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
. 2013 Apr;13(2):205-12.
doi: 10.1007/s11892-012-0348-6.

Personalized decision support in type 2 diabetes mellitus: current evidence and future directions

Michael J Wilkinson  1 , Aviva G Nathan, Elbert S Huang
Affiliations

Personalized decision support in type 2 diabetes mellitus: current evidence and future directions

Michael J Wilkinson et al. Curr Diab Rep. 2013 Apr.

Abstract

The management of type 2 diabetes comprises a complex series of medical decisions regarding goals of care, self-care behaviors, and medical treatments. The quality of these medical decisions is critical to determining whether an individual diabetes patient is treated appropriately, overtreated, or undertreated. It is hypothesized that the quality of these medical decisions can be enhanced by personalized decision support tools that summarize patient clinical characteristics, treatment preferences, and ancillary data at the point of care. We describe the current state of personalized diabetes decision support on the basis of 13 recently described tools. Three tools provided support for personalized decisions based on preferences, while the remaining 10 provided support for treatment decisions designed to achieve standard diabetes goals. For the tools that supported personalized decisions, patient participation in medical decisions improved. Future decision support tools must be designed to account for both clinical characteristics and patient preferences.

PubMed Disclaimer

Conflict of interest statement

Disclosure

Conflicts of interest: M.J. Wilkinson: none;

Figures

Fig. 1
Fig. 1
Conceptual framework for describing potential areas of personalization of diabetes care within the clinical decision making process. A = Consideration of clinical factors when determining risk factor goals. B = Consideration of patient preferences when determining risk factor goals. C = Consideration of clinical factors when making treatment decisions. D = Consideration of patient preferences when making treatment decisions. *Examples of risk factor goals: hemoglobin A1c, blood pressure, and cholesterol targets. **Examples of clinical factors: pharmacogenomics, comorbidity, life expectancy, stage of disease
See this image and copyright information in PMC

References

    1. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach: Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care. 2012;35:1364–1379. - PMC - PubMed
    1. Ismail-Beigi F, Moghissi E, Tiktin M, et al. Individualizing Glycemic Targets in Type 2 Diabetes Mellitus: Implications of Recent Clinical Trials. Ann Intern Med. 2011;154:554–559. - PubMed
    1. American Diabetes Association. Executive summary: Standards of medical care in diabetes--2012. Diabetes Care. 2012;35(Suppl 1):S4–S10. - PMC - PubMed
    1. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) The Lancet. 1998;352:837–853. - PubMed
    1. Holman RR, Paul SK, Bethel MA, et al. 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes. N Engl J Med. 2008;359:1577–1589. - PubMed

Publication types