RD Lawrence lecture 2013. Stratified approaches to the management of diabetes

Diabet Med. 2014 Apr;31(4):393-8. doi: 10.1111/dme.12391.

Abstract

A stratified approach to medicine aims to identify subgroups of patients who should be managed differently from others. Diabetes is a condition that offers considerable potential for stratification, in areas of drug response, complication risk and rate of progression amongst others. Approaches to stratification can be simple, using clinical phenotyping, or more complex involving genomic and other '-omic' technologies. In this review, I will highlight the utility of measuring endogenous insulin production to aid in diagnosis and appropriate treatment; outline key advances in monogenic diabetes where determining genetic aetiology can result in dramatic changes in treatment, and describe the developments in the field of pharmacogenetics in Type 2 diabetes.

Publication types

  • Lecture

MeSH terms

  • Aryl Hydrocarbon Hydroxylases / genetics
  • Cytochrome P-450 CYP2C9
  • Diabetes Mellitus, Type 1 / classification
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 2 / classification
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / metabolism*
  • Insulin Secretion
  • Pharmacogenetics
  • Phenotype

Substances

  • Hypoglycemic Agents
  • Insulin
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9
  • Aryl Hydrocarbon Hydroxylases