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

Precision medicine in diabetes prevention, classification and management

Fangying Xie  1 , Juliana Cn Chan  1   2   3   4 , Ronald Cw Ma  1   2   3   4
Affiliations
Review

Precision medicine in diabetes prevention, classification and management

Fangying Xie et al. J Diabetes Investig. 2018 Sep.

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.

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Figures

Figure 1
Figure 1
Effect of an increasing number of risk alleles and type 2 diabetes risk in the combined Chinese and Korean samples (adapted with permission from supplementary text of Ng et al.53).
Figure 2
Figure 2
The basic concept of personalized intervention and substantial interaction of genetic and modifiable risk factors. Figure reproduced with permission from GemVCare.
Figure 3
Figure 3
Potential application of precision medicine in diabetes at different stages of diabetes. DM, diabetes mellitus; MODY, maturity‐onset diabetes of the young; T2D, type 2 diabetes.
See this image and copyright information in PMC

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