7 Recognizing the wide range of patients with DM, recent guidelines now stress the need to personalize DM management goals and treatments.8 In the face of the “selleck products diabetes tsunami”9 the gap between knowledge derived from basic scientific and clinical research, including
newly recognized molecular mechanisms and updated medical management guidelines and their use at the bedside or point of care by practitioners, is growing. Developing strategies and tools to bridge this knowledge and implementation gap is increasingly urgent as medically Inhibitors,research,lifescience,medical relevant and novel scientific discoveries can now be applied to assess risk factors at the genomic level for chronic diseases like cancer and DM, as well as the sensitivity to and efficacy of drug therapy using tools Inhibitors,research,lifescience,medical like bioinformatics and pharmacogenomics. These fields, together with the evolving areas of genomics, proteomics, and metabolomics, constitute the premise and promise of personalized medicine. Evidence-based medicine seeks to narrow the gap between clinical research and practice by explicitly and systematically
focusing the attention of clinicians on the most up-to-date evidence from epidemiologic and clinical trial studies. Specifically, evidence-based medicine promotes the judicious use of meta-analyses of randomized controlled trials and other scientifically derived knowledge for clinical Inhibitors,research,lifescience,medical decision-making. However, an inherent weakness of the meta-analytical focus is that individuals vary greatly in regard to their manifestations of disease, symptoms, Inhibitors,research,lifescience,medical co-morbidities, genetic predisposition, and variance in molecular sensitivity to drugs, which cannot be reflected in guidelines derived from meta-analyses of the general patient population. According to the US President’s Council of Advisors on Science and Technology,10 personalized medicine refers to the tailoring Inhibitors,research,lifescience,medical of medical treatment to the individual characteristics
of each patient; […] the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease or their response to a specific treatment. Preventive or therapeutic interventions can then be concentrated on those who will benefit, sparing expense and side effects for those who will not.10 Given the large health and economic impact of DM, there is understandable interest in using MRIP personalized medicine strategies to identify those individuals who are most at risk of developing DM and its various complications, and who are most likely to benefit from a specific management strategy, in order to apply proven measures to delay or prevent their progression to DM and its subsequent complications.11,12 In this review we will provide an introduction to the principal personalized medicine tools and strategies, and provide examples of how they may be applied to diabetes, in particular to type 2 DM (DM2).