Tracking down genes to cure diabetes: an achievable task for the 21st century?

Both insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) are clinically and genetically heterogeneous disorders. Recent advances in molecular genetics have led to the recognition of genes involved in IDDM and in some subtypes of NIDDM, including maturity-onset diabetes of the young (MODY). Despite these successes, several IDDM susceptibility genes have not yet been identified, and very little is known about genes contributing to common forms of NIDDM. Studies of candidate genes and of genes mapped in animal models of IDDM or NIDDM, as well as whole genome scanning of diabetic families from different populations, should allow the identification of most diabetes susceptibility genes and of the molecular targets for new potential drugs. Tracking down diabetes genes will thus contribute to the development of novel predictive and therapeutic approaches for the coming century.