Approved Research

Using multi-omics to understand the aetiology of early onset and rapid progression of type 2 diabetes and related metabolic conditions across diverse ancestries

Lay summary

Lifelong conditions such as type 2 diabetes, heart disease, and high blood pressure disproportionately affect people belonging to certain ethnic groups. For example, nearly 41% of the global adult population living with type 2 diabetes are from India and China alone9. People belonging to these ethnicities are more likely to develop diabetes at younger ages, are often misdiagnosed, and spend a longer proportion of their life managing diabetes as well as related multiple long-term conditions such as hypertension and heart disease, fatty liver disease. Research has shown that the presentation and progression of diabetes can vary dramatically across ethnic groups, while diagnosis and treatment guidelines do not effectively account for this.

Genetic research into the causes of this disproportionate burden across ethnic groups is limited. Genetic discoveries have helped us identify causes of disease, identify the best treatment options, and to develop medications to treat these conditions. However, this research has been predominantly carried out in populations of white European ancestry. For example, while south Asians form 25% of the global population, they are represented in less than 0.5% of genetic research worldwide5. This has negatively affected our ability to understand what causes diseases in this and other underrepresented ethnic groups and help identify the best treatment and management options.

In a recent engagement with lay members of the local East London Bangladeshi and Pakistani community, we heard universal lived experiences of people and their immediate family members developing diabetes very young, and often struggling to effectively control and manage their condition. There was a desire to better understand why as a group they are at an increased risk. As a group they wanted to be better equipped with information on risk and management of diabetes particularly as they fear passing this down to their children.

Overall, there remains a large research gap in the use of genetics and indeed other types of data (such as protein levels) to explain the differences in the risk of diabetes across different ethnicities, especially south Asians. The group of researchers based primarily at Queen Mary University of London, will use UK Biobank data alongside a cohort called the Genes & Health study which is the largest study of British South Asians including both clinical and genetic data in the UK. We hope that the combined use of these excellent research resources will help us make important steps to address this inequity in research.