학술논문

Second international consensus report on gaps and opportunities for the clinical translation of precision diabetes medicine
Document Type
article
Author
Tobias, Deirdre KMerino, JordiAhmad, AbrarAiken, CatherineBenham, Jamie LBodhini, DhanasekaranClark, Amy LColclough, KevinCorcoy, RosaCromer, Sara JDuan, DaisyFelton, Jamie LFrancis, Ellen CGillard, PieterGingras, VéroniqueGaillard, RomyHaider, EramHughes, AliceIkle, Jennifer MJacobsen, Laura MKahkoska, Anna RKettunen, Jarno LTKreienkamp, Raymond JLim, Lee-LingMännistö, Jonna MEMassey, RobertMclennan, Niamh-MaireMiller, Rachel GMorieri, Mario LucaMost, JasperNaylor, Rochelle NOzkan, BigePatel, Kashyap AmratlalPilla, Scott JPrystupa, KatsiarynaRaghavan, SridharanRooney, Mary RSchön, MartinSemnani-Azad, ZhilaSevilla-Gonzalez, MagdalenaSvalastoga, PernilleTakele, Wubet WorkuTam, Claudia Ha-tingThuesen, Anne Cathrine BTosur, MustafaWallace, Amelia SWang, Caroline CWong, Jessie JYamamoto, Jennifer MYoung, KatherineAmouyal, ChloéAndersen, Mette KBonham, Maxine PChen, MinglingCheng, FeifeiChikowore, TinasheChivers, Sian CClemmensen, ChristofferDabelea, DanaDawed, Adem YDeutsch, Aaron JDickens, Laura TDiMeglio, Linda ADudenhöffer-Pfeifer, MonikaEvans-Molina, CarmellaFernández-Balsells, María MercèFitipaldi, HugoFitzpatrick, Stephanie LGitelman, Stephen EGoodarzi, Mark OGrieger, Jessica AGuasch-Ferré, MartaHabibi, NahalHansen, TorbenHuang, ChuiguoHarris-Kawano, AriannaIsmail, Heba MHoag, BenjaminJohnson, Randi KJones, Angus GKoivula, Robert WLeong, AaronLeung, Gloria KWLibman, Ingrid MLiu, KaiLong, S AliceLowe, William LMorton, Robert WMotala, Ayesha AOnengut-Gumuscu, SunaPankow, James SPathirana, MaleesaPazmino, SofiaPerez, DiannaPetrie, John RPowe, Camille EQuinteros, AlejandraJain, RashmiRay, DebashreeRied-Larsen, Mathias
Source
Nature Medicine. 29(10)
Subject
Health Services and Systems
Biomedical and Clinical Sciences
Health Sciences
Health Services
Diabetes
Clinical Research
Pediatric
Metabolic and endocrine
Good Health and Well Being
Humans
Precision Medicine
Consensus
Diabetes Mellitus
Evidence-Based Medicine
Medical and Health Sciences
Immunology
Biomedical and clinical sciences
Health sciences
Language
Abstract
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.