan Pearson, who led the study by the Diabetes Research Group, said: “Variants in the CYP2C9 gene have been known to effect blood levels of the sulphonylurea drugs for many years, but this is the first time that anyone has shown that this impacts on response to diabetes drugs.
"This is the first study to show such a large effect of an individual’s genes on response to diabetes drugs used in Type 2 diabetes, and is a significant step on the path towards being able to use genetics to personalise medicine for those with Type 2 diabetes.”