Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Diabetes is a leading cause of blindness, kidney failure, heart attacks, strokes, and amputations of the lower limbs.
According to data from the International Diabetes Federation, in 2021 a staggering 537 million adults (20-79 years old) worldwide were living with diabetes, and the global diabetic population is anticipated to rise to 643 million by 2030 and a remarkable 783 million by 2045.
Diabetes primarily presents in type 1 diabetes, type 2 diabetes, and gestational diabetes, which occurs during pregnancy, as well as genetically associated congenital diabetes.
Type 1 diabetes is believed to originate from an autoimmune response where the body mistakenly attacks itself, inhibiting the production of insulin. This form of diabetes, which accounts for roughly 5-10% of all diabetes cases, can be diagnosed at any stage of life, with symptoms often appearing rapidly. Individuals with type 1 diabetes must take insulin daily to live, and unfortunately, there are currently no known preventive measures for this type of diabetes.
In contrast, type 2 diabetes is characterized by the body's inefficient use of insulin, leading to difficulties in maintaining normal blood sugar levels. This form is prevalent in 90-95% of people with diabetes. It typically develops gradually over several years, primarily diagnosed in adults, although the number of children, teens, and young adults diagnosed is on the rise.
A study shows that in 2018, results involving a population from 184 countries estimated that imbalances in dietary intake contributed to 14.1 million new cases of type 2 diabetes, representing 70.3% of all new global cases. This was predominantly attributed to inadequate intake of whole grains, overconsumption of refined rice and wheat, and excessive consumption of processed meats.
The heritability of type 2 diabetes, as suggested by various studies involving populations, families, and twins, is estimated to be between 20% and 80%. If an individual has one parent with type 2 diabetes, the lifetime risk of developing the disease is around 40%. This risk significantly increases to 70% if both parents have type 2 diabetes.
Symptoms may not always be noticeable, making it crucial for those at risk to regularly test their blood sugar. Type 2 diabetes can often be prevented or delayed with healthy lifestyle modifications such as weight loss, healthy eating, and regular physical activity.
Gestational diabetes, on the other hand, is a condition where glucose metabolism is interrupted during pregnancy. While most women return to normal blood sugar levels 6-12 weeks after giving birth, gestational diabetes can have negative implications for both the mother and the baby.
For the mother, gestational diabetes can reduce her immunity, increasing susceptibility to infections. Metabolic disorders associated with gestational diabetes significantly escalate the risk of complications like hypoglycemia and diabetic ketoacidosis.
In terms of the fetus, gestational diabetes heightens the risk of macrosomia, which can lead to increased risks of difficult labor, surgical delivery, and birth injuries. Elevated blood sugar levels during pregnancy could potentially result in embryonic developmental issues or death, as well as a higher rate of fetal malformation.
Monogenic diabetes, specifically Maturity-Onset Diabetes of the Young (MODY), can develop in infants due to single-gene mutations. The occurrence of MODY results from a mutation in a single gene. If a parent carries this mutation, there is a 50% likelihood of their child inheriting it. In cases where the mutation is passed on, the child usually develops MODY before age 25, regardless of their weight, lifestyle, or ethnic background.
This kind of diabetes is often neglected despite its distinctiveness from both type 1 and type 2 diabetes. It is also strongly present in families. Presently, the management of MODY is reliant on medication and modifications to lifestyle.
Over two decades, BGI has been dedicated to researching diabetes and providing healthcare solutions for its prevention and treatment.
For those with a family history of diabetes, it becomes crucial to undergo genetic testing for monogenic diabetes. BGI provides a range of single-gene genetic disease tests for various systems or diseases, including monogenic diabetes. These tests encompass over 4,000 genes and can detect more than 5,000 diseases. The sequencing coverage exceeds 95%, ensuring an accuracy rate of 99%.
To aid diabetic patients in comprehending their drug compatibility, BGI has developed a test that helps determine the appropriate drugs and their dosages for patients, and it can predict potential adverse drug reactions.
These services are designed to make genetic testing for diabetes widely accessible, thereby leveraging genomics technology to aid in the prevention and management of diabetes.
BGI, in collaboration with a consortium of nine Danish research institutes, initiated the LuCAMP program. Within the framework of LuCAMP, an exome sequencing project was launched that sequenced the entire exome (all protein-coding regions of the genome) of 3,000 patients with visceral obesity and 3,000 healthy individuals.
The evaluation and understanding of gut microbiota have emerged as a significant area of research in human diseases, including type 2 diabetes. In 2012, in a research project spearheaded by BGI-Research and published in Nature, the team identified approximately 60,000 gut microbial gene markers associated with type 2 diabetes and introduced the concept of a metagenomic linkage group, facilitating further metagenome-wide association studies in human diseases.
Furthermore, in three separate research conducted in 2017, 2020, and 2022, BGI-Research collaborated with Shanghai Ruijin Hospital, and revealed that various oral antidiabetic drugs (OADs), including acarbose, berberine alone, and berberine combined with probiotic supplements could significantly alter the gut microbiota in patients with treatment-naïve type 2 diabetes, which in turn, had profound effects on host glucose and lipid metabolism underlying the clinical benefits in individuals with type 2 diabetes. These studies provide valuable insights into the mutual interactions among the gut microbiota, OADs, and therapeutic efficacy, facilitating more precise microbiota-based treatment and prevention strategies for type 2 diabetes.
In 2022, in another study published in Aging Cell led by BGI-Research, it was discovered that genetic risks associated with kidney disease in type 2 diabetes negatively impacted the patients' lifespan, as complications from kidney diseases often lead to death in these patients.
Also in the same year, in collaboration with the Harris Birthright Research Centre for Fetal Medicine at King's College Hospital and the Prince of Wales Hospital at the Chinese University of Hong Kong, BGI-Research has put forth new lipid biomarkers for the early prediction of gestational diabetes. These biomarkers can be employed for subsequent treatment control and monitoring of gestational diabetes. The research findings were published in the international obstetrics and gynecology journal, British Journal of Obstetrics and Gynaecology.
As we continue to broaden our understanding of diabetes, we're increasingly equipped to manage this global health challenge. The groundbreaking work by organizations like BGI, using genomics and technology, brings us closer to a future where diabetes can be prevented, detected early, and managed effectively. Through ongoing research and innovation, we aim to turn the tide on diabetes, improving lives worldwide.
CDC: What is Diabetes?
IDF: IDF DIABETES ATLAS, 10th edition 2021
Nature Medicine: Incident type 2 diabetes attributable to suboptimal diet in 184 countries
Everyday Health: Having a Parent with Type 2 Diabetes: What to Know About Your Risk
Diabetes UK: Maturity onset diabetes of the young (MODY)
World Journal of Diabetes: Genetics of type 2 diabetes
Nature: A metagenome-wide association study of gut microbiota in type 2 diabetes
Diabetologia: Cancer incidence in persons with type 1 diabetes: a five-country study of 9,000 cancers in type 1 diabetic individuals
Aging Cell: Genetic trade-offs between complex diseases and longevity
Nature Communication: Analyses of gut microbiota and plasma bile acids enable stratification of patients for antidiabetic treatment
Nature Communication: Gut microbiome-related effects of berberine and probiotics on type 2 diabetes (the PREMOTE study)
Gut Microbes: Combined berberine and probiotic treatment as an effective regimen for improving postprandial hyperlipidemia in type 2 diabetes patients: a double blinded placebo controlled randomized study
BJOG: Maternal plasma diacylglycerols and triacylglycerols in the prediction of gestational diabetes mellitus