The Need for Precision Medicine to be Applied to Diabetes

J Diabetes Sci Technol. 2020 Nov;14(6):1122-1128. doi: 10.1177/1932296819894295. Epub 2020 Jan 6.

Abstract

Precision medicine refers to the tailoring of medical treatment for an individual based on large amounts of biologic and extrinsic data. The fast advancing fields of molecular biology, gene sequencing, machine learning, and other technologies enable precision medicine to utilize this detailed information to enhance clinical management decision-making for an individual in the real time of the disease course. Traditional clinical decision making is based on reacting to a relatively limited number of phenotypes that are determined by history, physical examination, and conventional lab tests. Precision medicine depends on highly detailed profiling of the patient's genetic, morphologic, and metabolic makeup. The precision medicine approach can be applied to individuals with diabetes to select treatments most likely to offer benefit and least likely to cause side effects, offering prospects of improved clinical outcomes and economic costs savings over current empiric practices. As genetic, metabolomic, immunologic, and other sophisticated testing becomes less expensive and more widespread in the medical record, it is expected that precision medicine will become increasingly applied to diabetes care.

Keywords: diabetes; genes; omics; pharmacogenetics; phenotype; precision medicine.

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / drug effects*
  • Blood Glucose / genetics
  • Blood Glucose / metabolism
  • Clinical Decision-Making
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / genetics
  • Genetic Predisposition to Disease
  • Genomics*
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Patient Selection
  • Pharmacogenetics*
  • Pharmacogenomic Variants
  • Phenotype
  • Precision Medicine*
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Hypoglycemic Agents