KEM Hospital & Research Centre, Pune’s
collaborative research with Swedish University published in
Lancet - Regional Health Southeast Asia

A collaborative research between KEM Hospital Research Centre, Pune and Lund University in Sweden on genetic similarities and differences between subgroups of type 2 diabetes in India and Europe has been published in The Lancet Regional Health - Southeast Asia in May 2023. This is the second publication under this collaboration. The knowledge will help improve treatment of the disease in India, where type 2 diabetes represents a growing disease burden. The research exchange was supported by the Department of Science and Technology (DST) in India and the Swedish Research Council in Sweden. The collaborative research was led by Dr Rashmi Prasad, Associate Professor in Genomics, Diabetes, and Endocrinology at Lund University Diabetes Centre (LUDC) together with Prof. Dr. Chittaranjan S Yajnik, Director & Consultant – Diabetes Unit at King Edward Memorial (KEM) Hospital and Research Centre in Pune, India. The new study confirms that the genetic scores developed in European patients are applicable on patients in western India, though there are differences in the associations between the two populations. The results are based on clinical data from 2217 patients with type 2 diabetes from the WellGen study in western India, genetic data was available in 821 people of this group.

Researchers at Lund University, Malmo, Sweden have shown that diabetes can be divided into five subgroups, including SAID (severe auto-immune diabetes), SIDD (severe insulindeficient diabetes), SIRD (severe insulin-resistant diabetes), MOD (mild obesity-related diabetes) and MARD (mild age-related diabetes). SAID is also known as type 1 diabetes, the remaining four subgroups belong to type 2 diabetes. This paper was published in the Lancet Diabetes & Endocrinology in 2018. Dr Rashmi Prasad is one of the authors of this acclaimed study. The paper generated a lot of interest and was replicated in many other populations which confirmed that diabetes can be divided into the above subgroups based on clinical and biochemical characteristics and that this classification is useful to guide treatment and may help predict complications. In 2021, the Swedish group at LUDC published a new study in the Nature Genetics that demonstrated genetic differences between the four subgroups of type 2 diabetes in Sweden.

Dr Yajnik said that our first study under this collaboration was published in Diabetologia in 2021 and was on people who were diagnosed with type 2 diabetes below 45 years of age. We confirmed the 4 subgroups in the Indian type 2 diabetes patients but the proportion of subgroups was different in Indian and Swedish cohorts. We found that the commonest subgroup of diabetes in Indian cohort was severely insulin deficient (SIDD), while in Sweden it was mild obesity-related (MOD) and associated with insulin resistance. This difference could be due to genetic or environmental factors. There are a number of differences in the environment and lifestyle of these two populations which reflect in body size and metabolism. These differences start from before conception and persist through lifecourse.