The onset and outcomes of type 2 diabetes and the patient’s response to medication have been linked to different clinical characteristics, suggesting a move away from a ‘one-size fits all’ regime and towards more personalised care could be beneficial.
This is according to research from the University of Dundee, published in Nature Medicine, which found a method to determine how people with type 2 diabetes differ from each other. Their findings have the potential to offer a more personalised treatment regime and could transform the management of the disease, they said.
By examining phenotypic variations, or variations based on observable traits, such as body weight or blood fat, which are determined by a person’s genomic makeup and environmental factors, the researchers identified how different groups of a European population would respond to the disease and treatment.
Type 2 diabetes affects over four million people in the UK and is the most significant cause of blindness and amputation in the UK. Complications arising from the condition can also lead to life-threatening heart and kidney disease.
Using data collected from over 23 000 Scottish patients with newly diagnosed type 2 diabetes, the researchers developed an innovative way to visualise how much people with type 2 diabetes differ based on nine clinical characteristics.
Considerable phenotypic heterogeneity was associated with type 2 diabetes. For example, the results showed that patients at risk of retinopathy are phenotypically different from those at risk of cardiovascular illness which occurs as a result of the type 2 diabetes diagnosis. The findings highlight the complexity of the condition which is caused by many different mechanisms.
Ewan Pearson, Professor of Diabetic Medicine at the University of Dundee, said: ‘Clinically, we need to move away from a one-size-fits-all approach to the management of people with type 2 diabetes and be more precise in their care.’
He added: ‘Our study demonstrates how we can look at an individual with type 2 diabetes and illustrate in an intuitive way the main reasons they have diabetes and use this to manage them better to reduce their individual risks.’
It is hoped that this research will help clinicians by simplifying the complexity of treating type 2 diabetes.
John Dennis from the University of Exeter Medical School, who supported the research, said: ‘At the moment, clinicians are in the difficult position of making decisions that impact on health in type 2 diabetes based on very little evidence. Our findings can provide more personalised information to support the clinical care of people with type 2 diabetes.’
The findings come after Diabetes UK warned last month that integrated Care Systems (ICSs) must urgently draw up plans to catch up on the backlog of diabetes care, with concerns people with condition are not accessing services as needed.