Precision diabetes: learning from monogenic diabetes.

2.50
Hdl Handle:
http://hdl.handle.net/11287/620315
Title:
Precision diabetes: learning from monogenic diabetes.
Authors:
Hattersley, Andrew T.; Patel, Kashyap
Abstract:
The precision medicine approach of tailoring treatment to the individual characteristics of each patient or subgroup has been a great success in monogenic diabetes subtypes, MODY and neonatal diabetes. This review examines what has led to the success of a precision medicine approach in monogenic diabetes (precision diabetes) and outlines possible implications for type 2 diabetes. For monogenic diabetes, the molecular genetics can define discrete aetiological subtypes that have profound implications on diabetes treatment and can predict future development of associated clinical features, allowing early preventative or supportive treatment. In contrast, type 2 diabetes has overlapping polygenic susceptibility and underlying aetiologies, making it difficult to define discrete clinical subtypes with a dramatic implication for treatment. The implementation of precision medicine in neonatal diabetes was simple and rapid as it was based on single clinical criteria (diagnosed <6 months of age). In contrast, in MODY it was more complex and slow because of the lack of single criteria to identify patients, but it was greatly assisted by the development of a diagnostic probability calculator and associated smartphone app. Experience in monogenic diabetes suggests that successful adoption of a precision diabetes approach in type 2 diabetes will require simple, quick, easily accessible stratification that is based on a combination of routine clinical data, rather than relying on newer technologies. Analysing existing clinical data from routine clinical practice and trials may provide early success for precision medicine in type 2 diabetes.
Citation:
Precision diabetes: learning from monogenic diabetes. 2017 Diabetologia
Publisher:
Springer
Journal:
Diabetologia
Issue Date:
17-Mar-2017
URI:
http://hdl.handle.net/11287/620315
DOI:
10.1007/s00125-017-4226-2
PubMed ID:
28314945
Additional Links:
https://dx.doi.org/10.1007/s00125-017-4226-2
Note:
This article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site.
Type:
Journal Article
Language:
en
ISSN:
1432-0428
Appears in Collections:
Diabetes/Endocrine Services; 2017 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorHattersley, Andrew T.en
dc.contributor.authorPatel, Kashyapen
dc.date.accessioned2017-03-23T10:36:17Z-
dc.date.available2017-03-23T10:36:17Z-
dc.date.issued2017-03-17-
dc.identifier.citationPrecision diabetes: learning from monogenic diabetes. 2017 Diabetologiaen
dc.identifier.issn1432-0428-
dc.identifier.pmid28314945-
dc.identifier.doi10.1007/s00125-017-4226-2-
dc.identifier.urihttp://hdl.handle.net/11287/620315-
dc.description.abstractThe precision medicine approach of tailoring treatment to the individual characteristics of each patient or subgroup has been a great success in monogenic diabetes subtypes, MODY and neonatal diabetes. This review examines what has led to the success of a precision medicine approach in monogenic diabetes (precision diabetes) and outlines possible implications for type 2 diabetes. For monogenic diabetes, the molecular genetics can define discrete aetiological subtypes that have profound implications on diabetes treatment and can predict future development of associated clinical features, allowing early preventative or supportive treatment. In contrast, type 2 diabetes has overlapping polygenic susceptibility and underlying aetiologies, making it difficult to define discrete clinical subtypes with a dramatic implication for treatment. The implementation of precision medicine in neonatal diabetes was simple and rapid as it was based on single clinical criteria (diagnosed <6 months of age). In contrast, in MODY it was more complex and slow because of the lack of single criteria to identify patients, but it was greatly assisted by the development of a diagnostic probability calculator and associated smartphone app. Experience in monogenic diabetes suggests that successful adoption of a precision diabetes approach in type 2 diabetes will require simple, quick, easily accessible stratification that is based on a combination of routine clinical data, rather than relying on newer technologies. Analysing existing clinical data from routine clinical practice and trials may provide early success for precision medicine in type 2 diabetes.en
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urlhttps://dx.doi.org/10.1007/s00125-017-4226-2en
dc.rightsArchived with thanks to Diabetologia. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.en
dc.subjectWessex Classification Subject Headings::Endocrinology::Diabetesen
dc.titlePrecision diabetes: learning from monogenic diabetes.en
dc.typeJournal Articleen
dc.identifier.journalDiabetologiaen
dc.description.noteThis article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site.en
dc.type.versionIn press (epub ahead of print)en

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