Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023:280:107-129.
doi: 10.1007/164_2022_590.

Precision Medicine in Diabetes

Adem Y Dawed  1 , Eram Haider  1 , Ewan R Pearson  2
Affiliations

Precision Medicine in Diabetes

Adem Y Dawed et al. Handb Exp Pharmacol. 2023.

Abstract

Tailoring treatment or management to groups of individuals based on specific clinical, molecular, and genomic features is the concept of precision medicine. Diabetes is highly heterogenous with respect to clinical manifestations, disease progression, development of complications, and drug response. The current practice for drug treatment is largely based on evidence from clinical trials that report average effects. However, around half of patients with type 2 diabetes do not achieve glycaemic targets despite having a high level of adherence and there are substantial differences in the incidence of adverse outcomes. Therefore, there is a need to identify predictive markers that can inform differential drug responses at the point of prescribing. Recent advances in molecular genetics and increased availability of real-world and randomised trial data have started to increase our understanding of disease heterogeneity and its impact on potential treatments for specific groups. Leveraging information from simple clinical features (age, sex, BMI, ethnicity, and co-prescribed medications) and genomic markers has a potential to identify sub-groups who are likely to benefit from a given drug with minimal adverse effects. In this chapter, we will discuss the state of current evidence in the discovery of clinical and genetic markers that have the potential to optimise drug treatment in type 2 diabetes.

Keywords: Adverse drug outcomes; Genomics; Glycaemic response; Precision medicine; Type 2 diabetes.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Amoah AG, Owusu SK, Schuster DP, Osei K (2002) Pathogenic mechanism of type 2 diabetes in Ghanaians – the importance of beta cell secretion, insulin sensitivity and glucose effectiveness. S Afr Med J 92:377–384 - PubMed
    1. Anjana RM, Baskar V, Nair ATN, Jebarani S, Siddiqui MK, Pradeepa R, Unnikrishnan R, Palmer C, Pearson E, Mohan V (2020) Novel subgroups of type 2 diabetes and their association with microvascular outcomes in an Asian Indian population: a data-driven cluster analysis: the INSPIRED study. BMJ Open Diabetes Res Care 8
    1. Balaich J, Estrella M, Wu G, Jeffrey PD, Biswas A, Zhao L, Korennykh A, Donia MS (2021) The human microbiome encodes resistance to the antidiabetic drug acarbose. Nature
    1. Baye AM, Fanta TG, Siddiqui MK, Dawed AY (2021) The genetics of adverse drug outcomes in type 2 diabetes: a systematic review. Front Genet 12:675053 - PubMed - PMC
    1. Becker ML, Visser LE, Trienekens PH, Hofman A, van Schaik RH, Stricker BH (2008) Cytochrome P450 2C9 *2 and *3 polymorphisms and the dose and effect of sulfonylurea in type II diabetes mellitus. Clin Pharmacol Ther 83:288–292 - PubMed

LinkOut - more resources