Clinical and genetic predictors of diabetes drug's response

Drug Metab Rev. 2019 Nov;51(4):408-427. doi: 10.1080/03602532.2019.1656226. Epub 2019 Aug 28.

Abstract

Diabetes is a major health problem worldwide. Glycemic control is the main goal in the management of type 2 diabetes. While many anti-diabetic drugs and guidelines are available, almost half of diabetic patients do not reach their treatment goal and develop complications. The glucose-lowering response to anti-diabetic drug differs significantly between individuals. Relatively little is known about the factors that might underlie this response. The identification of predictors of response to anti-diabetic drugs is essential for treatment personalization. Unfortunately, the evidence on predictors of drugs response in type 2 diabetes is scarce. Only a few trials were designed for specific groups of patients (e.g. patients with renal impairment or older patients), while subgroup analyses of larger trials are frequently unreported. Physicians need help in picking the drug which provides the maximal benefit, with minimal side effects, in the right dose, for a specific patient, using an omics-based approach besides the phenotypic characteristics.

Keywords: Personalized diabetes therapy; drug metabolism; drug response; omics-based therapy; type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Acarbose / pharmacokinetics
  • Acarbose / therapeutic use
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / genetics*
  • Diabetes Mellitus, Type 2 / metabolism
  • Humans
  • Hypoglycemic Agents / pharmacokinetics
  • Hypoglycemic Agents / therapeutic use*
  • Metformin / pharmacokinetics
  • Metformin / therapeutic use
  • Precision Medicine
  • Predictive Value of Tests
  • Randomized Controlled Trials as Topic

Substances

  • Hypoglycemic Agents
  • Metformin
  • Acarbose