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PERSONALIZED MEDICINE FOR T2DM IN 2019

Harnessing heterogeneity in type 2 diabetes mellitus

Nature Reviews Endocrinology volume 16, pages 79–80 (2020)Cite this article

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Personalized, or precision, medicine in type 2 diabetes mellitus is becoming a reality with new insights into the contributions of subgroup analyses. The roadmap to future implementation must take into account individual and subgroup variability in genetic architecture, environment, clinical measures, lifestyle, cost-effectiveness and treatment burden.

Key advances

  • Subgroup analyses have divided patients with type 2 diabetes mellitus (T2DM) into at least five clusters that differ with regard to genetics, insulin secretion, disease progression and disease complications4,7.

  • Specific phenotypic measures of readily measured continuous clinical features can help predict specific outcomes such as fatty liver disease or neuropathy4.

  • Autoimmunity screening might be beneficial in all patients with T2DM7.

  • Deep longitudinal omics profiling can lead to prediction models of insulin resistance with increased acceptance of diet and exercise changes in research participants8.

  • Individuals with biomarkers of insulin resistance can benefit from targeted treatments with PPAR γ agonists as opposed to sulfonylureas to address cardiovascular protection9.

  • Models based on multi-criteria decision analyses that include disease outcomes, patient preferences and medication characteristics can improve personalized treatments10.

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Author information

Authors and Affiliations

  1. Departments of Medicine, University of Chicago, Chicago, IL, USA

    Louis H. Philipson

  2. Department of Pediatrics, University of Chicago, Chicago, IL, USA

    Louis H. Philipson

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  1. Louis H. Philipson
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Correspondence to Louis H. Philipson.

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The author declares no competing interests.

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Philipson, L.H. Harnessing heterogeneity in type 2 diabetes mellitus. Nat Rev Endocrinol 16, 79–80 (2020). https://doi.org/10.1038/s41574-019-0308-1

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