Review

. 2020 Jul;43(7):1617-1635.

doi: 10.2337/dci20-0022.

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}, John J Nolan¹⁴, Jill M Norris¹⁵, Ewan R Pearson¹⁶, Louis Philipson^{17

18}, Allison T McElvaine¹⁹, William T Cefalu¹¹, Stephen S Rich^{20

21}, Paul W Franks^{22

23}

Affiliations

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

PMID: 32561617
PMCID: PMC7305007
DOI: 10.2337/dci20-0022

Review

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. Diabetes Care. 2020 Jul.

. 2020 Jul;43(7):1617-1635.

doi: 10.2337/dci20-0022.

Authors

Affiliations

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

PMID: 32561617
PMCID: PMC7305007
DOI: 10.2337/dci20-0022

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 realize 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.

PubMed Disclaimer

Figures

**Figure 1**
PMDI activities. PM, precision medicine; RFA, research funding announcement.

**Figure 5**
The path to precision diabetes medicine. HEA, health economic assessment. Adapted from Fitipaldi et al. (136).

See this image and copyright information in PMC

Cited by

Type 2 Diabetes Mellitus Aggravates Complement Dysregulation and Affects Cortisol Response in Patients with Post-COVID-19.
Ji W, Xie X, Bai G, Fan Y, He Y, Zhang L, Zhou H, Li L, Qiang D, Li H. Ji W, et al. Diabetes Metab Syndr Obes. 2024 Oct 19;17:3849-3861. doi: 10.2147/DMSO.S480457. eCollection 2024. Diabetes Metab Syndr Obes. 2024. PMID: 39449862 Free PMC article.
Unveiling Diabetes: Categories, Genetics, Diagnostics, Treatments, and Future Horizons.
Alam A, Dhoundiyal S, Ahmad N, Rao GSNK. Alam A, et al. Curr Diabetes Rev. 2024;20(4):e180823219972. doi: 10.2174/1573399820666230818092958. Curr Diabetes Rev. 2024. PMID: 37594107 Review.
Autoimmune Inflammation and Insulin Resistance: Hallmarks So Far and Yet So Close to Explain Diabetes Endotypes.
Petrelli A, Giovenzana A, Insalaco V, Phillips BE, Pietropaolo M, Giannoukakis N. Petrelli A, et al. Curr Diab Rep. 2021 Dec 13;21(12):54. doi: 10.1007/s11892-021-01430-3. Curr Diab Rep. 2021. PMID: 34902055 Free PMC article. Review.
Toward an Improved Classification of Type 2 Diabetes: Lessons From Research into the Heterogeneity of a Complex Disease.
Redondo MJ, Balasubramanyam A. Redondo MJ, et al. J Clin Endocrinol Metab. 2021 Nov 19;106(12):e4822-e4833. doi: 10.1210/clinem/dgab545. J Clin Endocrinol Metab. 2021. PMID: 34291809 Free PMC article. Review.
Insulin Secretion Capacity as a Crucial Feature to Distinguish Type 1 From Type 2 Diabetes and to Indicate the Need for Insulin Therapy - A Critical Discussion of the ADA/EASD Consensus Statement on the Management of Type 1 Diabetes in Adults.
Fritsche A. Fritsche A. Exp Clin Endocrinol Diabetes. 2023 Sep;131(9):500-503. doi: 10.1055/a-2016-8392. Epub 2023 Jun 12. Exp Clin Endocrinol Diabetes. 2023. PMID: 37308105 Free PMC article.

See all "Cited by" articles

References

1. Hattersley AT, Patel KA. Precision diabetes: learning from monogenic diabetes. Diabetologia 2017;60:769–777 - PMC - PubMed
1. De Franco E, Flanagan SE, Houghton JA, et al. . The effect of early, comprehensive genomic testing on clinical care in neonatal diabetes: an international cohort study. Lancet 2015;386:957–963 - PMC - PubMed
1. Oram RA, Patel K, Hill A, et al. . A type 1 diabetes genetic risk score can aid discrimination between type 1 and type 2 diabetes in young adults. Diabetes Care 2016;39:337–344 - PMC - PubMed
1. Grubb AL, McDonald TJ, Rutters F, et al. . A type 1 diabetes genetic risk score can identify patients with GAD65 autoantibody-positive type 2 diabetes who rapidly progress to insulin therapy. Diabetes Care 2019;42:208–214 - PMC - PubMed
1. Sharp SA, Rich SS, Wood AR, et al. . Development and standardization of an improved type 1 diabetes genetic risk score for use in newborn screening and incident diagnosis. Diabetes Care 2019;42:200–207 - PMC - PubMed

Publication types

Actions
Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- ClinicalTrials.gov
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials