Another part of our research focusses on type 2 diabetes. Type 2 diabetes is responsible for about 90% of all diabetes cases and is caused by a combination of insulin resistance and insufficient insulin secretion. In addition to genetic susceptibility overweight and an inactive life style are major risk factors. Our studies use a combination of modern omics techniques, data science and bioinformatics to identify biomarkers for disease progression.
Patients with type 2 diabetes follow different trajectories of glycaemic progression once the disease has developed. Whilst the majority show no or limited glycaemic progression, about 10-30 percent are unable to achieve HbA1c levels below the glycaemic target whereas especially this group has an increased risk of diabetic complications. Early identification of the persons at risk may help to redirect our clinical resources to those who may benefit the most thereby facilitating value-based healthcare. At present there are however no good instruments to identify those at risk of progression at an early stage.
As indicated above clinical studies have not yet yielded strong predictors of glycaemic progression.
In our group were investigating the utility as biomarkers of various omic datatypes in diabetes and diabetes progression. This research is performed in close collaboration with partners from Amsterdam UMC, Location VUmc. We use data from the Hoorn studies and the Hoorn Diabetes Care System Cohort (DCS) for our studies. These cohort studies contain longitudinally collected clinical data and biomaterials of thousands of healthy and affected persons (www.hoornstudies.com).
The role of genetic variation in the development of diabetic complications is investigated in a Accelerated Medicines Program T2D grant. Within the large BBMRI-NL consortium metabolomic data from various T2D cohort studies is combined to identify metabolites associated with glycaemic control and diabetes progression (BBMRI-NL). In addition we are investigating the role of small and mRNA, and their interactome in relation to rapid disease progression (Dutch Diabetes Research Foundation and ZoNMw). In two EU-funded projects (IMI-DIRECT and IMI-Rhapsody) we investigate the utility of various omics measurements (Genomics, Transcriptomics, metabolomics and peptidomics) in risk stratification for type 2 diabetes development and progression.