Genetic determinants of non-insulin-dependent diabetes mellitus: strategies and recent results.

Non-insulin-dependent diabetes mellitus (NIDDM) is a clinically and genetically heterogeneous disorder. Recent advances in molecular genetics have allowed recognition of the genes involved in some subtypes of NIDDM with a well-defined mode of inheritance and a strong association with genetic factors. Thus, maturity-onset diabetes of the young (MODY), an autosomal dominant form of NIDDM, was shown to be caused by, or associated with, mutations in at least four genes. A maternally transmitted form of diabetes, often associated with deafness, was shown to be due to mutations in mitochondrial DNA. Despite these successes, little is known about susceptibility genes to the common polygenic forms of NIDDM. Studies of genes involved in insulin secretion or insulin action have been successful to a certain extent by showing the implication of the IRS-1 gene, the Rad gene, the glucagon receptor gene, or the sulfonylurea receptor (SUR) gene (among others) in a low percentage of cases of NIDDM in particular populations. However, the majority of susceptibility genes to NIDDM are still to be described. The aim of this review was to consider the strategies that can be used to identify the genetic determinants of NIDDM, and to summarise the significant results of recent literature.