Towards a genotype-based approach for a patient-centered pharmacologic therapy of type 2 diabetes

The recent data reported by Tang and colleagues in Science Translational Medicine suggest that alpha-2 adrenoceptors (α2AAR) genetic heterogeneity may explain diverging results regarding the effects of α2AAR antagonists on insulin secretion and glucose control in patients with type 2 diabetes. They first confirmed that the risk variant for rs553668 (the A allele for a single-nucleotide polymorphism in ADRA2A) is likely to cause defective insulin secretion in human pancreatic islets. Second they showed that blocking α2AAR with yohimbine dose-dependently improves the reduced insulin secretion during an oral glucose tolerance test in patients with the risk variant. The successful translation of genomic information into clinical intervention in patients with type 2 diabetes provides proof of concept for the feasibility of individualized treatment based on genotype.