ABSTRACT
Type 2 diabetes mellitus is a complex, polygenic disease with a heterogeneous pathophysiology, mainly characterized by obesity-associated insulin resistance and a progressive failure of pancreatic
β
-cells. Its incidence can be lowered by reduction of the intra-abdominal fat mass and by pharmacological control of postprandial blood glucose levels. Several phenotypic risk factors and biomarkers (e.g., abdominal obesity, serum adiponectin, HbA1c, nutritional pattern, and physical activity) are known that determine the individual disease risk. Such a risk assessment can provide the basis for a personalized decision as to the quality and intensity of a preventive intervention. So far, genotyping for the presently known gene variants that confer an increased risk for type 2 diabetes adds relatively little to the information provided by the phenotypic risk
factors. However, a risk assessment based on genetic information is necessary for a personalized intervention that begins before phenotypic risk factors are detectable. Furthermore, data from experimental animals indicate that the response to nutritional parameters, e.g., the dietary fat content, is determined by gene variants that modify disease risk and progression. Thus, identification of these genes and elucidation of their role in the human disease will allow a personalized, diet-based intervention.
