[acb-diabetics] treatment of diabetes should be directed toward hetogrogenictic type

[Patricia LaFrance-Wolf]

Using Genotypes to Individualize Diabetes Treatment

 

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A new consensus report outlines current knowledge of the heterogeneity of
Type 2 diabetes as well as areas that need to be further explored, based on
phenotypes

and genotypes. Experts also provide recommendations to bring health care
professionals closer to the goal of individualizing therapy. 

"Although Type 2 diabetes is considered to be heterogeneous with regard to
its clinical presentation, features and pathogenesis, including
pathophysiology

and underlying genetic risk factors, patients are generally treated
similarly, independent of the underlying differences that might affect
therapeutic

response. Further insight into the heterogeneity of the Type 2 diabetes
patient population might help explain and, ultimately, reduce the high rate
of

treatment failure," the experts wrote. 

Current knowledge is based on head-to-head comparison studies, crude or
deficient baseline phenotyping and genotyping, and inadequate subset
analyses, rendering

the current models of treatment for Type 2 diabetes nonspecific, according
to the report. To date, understanding "has not yet reached a point at which

it can guide individualized therapy decisions," the experts wrote. However,
progress is apparent.

"Recent advances in genetics, such as the identification of the responsible
genes for several forms of Maturity Onset Diabetes of the Young (MODY), now

referred to as monogenic diabetes, have established precedents linking
specific drug therapies to defined subtypes of diabetes patients," Robert J.
Smith,

MD

,

 of Brown University, Providence, RI, said in a press release. "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." 

An international working group of experts in epidemiology, pathophysiology,
genetics, clinical trials and clinical care participated in an April 2009
conference

during which they reviewed the current knowledge of phenotypic and genotypic
heterogeneity in Type 2 diabetes. The conference was sponsored by The
Endocrine

Society and American Diabetes Association. Then, a writing group prepared
recommendations for individualized treatment of Type 2 diabetes, such as: 

Extend analysis of existing data and data sources: data and sources that
could be potentially valuable in individualizing therapy have been largely
underutilized.

Pooled analyses or meta-analyses of such data may provide insight into the
relative effectiveness of specific interventions in subgroups of patients
with

Type 2 diabetes. 

Expand existing or develop new data registries: All new and existing
diabetes registries should systematically collect data to address phenotypic
and genetic

heterogeneity measures, including material for future biomarker and genetic
analysis and hypotheses generated by examining existing data. 

Develop new clinical trials: future randomized studies of diabetes therapies
should collect phenotypic information relevant to response to therapy. 

Develop new technologies: targeting therapy toward more appropriate
subgroups of patients will require increasingly accurate and efficient
methods to measure

markers for diabetes heterogeneity and heterogeneous response to treatment. 

Expand basic research: basic research is needed to explore numerous
fundamental issues that underlie the heterogeneous response to diabetes
therapies. 

"The recommendations in this consensus statement highlight the need for the
research community and industry to each play their part in improving our
ability

to individualize therapy so that patients can get the most accurate and
appropriate treatment," Robert A. Vigersky, MD

,

 president of The Endocrine Society, said in a press release. 

Smith RJ. 

J Clin Endocrinol Metab

. 2010;95:1566-1574. 

High Glycemic Foods Can Increase Risk for Heart Disease in Women

Baby Boomers Will Outlive Their Children 

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This article originally posted 

13 April, 2010

 and appeared in  

Issue 517

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This article originally posted 13 April, 2010 and appeared in  

Issue 517

 

Using Genotypes to Individualize Diabetes Treatment

 

A panel of diabetes experts is encouraging efforts to increase understanding
of the heterogeneity of Type 2 diabetes to achieve individualized treatments

and improve treatment responses....

 

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Click here to find out more! frame

 

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A new consensus report outlines current knowledge of the heterogeneity of
Type 2 diabetes as well as areas that need to be further explored, based on
phenotypes

and genotypes. Experts also provide recommendations to bring health care
professionals closer to the goal of individualizing therapy. 

 

"Although Type 2 diabetes is considered to be heterogeneous with regard to
its clinical presentation, features and pathogenesis, including
pathophysiology

and underlying genetic risk factors, patients are generally treated
similarly, independent of the underlying differences that might affect
therapeutic

response. Further insight into the heterogeneity of the Type 2 diabetes
patient population might help explain and, ultimately, reduce the high rate
of

treatment failure," the experts wrote. 

 

Current knowledge is based on head-to-head comparison studies, crude or
deficient baseline phenotyping and genotyping, and inadequate subset
analyses, rendering

the current models of treatment for Type 2 diabetes nonspecific, according
to the report. To date, understanding "has not yet reached a point at which

it can guide individualized therapy decisions," the experts wrote. However,
progress is apparent.

 

"Recent advances in genetics, such as the identification of the responsible
genes for several forms of Maturity Onset Diabetes of the Young (MODY), now

referred to as monogenic diabetes, have established precedents linking
specific drug therapies to defined subtypes of diabetes patients," Robert J.
Smith,

MD, of Brown University, Providence, RI, said in a press release. "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." 

 

An international working group of experts in epidemiology, pathophysiology,
genetics, clinical trials and clinical care participated in an April 2009
conference

during which they reviewed the current knowledge of phenotypic and genotypic
heterogeneity in Type 2 diabetes. The conference was sponsored by The
Endocrine

Society and American Diabetes Association. Then, a writing group prepared
recommendations for individualized treatment of Type 2 diabetes, such as: 

 

list of 5 items

. Extend analysis of existing data and data sources: data and sources that
could be potentially valuable in individualizing therapy have been largely
underutilized.

Pooled analyses or meta-analyses of such data may provide insight into the
relative effectiveness of specific interventions in subgroups of patients
with

Type 2 diabetes. 

. Expand existing or develop new data registries: All new and existing
diabetes registries should systematically collect data to address phenotypic
and

genetic heterogeneity measures, including material for future biomarker and
genetic analysis and hypotheses generated by examining existing data. 

. Develop new clinical trials: future randomized studies of diabetes
therapies should collect phenotypic information relevant to response to
therapy. 

. Develop new technologies: targeting therapy toward more appropriate
subgroups of patients will require increasingly accurate and efficient
methods to

measure markers for diabetes heterogeneity and heterogeneous response to
treatment. 

. Expand basic research: basic research is needed to explore numerous
fundamental issues that underlie the heterogeneous response to diabetes
therapies.

 

list end

 

"The recommendations in this consensus statement highlight the need for the
research community and industry to each play their part in improving our
ability

to individualize therapy so that patients can get the most accurate and
appropriate treatment," Robert A. Vigersky, MD, president of The Endocrine
Society,

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