Published online Sep 15, 2018. doi: 10.4239/wjd.v9.i9.157
Peer-review started: March 22, 2018
First decision: May 16, 2018
Revised: June 6, 2018
Accepted: July 10, 2018
Article in press: July 10, 2018
Published online: September 15, 2018
Processing time: 176 Days and 6.3 Hours
In a high percentage of patients, clinical presentation alone does not define the type of diabetes. This is very important, since it hinders implementation of an individualized and safe treatment. The current classification system of diabetes is useful and easy for typical patients. However, there are many situations in which it is difficult to determine what type of diabetes is presenting due to the great heterogeneity in the pathogenesis. The current classification of diabetes is not satisfactory and its revision has been under consideration for many years. Previous studies carried out in the Uruguayan population have demonstrated the existence of patients for who it is not possible to classify into any of the categories provided in the international guidelines. We continue to investigate this type of patient because it is very important to assist them appropriately and improve their quality of life. In this way, it is possible to abolish the trial stage and error that patients suffer from when not being correctly diagnosed. At this time, different researchers have proposed that the classifications of diabetes should be revised, and this is the principal objective of our work. We have emphatically proposed the inclusion of genetics determination for HLA to elucidate atypical diabetes patients. Such an approach and related data will permit correct classification and treatment for these kinds of patients.
To date, we have investigated genes related to type 1 diabetes in patients with atypical diabetes. In this study, we sought to analyze the major gene related to type 2 diabetes, the TCF7L2 gene, in the atypical diabetes patients.
To analyze the association of the two most important single nucleotide polymorphisms (SNPs) of the TCF7L2 gene-rs12255372 and rs7903146-with atypical diabetes.
This case-control study was conducted in atypical and classical cases of type 2 diabetes using genotypification with TaqMan probes for the rs12255372 and rs7903146SNPs of the TCF7L2 gene.
The SNPs of the TCF7L2 gene that were analyzed in this work showed no association with atypical diabetes; nevertheless, the rs12255372 SNP was associated with classical diabetes.
As has been shown in previous studies, the genetics of atypical diabetes are different from those of classical diabetes, despite a shared phenotype.
To continue the characterization of the atypical diabetes subpopulation it will be important to obtain measurements of C-peptide in these patients and to study if there is any difference for this marker between the populations classified.