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Monogenic diabetes : From genetic insights to population-based precision in care. reflections from a diabetes care editors’ expert forum

Riddle, Matthew C. ; Philipson, Louis H. ; Rich, Stephen S. ; Carlsson, Annelie LU orcid ; Franks, Paul W. LU ; Greeley, Siri Atma W. ; Nolan, John J. ; Pearson, Ewan R. ; Zeitler, Philip S. and Hattersley, Andrew T. (2020) In Diabetes Care 43(12). p.3117-3128
Abstract

Individualization of therapy based on a person’s specific type of diabetes is one key element of a “precision medicine” approach to diabetes care. However, applying such an approach remains difficult because of barriers such as disease heterogeneity, difficulties in accurately diagnosing different types of diabetes, multiple genetic influences, incomplete understanding of pathophysiology, limitations of current therapies, and environmental, social, and psychological factors. Monogenic diabetes, for which single gene mutations are causal, is the category most suited to a precision approach. The pathophysiological mechanisms of monogenic diabetes are understood better than those of any other form of diabetes. Thus, this category offers... (More)

Individualization of therapy based on a person’s specific type of diabetes is one key element of a “precision medicine” approach to diabetes care. However, applying such an approach remains difficult because of barriers such as disease heterogeneity, difficulties in accurately diagnosing different types of diabetes, multiple genetic influences, incomplete understanding of pathophysiology, limitations of current therapies, and environmental, social, and psychological factors. Monogenic diabetes, for which single gene mutations are causal, is the category most suited to a precision approach. The pathophysiological mechanisms of monogenic diabetes are understood better than those of any other form of diabetes. Thus, this category offers the advantage of accurate diagnosis of nonoverlapping etiological subgroups for which specific interventions can be applied. Although representing a small proportion of all diabetes cases, monogenic forms present an opportunity to demonstrate the feasibility of precision medicine strategies. In June 2019, the editors of Diabetes Care convened a panel of experts to discuss this opportunity. This article summarizes the major themes that arose at that forum. It presents an overview of the common causes of monogenic diabetes, describes some challenges in identifying and treating these disorders, and reports experience with various approaches to screening, diagnosis, and management. This article complements a larger American Diabetes Association effort supporting implementation of precision medicine for monogenic diabetes, which could serve as a platform for a broader initiative to apply more precise tactics to treating the more common forms of diabetes.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetes Care
volume
43
issue
12
pages
12 pages
publisher
American Diabetes Association
external identifiers
  • scopus:85096981864
  • pmid:33560999
ISSN
0149-5992
DOI
10.2337/dci20-0065
language
English
LU publication?
yes
id
1548eeb7-336e-4fcf-ba61-c664b15d340a
date added to LUP
2020-12-10 07:26:54
date last changed
2024-06-14 04:33:12
@article{1548eeb7-336e-4fcf-ba61-c664b15d340a,
  abstract     = {{<p>Individualization of therapy based on a person’s specific type of diabetes is one key element of a “precision medicine” approach to diabetes care. However, applying such an approach remains difficult because of barriers such as disease heterogeneity, difficulties in accurately diagnosing different types of diabetes, multiple genetic influences, incomplete understanding of pathophysiology, limitations of current therapies, and environmental, social, and psychological factors. Monogenic diabetes, for which single gene mutations are causal, is the category most suited to a precision approach. The pathophysiological mechanisms of monogenic diabetes are understood better than those of any other form of diabetes. Thus, this category offers the advantage of accurate diagnosis of nonoverlapping etiological subgroups for which specific interventions can be applied. Although representing a small proportion of all diabetes cases, monogenic forms present an opportunity to demonstrate the feasibility of precision medicine strategies. In June 2019, the editors of Diabetes Care convened a panel of experts to discuss this opportunity. This article summarizes the major themes that arose at that forum. It presents an overview of the common causes of monogenic diabetes, describes some challenges in identifying and treating these disorders, and reports experience with various approaches to screening, diagnosis, and management. This article complements a larger American Diabetes Association effort supporting implementation of precision medicine for monogenic diabetes, which could serve as a platform for a broader initiative to apply more precise tactics to treating the more common forms of diabetes.</p>}},
  author       = {{Riddle, Matthew C. and Philipson, Louis H. and Rich, Stephen S. and Carlsson, Annelie and Franks, Paul W. and Greeley, Siri Atma W. and Nolan, John J. and Pearson, Ewan R. and Zeitler, Philip S. and Hattersley, Andrew T.}},
  issn         = {{0149-5992}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{3117--3128}},
  publisher    = {{American Diabetes Association}},
  series       = {{Diabetes Care}},
  title        = {{Monogenic diabetes : From genetic insights to population-based precision in care. reflections from a diabetes care editors’ expert forum}},
  url          = {{http://dx.doi.org/10.2337/dci20-0065}},
  doi          = {{10.2337/dci20-0065}},
  volume       = {{43}},
  year         = {{2020}},
}