Diabetes Research and Clinical Practice - Volume 120 - Supplement 1 - October 2016

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tissue-specific cis-eQTL analyses and conformational capture.
We combine these “regulatory variant” data with transcript
level information to define the best-supported transcripts in
each GWAS region. Finally, we connect loci through analyses
of protein-protein interaction, co-expression and pathway
data. These efforts are starting to bear fruit, with around
one-third of GWAS signals now featuring a well-supported
priority transcript. We follow up these priority candidates
through cellular, molecular, rodent and human studies to
consolidate mechanistic evidence. To build engagement, we
are co-developing, via the Accelerating Medicines Partnership,
a dedicated T2D knowledge portal that facilitates access to
these data for the wider research community.
PL-03
Precision medicine 2016: Opportunities & challenges
Victor J. DZAU1. 1National Academy of Medicine, Washington, DC,
USA
Since the turn of the century, the global research community
has made significant progress in genomics and other omics-
based fields, biostatistics, bioinformatics, and computational
biology, including the application of these fields to medicine.
These efforts have resulted in new diagnostic and therapeu-
tic advances based on an improved understanding of the
molecular basis of disease in individual patients, heralding
a new era of precision medicine. Precision medicine has
the potential to guide health care decisions toward the most
effective prevention of disease or treatment for a given patient,
and thus, improve care quality, while reducing the need
for unnecessary diagnostic testing and therapies. Moreover,
when applied at the population level, precision medicine
holds immense promise for public health, particularly in
disease prevention and risk assessment. Despite recent
breakthroughs, there are notable challenges and barriers to
broad precision medicine implementation and integration
in clinical and preventive practice. For example, there are
concerns that technologies may drive up costs in the short
run and also may further advance disparities in health care
delivery. A lack of sufficient IT infrastructure, as well as
effective training for the medical workforce may impede
integration into clinical practice. Furthermore, concerns
about data ownership, privacy, and sharingmust be addressed
before precision medicine can be broadly implemented.
Dr. Dzau will discuss the potential of precision medicine to
revolutionize medicine and improve health, barriers and
challenges to its introduction and use at scale in disease
prevention and treatment, and future policy directions to help
overcome these challenges.
Presidential Lecture
PR-01
The unrelenting challenge of diabetes in our world: Small step
and big changes
Wayne H-H. SHEU 1. 1Taichung Veterans General Hospital,
Taichung, Taiwan
On behalf of Chairman, 11th IDF-WPR Congress and Chair of
IDF WPR, 206-2017, I would like to take this opportunity to
welcome all the delegates to attend this exciting meeting.
The number of people with diabetes, including those in
Western Pacific Region, has continuously rising during the
past decades. Despite that well established known traditional
risk factors for diabetes (eg, genetic, lifestyle, and behavioral
risk factors), recent researches have focused on identifying
the contributions of genetic and epigeneticmechanisms. Given
the unrelenting increases in global health expenditure attrib-
utable to diabetes, an integrated and comprehensive approach
is needed to prevent diabetes as well as provide good care in
people with diabetes and related complications.
What is the next step in addressing the epidemic of diabetes
in our region? It is clear that the development of new drugs
and regimens are not sufficient. In consideration of wide
diversity of populations, cultures, medical systems and
economic developments in this region, I believe that all stake
holders should be linked together to solve these complex
barriers. The emphasis has to be on prevention at level before
disease occurrence but also prevention of diabetes related
complications, for example the community-based prevention
programs and education campaigns run by local governments
and professional societies.
Perhaps new incentives, in particularly targeting educations,
are needed to encourage the all professionals work with
patients themselves, families and the medical community
to provide performances-based plus values-added diabetes
care. It is time for an entirely different approach. All of us have
to reach out, and together, we can have a small step and get big
changes.
PR-02
Biological role of ALDH2 in metabolic diseases – Asian
perspectives
Lee-Ming CHUANG1. 1Department of Internal Medicine, National
Taiwan University Hospital, Taipei, Taiwan
The ALDH2 gene encodes mitochondrial aldehyde dehydro-
genase 2 (ALDH2), which catalyzes the metabolism of
acetaldehyde and other bioreactive aldehydes, including
propionaldehyde, butyraldehyde, and 4-hydroxynonenal
(4-HNE). Increased 4-HNE level in adipose tissue contributes
to insulin resistance and diabetes. An E487K mutation,
denoted as ALDH2*2, encoded by the rs671 A allele of the
ALDH2 gene, results in a reduction of enzymatic activity by
∼90%. The rs671 variant is present in a substantial proportion
of the East Asian population (560 million) but not in Western
populations. The Asian flush syndrome is thus named as
a result of marked elevation of circulating acetaldehyde
after alcohol drinking in carriers of mutant alleles. Recently,
a large-scale meta-analysis in East Asian population identified
strong associations of genetic variations of the ALDH2 gene
with many parameters of the metabolic syndrome and the
risk of cardiovascular diseases. We also documented that
genetic variations of the ALDH2 gene were associated with
development of hypertension through gene and alcohol
interaction. In normal population, subjects carrying ALDH2
mutation have lower estimated glomerular filtration rate
(eGFR). In patients with type 2 diabetic, genetic variations of
the ALDH2 gene are also associated with urinary albumin-
creatinine ratio. In the aldh2*2-knockin mice model, we also
observed reductions in eGFR, glucose tolerance and insulin
sensitivity, and presence of hepatic steatosis due to increased
body weight on high-fat high-sucrose diet. With the intro-
duction of small-molecule chaperone for mutant ALDH2 such
as alda-1, our findings provide a therapeutic opportunity for
the huge population carrying this mutation and herald the
era of precision medicine by considering high prevalence of
the ALDH2 genetic variations in East Asian populations.
Current Diabetes Burden and
Performance in WPR
S01-1
DiabCare Malaysia: Journey to improving diabetes care in
Malaysia
Mafauzy MOHAMED1. 1Health Campus, Universiti Sains Malaysia,
Malaysia
Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1–S39 S2