Precision medicine in type 1 diabetes

Diabetologia. 2022 Nov;65(11):1854-1866. doi: 10.1007/s00125-022-05778-3. Epub 2022 Aug 22.

Abstract

First envisioned by early diabetes clinicians, a person-centred approach to care was an aspirational goal that aimed to match insulin therapy to each individual's unique requirements. In the 100 years since the discovery of insulin, this goal has evolved to include personalised approaches to type 1 diabetes diagnosis, treatment, prevention and prediction. These advances have been facilitated by the recognition of type 1 diabetes as an autoimmune disease and by advances in our understanding of diabetes pathophysiology, genetics and natural history, which have occurred in parallel with advancements in insulin delivery, glucose monitoring and tools for self-management. In this review, we discuss how these personalised approaches have improved diabetes care and how improved understanding of pathogenesis and human biology might inform precision medicine in the future.

Keywords: C-peptide; Continuous glucose monitoring; Genetics; Insulin; Personalised medicine; Precision medicine; Review; Type 1 diabetes.

Publication types

  • Review
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 1* / genetics
  • Diabetes Mellitus, Type 1* / therapy
  • Diabetes Mellitus, Type 2* / therapy
  • Humans
  • Insulin / therapeutic use
  • Precision Medicine

Substances

  • Blood Glucose
  • Insulin