Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine.
Tobias DK., Merino J., Ahmad A., Aiken C., Benham JL., Bodhini D., Clark AL., Colclough K., Corcoy R., Cromer SJ., Duan D., Felton JL., Francis EC., Gillard P., Gingras V., Gaillard R., Haider E., Hughes A., Ikle JM., Jacobsen LM., Kahkoska AR., Kettunen JLT., Kreienkamp RJ., Lim L-L., Männistö JME., Massey R., Mclennan N-M., Miller RG., Morieri ML., Most J., Naylor RN., Ozkan B., Patel KA., Pilla SJ., Prystupa K., Raghavan S., Rooney MR., Schön M., Semnani-Azad Z., Sevilla-Gonzalez M., Svalastoga P., Takele WW., Tam CH-T., Thuesen ACB., Tosur M., Wallace AS., Wang CC., Wong JJ., Yamamoto JM., Young K., Amouyal C., Andersen MK., Bonham MP., Chen M., Cheng F., Chikowore T., Chivers SC., Clemmensen C., Dabelea D., Dawed AY., Deutsch AJ., Dickens LT., DiMeglio LA., Dudenhöffer-Pfeifer M., Evans-Molina C., Fernández-Balsells MM., Fitipaldi H., Fitzpatrick SL., Gitelman SE., Goodarzi MO., Grieger JA., Guasch-Ferré M., Habibi N., Hansen T., Huang C., Harris-Kawano A., Ismail HM., Hoag B., Johnson RK., Jones AG., Koivula RW., Leong A., Leung GKW., Libman IM., Liu K., Long SA., Lowe WL., Morton RW., Motala AA., Onengut-Gumuscu S., Pankow JS., Pathirana M., Pazmino S., Perez D., Petrie JR., Powe CE., Quinteros A., Jain R., Ray D., Ried-Larsen M., Saeed Z., Santhakumar V., Kanbour S., Sarkar S., Monaco GSF., Scholtens DM., Selvin E., Sheu WH-H., Speake C., Stanislawski MA., Steenackers N., Steck AK., Stefan N., Støy J., Taylor R., Tye SC., Ukke GG., Urazbayeva M., Van der Schueren B., Vatier C., Wentworth JM., Hannah W., White SL., Yu G., Zhang Y., Zhou SJ., Beltrand J., Polak M., Aukrust I., de Franco E., Flanagan SE., Maloney KA., McGovern A., Molnes J., Nakabuye M., Njølstad PR., Pomares-Millan H., Provenzano M., Saint-Martin C., Zhang C., Zhu Y., Auh S., de Souza R., Fawcett AJ., Gruber C., Mekonnen EG., Mixter E., Sherifali D., Eckel RH., Nolan JJ., Philipson LH., Brown RJ., Billings LK., Boyle K., Costacou T., Dennis JM., Florez JC., Gloyn AL., Gomez MF., Gottlieb PA., Greeley SAW., Griffin K., Hattersley AT., Hirsch IB., Hivert M-F., Hood KK., Josefson JL., Kwak SH., Laffel LM., Lim SS., Loos RJF., Ma RCW., Mathieu C., Mathioudakis N., Meigs JB., Misra S., Mohan V., Murphy R., Oram R., Owen KR., Ozanne SE., Pearson ER., Perng W., Pollin TI., Pop-Busui R., Pratley RE., Redman LM., Redondo MJ., Reynolds RM., Semple RK., Sherr JL., Sims EK., Sweeting A., Tuomi T., Udler MS., Vesco KK., Vilsbøll T., Wagner R., Rich SS., Franks PW.
Precision medicine is part of the logical evolution of contemporary evidence-based medicine that seeks to reduce errors and optimize outcomes when making medical decisions and health recommendations. Diabetes affects hundreds of millions of people worldwide, many of whom will develop life-threatening complications and die prematurely. Precision medicine can potentially address this enormous problem by accounting for heterogeneity in the etiology, clinical presentation and pathogenesis of common forms of diabetes and risks of complications. This second international consensus report on precision diabetes medicine summarizes the findings from a systematic evidence review across the key pillars of precision medicine (prevention, diagnosis, treatment, prognosis) in four recognized forms of diabetes (monogenic, gestational, type 1, type 2). These reviews address key questions about the translation of precision medicine research into practice. Although not complete, owing to the vast literature on this topic, they revealed opportunities for the immediate or near-term clinical implementation of precision diabetes medicine; furthermore, we expose important gaps in knowledge, focusing on the need to obtain new clinically relevant evidence. Gaps include the need for common standards for clinical readiness, including consideration of cost-effectiveness, health equity, predictive accuracy, liability and accessibility. Key milestones are outlined for the broad clinical implementation of precision diabetes medicine.