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Consensus Report On Precision Diabetes Medicine

Consensus Report On Precision Diabetes Medicine

The American Diabetes Association (ADA) launched its Precision Medicines in Diabetes Initiatives (PMDI) in 2018 in partnership with the European Association for the Study of Diabetes (EASD). This first consensus report describes a foundation for precision diabetes medicines; it discusses the current state of play for precision diagnostics and precision therapeutics (including prevention and treatment), and key barriers to and opportunities for implementation of precision diabetes medicine.

Precision diabetes medicine is an approach to optimise the diagnosis, prognostics, monitoring, and prevention or treatment of diabetes by integrating multidimensional data, from both traditional data sources and emergent sources of “big data”. The use of complex data to characterise individual differences is the major distinction between precision diabetes medicine and the standard medical approaches.

Whilst precision diagnosis and treatment of monogenic diabetes are already feasible and effective, the application to other types of diabetes are not yet realised, including the potential application for type 2 diabetes, which “has been shown to be a complex combination of multiple conditions and processes, defined by process-specific subgroups in which individuals with extreme burdens of risk in particular pathway reside and for whom a specific therapeutic approach may be optimal”.

The implementation of precision diabetes medicine needs multiple steps to succeed:

  1. Understanding the disease (risk factors, mechanisms, natural history)
  2. Identifying disease-specific biomarkers (diagnostic, monitoring, predictive, prognostic, pharmacodynamic/response, safety, susceptibility, surrogate endpoint)
  3. Vertical integration of biomarkers and generation of algorithms
  4. Regulatory engagement
  5. Patient engagement
  6. Testing single biomarkers or biomarker sets in intervention trials
  7. Clinician education
  8. Regulatory approval
  9. Health economic assessment
  10. Clinical translation (continued clinician education and decision support)
  11. Patient feedback

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Editorial Board

Image
Dr. Salvatore A. De Cosmo's image

Dr. Salvatore A. De Cosmo

Head of Unit of Internal Medicine and Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza” San Giovanni, Rotondo, Italy
,
Image
Dr. Juan José Gorgojo Martínez's image

Dr. Juan José Gorgojo Martínez

Head of Department of Endocrinology and Nutrition, University Hospital Fundación, Alcorcon, Madrid, Spain
,
Image
Dr. Patrick Holmes' image

Dr. Patrick Holmes

General Practitioner, St. George's Medical Practice, Darlington, UK

Editorial Board

Image
Dr. Salvatore A. De Cosmo's image

Dr. Salvatore A. De Cosmo

Head of Unit of Internal Medicine and Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza” San Giovanni, Rotondo, Italy
Image
Dr. Juan José Gorgojo Martínez's image

Dr. Juan José Gorgojo Martínez

Head of Department of Endocrinology and Nutrition, University Hospital Fundación, Alcorcon, Madrid, Spain
Image
Dr. Patrick Holmes' image

Dr. Patrick Holmes

General Practitioner, St. George's Medical Practice, Darlington, UK

Publication under Spotlight

Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).

Diabetes Care.
2020;43(7):1617-1635.

Authors: Wendy K Chung, Karel Erion, Jose C Florez, Andrew T Hattersley, Marie-France Hivert, Christine G Lee, Mark I McCarthy, John J Nolan, Jill M Norris, Ewan R Pearson, Louis Philipson, Allison T McElvaine, William T Cefalu, Stephen S Rich, and Paul W Franks

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