New ‘precision medicine’ could improve care globally
October 2024
Precision medicine is a potential new way to improve diabetes care. (photos courtesy UVA Health)
Story courtesy of UVA Health
Stephen S. Rich, Ph.D.
A University of Virginia School of Medicine expert and his colleagues say there is a tremendous opportunity for “precision medicine” to transform diabetes care worldwide. Still, it will require bold new thinking and significant investments.
In a commentary in the scientific journal Nature Medicine, UVA’s Stephen S. Rich, Ph.D., and other leaders in the battle against diabetes detail an international effort to improve diabetes care and outline the challenges that effort must overcome. They note that diabetes — particularly type 2 diabetes — is a far more complex and diverse disease than many people assume, with huge variations in its causes and effects and in patients’ responses to treatment.
Precision medicine aims to account for all those variables, and more, in order to improve diabetes care and help patients live healthier lives. For example, true precision medicine would incorporate people’s lifestyles, diet, environment, behavior and other factors to determine the best treatment options for each individual. But scientists say, doctors and scientists need to develop more nuanced understanding of the disease’s subtypes and identify new biological markers of those subtype. Other urgent needs include implementing artificial intelligence in clinical care and ensuring that patients in lower-income countries are included.
“There is a global epidemic of diabetes, particularly type 2 diabetes, that reflects the interaction of genetic susceptibility with a Westernized lifestyle, including a poor diet and physical inactivity that leads to insulin resistance through apparently multiple biological pathways,” says Rich, of UVA’s newly formed Department of Genome Sciences.
The international group of investigators has already reached some important conclusions in an initial meeting. These include that there is widespread interest and investment around the world in better understanding the many variations, or “heterogeneity,” in diabetes; there are important opportunities to leverage existing data about the disease and great need for more data on non-Europeans; and there is an urgent need to address the many research gaps that stand in the way of improving care for people around the world.
While some of the challenges are daunting, particularly on a global scale, Rich and his colleagues say that they can be overcome “if the global medical and scientific communities embrace this shift toward a precision medicine approach for people living with diabetes, regardless of who they are or where they live.”
Rich’s group members expect their work to take 18 months to two years. But they hope it will ultimately have long-lasting and far-reaching patient benefits everywhere. Rich says, “We have found that each country represented in the group recognizes the importance of heterogeneity in diabetes, and all are undertaking research to implement a precision medicine and a precision health approach.”