PROVIDENCE, R.I.—A recent report examined what is known and what needs to be learned about the potential to individualize glycemic therapies in type 2 diabetes, which is heterogeneous in its clinical features, pathogenesis and predisposing or causal genetic factors, based on phenotypes and genotypes (J Clin Endocrinol Metab. March 1, 2010).
A 29-member international working group with expertise in diabetes epidemiology, physiology, genetics, clinical trials and clinical care participated concluded: “Recent advances in genetics, such as the identification of Kir6.2 mutations and the responsible genes for several forms of maturity onset diabetes of the young (MODY), have established precedents linking specifically effective therapies to defined diabetes subtypes. The recent increase in identified polygenic factors related to type 2 diabetes and our understanding of the pathogenesis of diabetes provide potential opportunities to individualize therapy. To further this process, we recommend expanded analysis of existing data sources and the development of new basic and clinical research studies, including a greater focus on identifying type 2 diabetes subtypes, their response to different therapies, and quantitation of cost effectiveness.”
Robert Smith, M.D., of Brown University in Providence, said: “As more genetic factors related to type 2 diabetes are identified and as our understanding of the progression of the disease evolves, we can expect to gain precision in identifying the best drug choices for individual patients and to more effectively halt the progression of diabetes.”
