The many faces of diabetes: addressing heterogeneity of a complex disease


Comment by Rob Sladek, McGill Associate Professor in the Departments of Medicine and Human Genetics

Diabetes is a group of chronic metabolic disorders that share the common feature of hyperglycaemia, meaning that, in principle, diabetes can be diagnosed via measurement of a single blood component. However, elevations in blood glucose can be caused by a number of genetic and acquired factors that reduce the circulating concentrations of insulin or decrease its effectiveness, leading to heterogeneity in the clinical presentation and progression of the disease.1 Although existing classifications for diabetes provide archetypes based on reasonably pure pathogenetic mechanisms,2 an important goal of clinical and genetic research in adult-onset type 2 diabetes is to identify more refined subtypes to accurately predict clinical outcomes and identify targeted therapies that ameliorate them.

The Lancet Diabetes & Endocrinology