Precision medicine and fight against diabetes

A new report contributed to by researchers from the University of Adelaide highlights the importance of precision diabetes medicine in clinical practice and emphasises the critical knowledge gaps that need to be addressed.

The report A new international consensus report on precision medicine in diabetes prevention and care highlights significant advancements in the adoption of precision medicine in diabetes prevention, diagnosis, treatment, and prognosis while also shedding light on numerous knowledge gaps.

"Precision medicine, sometimes known as personalised medicine, is an innovative approach to tailoring disease prevention and treatment that takes into account differences in people's genes, environments, and lifestyles," said the University of Adelaide's Dr Jessica Grieger, Senior Research Fellow, Robinson Research Institute and Adelaide Medical School who is a member of the team that contributed to the report.

"Precision medicine has potential application in preventing gestational diabetes."

Diabetes affects hundreds of millions of people worldwide, many of whom will develop life-threatening complications and die prematurely.

"What adds to the complexity is the heterogeneous nature of diabetes, encompassing various causes, clinical manifestations, and prognoses," said Dr Grieger.

"The heterogeneity underscores the need for more precise diagnostic, prevention and treatment strategies than exist today."

"Precision medicine, sometimes known as personalised medicine, is an innovative approach to tailoring disease prevention and treatment that takes into account differences in people's genes, environments, and lifestyles."Dr Jessica Grieger, Senior Research Fellow, Robinson Research Institute and Adelaide Medical School

The report, contributed to by a team of researchers from the University of Adelaide that included Dr Jo Zhou, Dr Nahal Habibi, Dr Maleesa Pathirana, and Dr Kai Liu, as well as Dr Grieger, was published in the journal Nature Medicine.

"Important maternal characteristics, including age, BMI, having polycystic ovary syndrome, and a history of gestational diabetes were identified as predictive factors for the success or failure in the prevention of gestational diabetes," said Dr Grieger.

The report shows clear progress in implementing precision diabetes medicine, shedding light on opportunities for its immediate or near-term clinical application, such as in diagnosing and treating monogenic diabetes.

"The effectiveness of lifestyle interventions is potentially superior to metformin interventions in certain individuals, supporting the clear need for tailoring of lifestyle recommendations for precision gestational diabetes prevention rather than the current 'one-size-fits-all' approach," said Dr Grieger.

Metformin is used to control blood glucose levels in people who have diabetes. It can be prescribed for adults and children over the age of 10.

Supported by the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD) and the Novo Nordisk Foundation, the consensus report was made possible through a huge collaborative effort involving 200 academic experts from 28 countries under the banner of the Precision Medicine in Diabetes Initiative (PMDI).

"While the consensus report highlights areas where precision medicine can have an impact in clinical practice, it also draws attention to research gaps and the need for improved research methods," said Professor Paul Franks, chair of the report and Scientific Director in Medical Science and Head of Translational Medicine at the Novo Nordisk Foundation.

"There is a big need for better reporting standards, study design standards, and specifically designed precision medicine trials. The consensus report provides a framework for what future research should focus on."

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