title: Clinical worthlessness of genetic prediction of common forms of diabetes mellitus and related chronic complications: A position statement of the Italian Society of Diabetology.
abstract: We are currently facing several attempts aimed at marketing genetic data for predicting multifactorial diseases, among which diabetes mellitus is one of the more prevalent. The present document primarily aims at providing to practicing physicians a summary of available data regarding the role of genetic information in predicting diabetes and its chronic complications.
  
  
  
  Firstly, general information about characteristics and performance of risk prediction tools will be presented in order to help clinicians to get acquainted with basic methodological information related to the subject at issue. Then, as far as type 1 diabetes is concerned, available data indicate that genetic information and counseling may be useful only in families with many affected individuals. However, since no disease prevention is possible, the utility of predicting this form of diabetes is at question. In the case of type 2 diabetes, available data really question the utility of adding genetic information on top of well performing, easy available and inexpensive non-genetic markers. Finally, the possibility of using the few available genetic data on diabetic complications for improving our ability to predict them will also be presented and discussed. For cardiovascular complication, the addition of genetic information to models based on clinical features does not translate in a substantial improvement in risk discrimination. For all other diabetic complications genetic information are currently very poor and cannot, therefore, be used for improving risk stratification.
  
  
  
  In all, nowadays the use of genetic testing for predicting diabetes and its chronic complications is definitively of little value in clinical practice.
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy; UOC Diabetology, Polo Pontino, "Sapienza" University of Rome, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Buzzetti
authors.affiliation: Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Prudente
authors.affiliation: Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Copetti
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona School of Medicine and Hospital Trust of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Dauriz
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy; UOC Diabetology, Polo Pontino, "Sapienza" University of Rome, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Zampetti
authors.affiliation: Section of Diabetes and Metabolic Disease, Department of Clinical and Experimental Medicine, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Garofolo
authors.affiliation: Section of Diabetes and Metabolic Disease, Department of Clinical and Experimental Medicine, University of Pisa and Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Penno
authors.affiliation: Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy; Mendel Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; Research Unit of Diabetes and Endocrine Diseases, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy. Electronic address: vincenzo.trischitta@uniroma1.it.
authors.forename: V
authors.initials: V
authors.lastname: Trischitta
mesh_terms: D019540:Area Under Curve; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D059647:Gene-Environment Interaction; D005819:Genetic Markers; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006680:HLA Antigens / Q000235:genetics*; D040941:Heredity; D006801:Humans; D010375:Pedigree; D057285:Precision Medicine / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D005819:Genetic Markers; D006680:HLA Antigens
keywords: Genetic prediction; Molecular medicine; Precision medicine