This is what Michael Snyder's diabetes onset looked like.
What's the News: Have you ever wondered what is going on in your body at the molecular level when you're sick? If you could see which medications, whether for treating cold symptoms or cancer, had an effect on you, and whether changing your diet, exercise, or some other factor would increase their effectiveness, you'd gain a lot of power over your body. This kind of detailed information would start with getting your genome sequenced, but it wouldn't stop there. It would require a constant stream of information about which genes are being expressed, at what levels, and in what tissues, and what else is going with your metabolism. That level of granularity has been the goal of geneticist Michael Snyder's work and it has yielded a striking new paper
: Snyder's team analyzed samples of his own blood, taken over the course of 14 months, and were able to watch in real-time as the geneticist developed type 2 diabetes and successfully arrested its progress. How the Heck:
Most tests that your doctor orders for you look for just a few disease markers in your blood. In the lab, though, scientists can look for thousands of markers at a time. They watch for correlations between the levels of those markers and whatever symptoms or conditions the subject has---whether he or she has the sniffles, for instance. If they do this enough, they'll have a biochemical signature of what having a cold looks like, for that subject.
Snyder's team took regular blood samples from him and threw the kitchen sink at them: they looked at what his immune system was doing, what genes were being expressed, and various markers of metabolism, including blood glucose levels.
Whenever he got sick---which was twice, when he caught colds caused by rhinovirus and respiratory syncytial virus (RSV)---they upped the number of samples to get a detailed look at what was happening.
The second time, when he had RSV, they noticed something strange: over the course of the illness, his levels of blood glucose jumped, a sign of diabetes coming on. Snyder had none of the usual risk factors for diabetes---he's a rather slender man, a nonsmoker, and has no family history of the disease---but the sequence of his genome had revealed he had a genetic disposition to it. Something about having RSV, it seemed, was triggering the condition.
Alerted to the fact, Snyder made dramatic changes in what he ate and other lifestyle changes, and was subsequently diagnosed with type 2 diabetes by a doctor. After about a year, his blood glucose levels were back down to where they were before.
What's the Context:
This impressively detailed study is proof-of-concept that knowledge of your biochemistry is power. It's much more dramatic than previous studies using just genome information (though those are still interesting: check out this story about a family who discovered through genome sequencing that they have a predisposition to blood clots and adjusted their lives accordingly).
Snyder told Nature News that once his life insurance company learned of his diabetes diagnosis, the premiums went through the roof. That, of course, is the downside of removing the uncertainty about one's health: insurance companies can revise their opinion of your insurability.
If Snyder hadn't had health insurance when he had these tests done, one has to wonder, would any health insurance company take him on? If such tests become routine, will insurance companies pay for them as a way to pinpoint the individuals who are the biggest risks? As exciting as these advances are, the insurance business is so closely entwined with people's health, at least in the United States, that such questions will need to be addressed soon.
Reference: Chen, R. et al. Personal Omics Profiling Reveals Dynamic Molecular and Medical Phenotypes
. Cell 148, 1293–1307 (2012).