{"id":7401,"date":"2020-11-12T22:57:50","date_gmt":"2020-11-12T17:57:50","guid":{"rendered":"https:\/\/drmohans.com\/?p=7401"},"modified":"2024-11-27T05:19:06","modified_gmt":"2024-11-27T05:19:06","slug":"towards-precision-medicine-in-diabetes","status":"publish","type":"post","link":"https:\/\/drmohans.com\/backend\/towards-precision-medicine-in-diabetes\/","title":{"rendered":"Towards Precision Medicine in Diabetes"},"content":{"rendered":"

Until recently, a \u201cone-size-fits-all\u201d approach was used to treat most forms of diabetes. Not anymore. Personalised therapy is all set to bring new hope and cheer for people with diabetes<\/p>\n

The era of big data, genomics and molecular medicine offer novel treatment opportunities. One such emerging area is precision diabetes. It is already proving to be a life-changer for people with rare forms of diabetes, that are directly inherited. Rapid strides in frontier research have already made it a part of clinical tools at advanced diabetes centres. It is also bringing new promise to the more common forms of diabetes, like type 2.<\/p>\n

As the dream of personalised, precision medicine becomes more real, there is a new excitement among scientists. There is hope that the control of diabetes and its complications will become more effective, improving the quality of life of the people afflicted. Here is the sum-up of a scientific article, \u201cPrecision Diabetes<\/a> Is Slowly Becoming a Reality,\u201d by Drs V. Mohan and V. Radha of the Madras Diabetes Research Foundation<\/a>, Chennai, India, published in the journal Medical Principles and Practice in\u00a0January 2019.\u00a0<\/em><\/p>\n

WHAT IS PRECISION MEDICINE?<\/strong><\/h3>\n

The National Institutes of Health<\/a> (NIH), USA, define precision medicine as an emerging approach to disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle. The concept is not new. \u201cIn its crudest sense, conducting blood transfusion based on the specific blood group of a recipient is an example of precision medicine,\u201d write Mohan and Radha.<\/p>\n

The crux of precision medicine is customised delivery of healthcare, with tailored treatments for individual patients. The road to treatment, however, is still ongoing and long. Most therapeutic approaches are based on population averages, which unfortunately do not fit everyone. And the current methods of disease categorisation remains outmoded.<\/p>\n

NOT ONE SIZE FITS ALL<\/strong><\/h3>\n

In recent years, a new concept has arisen. It recognizes that even people suffering from the same disease may have very different reasons, symptoms, experiences and outcomes. And they may respond differently to standard treatments. As Mohan and Radha explain, this has led to the concept of personalised medicine, which, when further refined by scientific inputs, becomes precision medicine: \u201cPrecision medicine refers to collecting specific information about a patient and prescribing a specific treatment.\u201d<\/p>\n

<\/strong>This involves defining disease subtypes and biomarkers that can identify patients who are likely to benefit from a specific treatment or those who are likely to experience a particular side effect. Application of genotypic and phenotypic information forms the basis of precision medicine. Personalized medicine not only incorporates the principles of precision medicine but also takes into account the preferences, social, economic and other contexts of the patient.<\/p>\n

TOOLS & TECHNOLOGY<\/strong><\/h3>\n

The traditional sources of medical information are patient history, physical examination and laboratory workup. Ever since mapping and sequencing of the human genome began, a range of new \u201ctransformative and disruptive\u201d technologies have come up.<\/p>\n

They make it possible to get measurements of proteins, RNA<\/a>, genes, metabolites, lipids, DNA and chromosomes within tissues and cells. Such molecular snapshots of underlying biology at high resolution was not possible earlier. Cancer research was the first to adopt precision medicine. Now other fields, including endocrinology, are catching up fast.<\/p>\n

SO FAR WHAT WORKS<\/strong><\/h3>\n

Diabetes can be of four types, broadly: type 1 (T1DM), type 2 (T2DM), gestational diabetes<\/a> and monogenic diabetes. It is with the fourth type that precision diabetes has already come to be used in the clinical setting:<\/p>\n