Are genetic tests worthwhile in predicting diabetes or its complications?

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Takeaway

  • At this time, genetic tests are not useful as predictors of onset of diabetes or its complications.
  • Patients should be warned about the poor sensitivity of currently marketed diabetes risk tests and instead encouraged to enroll in clinical trials to better inform the field.

Why this matters

  • Genetic risk tests are being marketed to clinicians and patients.

Study design

  • Review of evidence for the ability of genetic tests to discriminate between people who will or who will not develop diabetes or its complications.
  • Funding: Italian Ministry of Health.

Key results

  • Genetic prediction of type 1 diabetes is feasible in families via diabetes-specific autoantibodies, but because there is currently no prevention approach, clinical usefulness is questionable.  
  • At present, the addition of genetic information to inexpensive and well-performing clinical prediction models does not result in any better prediction of type 2 diabetes (T2D) or cardiovascular disease in people with T2D.
  • Information on the genetic background of other diabetic complications affecting kidney, eyes, and peripheral nervous system is currently insufficient to even try predicting their occurrence.

Limitations

  • Further discovery of yet unidentified predisposing genetic factors might importantly change the present scenario.