Author Affiliations: Department of Medicine, Division of Nephrology, University of Washington, Seattle.
Gosmanov and Gosmanova thoughtfully note that we focus on environmental risk factors in our recent analysis of long-term renal outcomes of microalbuminuria in the DCCT/EDIC Study, excluding genetic risk factors. They suggest that DCCT/EDIC is an ideal population to address the interaction of environmental and genetic contributors to diabetes complications in order to move the field closer to the application of personalized medicine. We agree that DCCT/EDIC offers unique opportunities to advance genetic medicine but believe that it also exemplifies the difficulties in this endeavor.
de Boer IH, Paterson AD, Brunzell JD. Long-term Renal Outcomes of Patients With Type 1 Diabetes Mellitus and Microalbuminuria: An Analysis of the DCCT/EDIC Cohort—Reply. Arch Intern Med. 2011;171(17):1596-1597. doi:10.1001/archinternmed.2011.414