June 2017

92 APAC / June 2017 , Contact us to collect the specimen. The samples will be sent directly to our testing centre for genetic testing. A report will be sent to you after several working days. You may then explain and discuss the health plan with your patients or clients. Users of our services may also use our mobile app ‘MyGem’, to review and update their reports and health status for tracking.ions. DForesee™ and DProtect™ are tests based on combining patented genetic markers, non-modifiable (e.g. age and sex) and modifiable risk factors (e.g. smoking and body weight) to calculate the future risk of developing diabetes or its complications at a very early stage before these conditions appear. Genetic markers related to developing diabetes or its complications will be tested and results will show the high and low risk DNA carried by users. By using proprietary risk algorithms, probability of having diabetes or developing of complications will be predicted from current age to age of 65 in DForesee™ or age of 75 in DProtect™. MyGem™ App The MyGem™ App is a mobile platform designed to assist users to manage their health, with support from their healthcare professionals. This app empowers the users to take ownership of their well-being, and proactively monitor their key health indexes. Healthcare professionals can also keep track of these indexes to help both parties to make informed and shared decision. Use of report This report is useful for medical professionals to understand the health status of your patients. With a precise probability of current and other conditions, you will be able to have a better approach on your patient’s health plan by providing a target and motivation. Amongst diabetic subjects who use DProtect™ test, those with well-controlled blood glucose, blood pressure and blood lipids have reduced risk of developing these complications. Since patients with high genetic risk are more likely to develop complications, good control of other risk factors which can be controlled through careful management is particularly important in such subjects. The importance of treatment adherence 1 and early use of organ-protective drugs, notably statins and renin angiotensin system inhibitors 2-5 to prevent life-threatening diseases can be informed by the test. The report will also highlight the amplifying effects of age and disease duration on future risk of complications and the importance of act early to save life and money. In those subjects without diabetes, the report can inform their inherent risks of diabetes based on genetic risk score and family history and the impacts of weight reduction and cessation of smoking on their overall diabetes risk. DNA markers discovery Our Gemomic® Technology is based on decades of university research in our local population. Since 1995, we have established multiple prospective cohorts with ongoing evaluation to discover, evaluate and validate biomarkers for predicting diabetes and its complications including but not limited to heart disease, kidney failure, cancer, stroke and all- cause death. These cohorts, databases and biobanks included 20,000 patients enrolled into the Hong Kong Diabetes Registry 6, 4500 adults and adolescents as control subjects 7-8 and 1000 first degree relatives of families of young onset diabetes 9. We are also part of the Asian Genetic Epidemiology Network 10-11 and Global Diabetes Consortium 12, the latter supported by the United States National Institute of Health, which are our key collaborators for validating our discoveries, along with other respected universities in China, Europe, Australia, Singapore, Korea, Japan and USA. Using family-based linkage analysis 9,13-15, investigations of candidate genes 16-20 and genome wide association studies 21-23, we have discovered rare and common genetic variants predictive of diabetes and its complications 24-26 with replication in other cohorts or supported by independent meta- analysis 27. Validation Based on the genetic markers discovered in our Chinese cohorts with validation in other Asian populations or independent analysis, we have developed proprietary risk algorithms combining these genetic markers, with highly modifiable risk factors to predict probabilities of diabetes or its complications over time. Given the subtle inter-ethnic differences in genomic architectures as well as distribution, frequency and effect size of these genetic variants within the same loci 21,28, these genetic markers and algorithms are highly applicable to Asian populations which account for 60% of the global population with diabetes 29. Despite the modest effect size of these individual risk factors, whether genetic 21 or non-genetic 30, their joint effects can be amplified to increase the odds to 3-10 folds in complex diseases due to multiple causes 31. Based on these premises, we have used similar strategies to develop many risk equations for predicting multiple diabetic complications with personalised reports and decision support, which were proven to change practice and health care behaviours with positive clinical outcomes

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