Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Wendy K Chung^{1

2}, Karel Erion³, Jose C Florez^{4

5

6

7

8}, Andrew T Hattersley⁹, Marie-France Hivert^{5

10}, Christine G Lee¹¹, Mark I McCarthy^{12

13

14}, John J Nolan¹⁵, Jill M Norris¹⁶, Ewan R Pearson¹⁷, Louis Philipson^{18

19}, Allison T McElvaine²⁰, William T Cefalu¹¹, Stephen S Rich^{21

22}, Paul W Franks^{23

24}

Affiliations

¹ Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
² Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
³ American Diabetes Association, Arlington, VA, USA.
⁴ Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
⁵ Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA.
⁶ Metabolism Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
⁷ Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
⁸ Department of Medicine, Harvard Medical School, Boston, MA, USA.
⁹ Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK.
¹⁰ Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
¹¹ National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
¹² Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.
¹³ Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK.
¹⁴ Genentech, South San Francisco, CA, USA.
¹⁵ School of Medicine, Trinity College, Dublin, Ireland.
¹⁶ Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
¹⁷ Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, Scotland, UK.
¹⁸ Department of Medicine, University of Chicago, Chicago, IL, USA.
¹⁹ Department of Pediatrics, University of Chicago, Chicago, IL, USA.
²⁰ Duke University School of Medicine, Durham, NC, USA.
²¹ Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.
²² Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
²³ Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Lund University, CRC, Skåne University Hospital - Malmö, Building 91, Level 12, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden. paul.franks@med.lu.se.
²⁴ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. paul.franks@med.lu.se.

PMID: 32556613
PMCID: PMC8185455
DOI: 10.1007/s00125-020-05181-w

Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Wendy K Chung et al. Diabetologia. 2020 Sep.

. 2020 Sep;63(9):1671-1693.

doi: 10.1007/s00125-020-05181-w.

Authors

Affiliations

¹ Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
² Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
³ American Diabetes Association, Arlington, VA, USA.
⁴ Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
⁵ Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA.
⁶ Metabolism Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
⁷ Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
⁸ Department of Medicine, Harvard Medical School, Boston, MA, USA.
⁹ Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK.
¹⁰ Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
¹¹ National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
¹² Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.
¹³ Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK.
¹⁴ Genentech, South San Francisco, CA, USA.
¹⁵ School of Medicine, Trinity College, Dublin, Ireland.
¹⁶ Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
¹⁷ Division of Population Health and Genomics, Ninewells Hospital and School of Medicine, University of Dundee, Dundee, Scotland, UK.
¹⁸ Department of Medicine, University of Chicago, Chicago, IL, USA.
¹⁹ Department of Pediatrics, University of Chicago, Chicago, IL, USA.
²⁰ Duke University School of Medicine, Durham, NC, USA.
²¹ Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.
²² Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
²³ Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Lund University, CRC, Skåne University Hospital - Malmö, Building 91, Level 12, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden. paul.franks@med.lu.se.
²⁴ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. paul.franks@med.lu.se.

PMID: 32556613
PMCID: PMC8185455
DOI: 10.1007/s00125-020-05181-w

Abstract

The convergence of advances in medical science, human biology, data science and technology has enabled the generation of new insights into the phenotype known as 'diabetes'. Increased knowledge of this condition has emerged from populations around the world, illuminating the differences in how diabetes presents, its variable prevalence and how best practice in treatment varies between populations. In parallel, focus has been placed on the development of tools for the application of precision medicine to numerous conditions. This Consensus Report presents the American Diabetes Association (ADA) Precision Medicine in Diabetes Initiative in partnership with the European Association for the Study of Diabetes (EASD), including its mission, the current state of the field and prospects for the future. Expert opinions are presented on areas of precision diagnostics and precision therapeutics (including prevention and treatment) and key barriers to and opportunities for implementation of precision diabetes medicine, with better care and outcomes around the globe, are highlighted. Cases where precision diagnosis is already feasible and effective (i.e. monogenic forms of diabetes) are presented, while the major hurdles to the global implementation of precision diagnosis of complex forms of diabetes are discussed. The situation is similar for precision therapeutics, in which the appropriate therapy will often change over time owing to the manner in which diabetes evolves within individual patients. This Consensus Report describes a foundation for precision diabetes medicine, while highlighting what remains to be done to realise its potential. This, combined with a subsequent, detailed evidence-based review (due 2022), will provide a roadmap for precision medicine in diabetes that helps improve the quality of life for all those with diabetes.

Keywords: Diabetes; Precision diagnostics; Precision medicine; Precision prevention; Precision therapeutics; Precision treatment; Prediction; Prognosis.

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Figures

**Figure 1**
PMDI activity timeline. RFA, request for applications

**Fig. 5**
The path to precision diabetes medicine

See this image and copyright information in PMC

References

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Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Affiliations

Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Authors

Affiliations

Abstract

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References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials