Thanks so much Wiebke!

>Last but not least

A huge thank you to our 64,848 volunteers and Community Advisory Board, funders and many partners for their incredible contributions to this work.

>What other work is Genes & Health doing on diabetes?

We are using genetic tools to study diabetes misclassification (when we confuse type 1 and type 2 diabetes), misdiagnosis (when tests like HbA1c go wrong). Soon we will also start work on monogenic and mitochondrial diabetes. Watch this space!

By using partitioned polygenic scores or these types of more standard clinical tests, we hope it is possible to develop more precise approaches to diabetes treatment, rather than the ‘one size fits all’ approach that we currently use.

>So do we need to use polygenic scores in the NHS?

Not necessarily. We can work out who has a genetic signature for low insulin production using a blood test called C-peptide, or unhealthy fat distribution by using a tape measure around the waist and hips.

>Ok, what else?

People with the highest risk of both low insulin production AND unhealthy fat distribution developed type 2 diabetes 8 years earlier, with a BMI 3mkg2 lower, and were more likely to develop eye complications.

>So what?

Good question! This isn’t just about satisfying our curiosity. Partitioned polygenic scores point towards ways to improve T2D treatment. People with a high genetic risk for low insulin production were less likely to respond to SGLT2 inhibitors and more likely to need insulin treatment.

2: South Asians have a higher genetic risk of unhealthy fat distribution – this means they are more likely to put fat in and around the middle of their bodies, and T2D is a known metabolic consequence.

1: South Asians have higher genetic risk for low insulin production – insulin is a hormone made by the pancreas to regulate blood glucose and with enough of it, our blood glucose can rise and lead to diabetes

>Why do some south Asians get T2D and GDM when they are young and slim?

Partitioned polygenic scores helped us shine a light on the specific reasons for this:

>Why do south Asians get more T2D?

Focus is often put on lifestyle factors. We find that south Asians have a greater genetic risk of T2D than white Europeans. So, lifestyle is important, but south Asians carry a greater predisposition from genetic factors that they cannot change.

Genes & Health represents 60,000 British Bangladeshi & Pakistani people, who are disproportionately affected by T2D & GDM. Our Community Advisory Group, led by Ahsan Khan, asked us to prioritise diabetes research Today we show our commitment to that, and this is what we found: