Precision medicine in diabetes prevention, classification and management

J Diabetes Investig. 2018 Sep;9(5):998-1015. doi: 10.1111/jdi.12830. Epub 2018 Apr 25.

Abstract

Diabetes has become a major burden of healthcare expenditure. Diabetes management following a uniform treatment algorithm is often associated with progressive treatment failure and development of diabetic complications. Recent advances in our understanding of the genomic architecture of diabetes and its complications have provided the framework for development of precision medicine to personalize diabetes prevention and management. In the present review, we summarized recent advances in the understanding of the genetic basis of diabetes and its complications. From a clinician's perspective, we attempted to provide a balanced perspective on the utility of genomic medicine in the field of diabetes. Using genetic information to guide management of monogenic forms of diabetes represents the best-known examples of genomic medicine for diabetes. Although major strides have been made in genetic research for diabetes, its complications and pharmacogenetics, ongoing efforts are required to translate these findings into practice by incorporating genetic information into a risk prediction model for prioritization of treatment strategies, as well as using multi-omic analyses to discover novel drug targets with companion diagnostics. Further research is also required to ensure the appropriate use of this information to empower individuals and healthcare professionals to make personalized decisions for achieving the optimal outcome.

Keywords: Genomics; Pharmacogenetics; Precision medicine.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus / classification*
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / therapy*
  • Disease Management*
  • Humans
  • Pharmacogenetics / classification
  • Pharmacogenetics / methods
  • Precision Medicine / classification*
  • Precision Medicine / methods*
  • Risk Factors