Utility of Precision Medicine in the Management of Diabetes: Expert Opinion from an International Panel.

Kalra S1, Das AK2, Bajaj S3, Priya G4, Ghosh S5, Mehrotra RN6, Das S7, Shah P8, Deshmukh V9, Sanyal D10, Chandrasekaran S11, Khandelwal D12, Joshi A13, Nair T14, Eliana F15, Permana H16, Fariduddin MD17, Shrestha PK18, Shrestha D19, Kahandawa S20, Sumanathilaka M21, Shaheed A22, Rahim AAA23, Orabi A24, Al-Ani A25, Hussein W26, Kumar D27, Shaikh K28.

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Abstract

AIM:

The primary objective of this review is to develop a practice-based expert group opinion on the role of precision medicine with a specific focus on sulfonylureas (SUs) in diabetes management.

BACKGROUND:

The clinical etiology, presentation and complications of diabetes vary from one patient to another, making the management of the disease challenging. The pre-eminent feature of diabetes mellitus (DM) are chronically elevated blood glucose concentrations; however, in clinical practice, the exclusion of autoimmunity, pregnancy, pancreatic disease or injury and rare genetic forms of diabetes is crucial. Within this framework, precision medicine provides unique insights into the risk factors and natural history of DM. Precision medicine goes beyond genomics and encompasses patient-centered care, molecular technologies and data sharing. Precision medicine has evolved in the field of diabetology. It has helped improve the efficacy of SUs, a class of drugs, which have been effectively used in the management of diabetes mellitus for decades, and it has enabled the expansion of SUs use in diabetes patients with genetic mutations.

REVIEW RESULTS:

After due discussions, the expert group analyzed studies that focused on the use of SUs in diabetes patients with genomic variations and rare mutations. The expert group opined that SUs are important glucose-lowering drugs and that precision medicine helps in improving the efficacy of SUs by matching them to those patients who will benefit most.