Funded by: PCHRD
Project Leader: Eva Maria Cutiongco-dela Paz, MD

Type 2 Diabetes Mellitus (T2DM) Type 2 DM has reached pandemic proportions and is regarded as a chronic public health hazard. In 2000, an estimated 171 million or 2.8% of the world population is affected with diabetes, which is expected to rise to 366 million in 2030 (Wild et al. 2004). In the Philippines, the epidemiological data are alarming. Between 2003 and 2008, the true prevalence of diabetes in the National Nutrition and Health Survey has increased from 4.6% to 7.1%. Management of these conditions remains at the forefront of health policies.

T2DM is a complex trait that implies susceptibility based both on genetic predisposition and environmental factors. Recent findings from genome-wide association studies (GWAS) have generated information on susceptibility, onset of complications and individual responses to pharmacotherapy of T2DM. Despite several initiatives being undertaken internationally to address personalized medicine, studies that correlate genetic variations to disease and drug responses remain limited in the Philippines. This program has been designed to characterize the genotype of Filipinos with the intention of possibly discovering useful biomarkers that can guide clinicians in providing optimal treatment and risk assessment for patients, particularly those withT2DM. With the emergence of several association studies showing strong correlation between genomic variations and clinical parameters, such as response to drugs, risk for diseases, prognostic stratification and side effect prediction, studies on genetic variations offer the opportunity to further optimize treatment and diagnostic strategies to those afflicted. However, since such variations occur significantly among different ethnicities, the applicability of the genetic tests that can be derived largely depends on the establishment of an a priori and well-established study on the local populations of interest. This program is designed to discover prospective genetic markers that can be used to predict responses of Filipinos to commonly prescribed drugs for Type 2 diabetes mellitus as well as to identify polymorphisms that can be used to determine susceptibility to T2DM and its related complications. This initiative offers a high-throughput screening of candidate genes; once identified, the findings may lead to the development of genetic test kits that can be provided at the point of care using various molecular diagnostic platforms.

The program seeks to address important genetic concerns in relation to T2DM: (1) the screening for useful candidate genetic biomarkers associated with response to commonly used drugs for T2DM (metformin, glimepiride, and gliclazide) (under Project 1); (2) the screening for candidate SNPs that are associated to susceptibility to T2DM and its related medical conditions — obesity, metabolic syndrome — with its common debilitating complications (under Project 2); and (3) the determination of differentially expressed genes during the occurrence of T2DM complications, particularly nephropathy, retinopathy, cerebrovascular disease, coronary artery disease and peripheral vascular disease (under Project 3).