By Analyzing His Own Biomarkers, A Scientist Diagnoses His Diabetes in Real-Time

By Veronique Greenwood | March 16, 2012 2:22 pm

spacing is important
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).

CATEGORIZED UNDER: Health & Medicine, Top Posts
  • Peter Ellis

    If such tests become routine, will insurance companies pay for them as a way to pinpoint the individuals who are the biggest risks?

    More to the point, should the companies be allowed to? Insurance exists for one purpose only: to share around risks and costs. In the limit, as risk prediction gets more accurate and costs get passed on to the at-risk people, insurance in fact negates its own reason for existence. Everyone pays for exactly the care they use, and none of the costs get shared. In that case, why bother paying an extra few percent to the middleman? Just pay the doctor (or the fireman, the policeman, or whatever) when you get ill (or burgled, or your house burns down). Fundamentally, whatever the field you’re insuring, fully accurate risk prediction negates the purpose of insurance.

    Historically, how it’s worked is that the insurance companies adjust premiums to reflect the cost of known risks (this person smokes, that person lives in a high crime area, that person goes skydiving), and spreads the unknown risks (accidental fires, lightning strikes, diseases with no known risk factors). We the public accept this as fair because (again historically speaking), the known risks are also largely controllable risks – this person chooses to smoke, to go skydiving, or to drive a fast car.

    However, particularly in the world of health insurance, we are rapidly moving into a world of known but uncontrollable risks. It is not someone’s fault if they were born with a risky combination of ApoE alleles, an MHC haplotype prone to diabetes, a causative variant for Huntington’s chorea or a broken Brca1 gene. Why should they be made to pay extra for factors that are out of their control?

    What is needed is a sea change in how insurance is targeted, what it is accepted to take into account, and what it explicitly should not take into account. It needs repurposing so those who choose to take on avoidable risk pay the price, while all the uncontrollable / faultless risks are ignored – even in cases where they can be accurately quantified.

  • Curious

    I am more curious about the link between the rsv infection and the onset of diabites. I vaguely recall an article about a researcher finding a retro virus in all human DNA that has links to auto immune problems. He suspected that it was triggered viral infections. Different viruses could cause different diseases. Diabetes, Psoriases, Multiple Sclerosis.

  • Tom

    This all still sounds like drug and food industry propaganda. Most oeople are the reality.thinkers know
    That diabetes is caused
    By differrnt diet related additives that should not be in the food supply. The thinking above is called dogmatic.

  • Chris

    Good reason to publish under a nom de plume.

  • bill

    Perhaps an insurance policy is needed to counteract insurance policies that penalize you for taking actions such as these. I’m thinking of a policy that says ‘if your premiums go up as a direct cause of having detected otherwise-unseen risk factors, this policy will pay for them’. Though then perhaps that becomes a hall of mirrors….

  • drkala

    I think there is a federal law about that which was enacted a few years back, although I hear there are people now trying to repeal it.

  • http://80beats Susan

    Did he ever consider that a medication he took when he had the cold brought on Diabetes? I took Prilosec, then Nexium and both raised my blood sugar levels; at first, it was a small amount 125, but within three months I was at 375-475 range. When I forgot to take the medicine one day, the next day my sugar was down to 140. When I was off the drug completely for about a year (in favor of Prevacid) I can now maintain a range between 95-105, as long as I separate the dose into two doses of 15 MG instead of one at 30, without any medical intervention.

  • Kelly

    The whole concept of health insurance is flawed. None of us will be able to go throughout life without health care. It is a certainty. Why waste money making insurance companies rich? Put that money directly into the health care system.

  • Tony Mach

    And the irony is that researcher like Snyder could find out the cause(s) of T2DM and contribute to a better prevention – that his insurer punishes him for that is just shortsighted. But what do I expect of companies that are interested in the short term profit…

  • Colin

    I don’t find this particularly interesting at all. It’s not a surprise at all that a person who monitors his blood glucose levels every day would receive an early warning as to the onset of Type 2 diabetes. I don’t see how that counts as “proof-of-concept that knowledge of your biochemistry is power.” It simply proves that knowledge of one aspect of your biochemistry (blood glucose), can inform you about one disease state (diabetes). This is obviously true….it doesn’t tell us anything at all new about how tracking one’s biochemsitry in a broader sense will lead to faster diagnosis of other disease states.

  • Geack

    @7. Susan –
    Why were you monitoring your blood sugar levels when you took those meds, if you didn’t already have diabetes?

  • Brent

    Why do these stories always attract idiotic political ranting? It would have been better if the author had left out the last paragraph. I guess it’s more glamorous to invent controversy.

  • juan

    it is pretty obvious for me that the “type 2 diabetes” (in fact some problem in his pancreas or in the insuline receptors in his cells) was triggered by the antiviral medication. Type 2 diabetes or such a dramatic rise in glucose doesn’t happen in a few days lapse.

  • http://discover Jacqueline

    I agree with Brent….very true.

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