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A new test to target tight glycemic control

Published in the December 2008 issue of Today’s Hospitalist

A NEW TEST FOR DIABETIC PATIENTS may help physicians target which patients should receive interventions like tight inpatient glycemic control and vitamin E therapy.

The new test works by identifying diabetes patients who have a genotype known as Hp2-2. Research indicates that these patients face a five-fold risk of mortality from cardiovascular disease when compared to diabetics with other genotypes.

Noah Berkowitz, MD, CEO and president of Synvista Therapeutics Inc., the company that created the technology that’s behind the new test, says a growing body of research indicates that diabetic patients with the Hp2-2 genotype benefit from tight glycemic control and vitamin E. By identifying and treating these patients, he explains, the test gives physicians a relatively easy way to target “the lion’s share of cardiovascular risk in the diabetes population.”

Dr. Berkowitz says that the test may also add some clarity to the debate over the value of the two interventions. While researchers have documented significant downsides to tight glycemic control and vitamin E, he predicts that patients with the genotype will show such a benefit that it will make the risk-benefit decision easier for physicians.

Who will order the test? Because the notion of prescribing therapy based on a genetic test is still relatively new, Dr. Berkowitz suspects that physicians who manage the patients with the most to gain will be the early adopters. That primarily means diabetologists and cardiologists.

Synvista has licensed its technology to ARUP Laboratories, which will perform the testing for $325. Synvista hopes to release its own version of the test next year that will be less expensive and more widely available.

For information about the test, call ARUP at 800- 522-2787 and refer to test number 0040116.