A precision medicine approach to treating people with type 2 diabetes can help to improve blood sugar levels and avoid damaging side-effects, according to new research.
The research team at the University of Exeter Medical School, Devon, UK, believe its findings into a more evidence-based approach to prescribing drugs could reduce the risk of potentially harmful side-effects such as weight gain and hypoglycaemia, at no additional cost to the NHS.
Although metformin is the first line of drug treatment in type 2 diabetes, many patients will eventually need additional drugs to lower their blood sugar levels.
In this study, which is funded by the Medical Research Council and published in Diabetes Care yesterday, researchers used anonymous data from more than 29,000 patients who had either taken part in trials or were treated in UK GP practices.
They found important differences in the likely success of the commonly prescribed drugs sulfonylureas and thiazolidinediones in lowering blood sugar levels, and in the risk of common side effects.
For example, obese females were more likely to have good blood glucose control on thiazolidinediones than sulfonylureas, while the opposite was true for non-obese males.
Lead author John Dennis said: “Our findings are important as they provide the first evidence that personalised or ‘precision’ medicine approaches in diabetes can be based on simple patient characteristics available to any doctor, rather than expensive genetics or other technology.
“This simple personalised approach could be implemented immediately within the NHS without any additional cost. The study is also a powerful demonstration of how the sharing of patient data can meaningfully benefit patients – in this case helping to make sure individual patients get the best drug for them.”
Professor Andrew Hattersley, a consultant in diabetes at the Royal Devon and Exeter Hospital and research professor at the University of Exeter Medical School said the research findings mean that clear guidelines could be created to achieve better health outcomes.
Dr Richard Evans, programme manager for stratified medicine and molecular pathology at the MRC, added that the results are likely to show significant impact and benefits to patients.
Sex and BMI alter the benefits and risks of sulfonylureas and thiazolidinediones in type 2 diabetes: A framework for evaluating stratification using routine clinical and individual trial data. Diabetes Care 2 August 2018.
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