Personalized approach in T2D is key for success

Treatment opportunities and challenges

The risks associated with T2D, especially cardiovascular (CV) complications, stress the importance of early intervention.^1,2 Newer medications like SGLT2 inhibitors and GLP-1 receptor agonists offer promising results, not just for glucose control but also regarding CV and renal benefits.^3,4 However, therapeutic inertia and the complexity of the disease pose significant challenges which accentuate the need for better follow-up, treatment strategies and personalized care.⁵

Personalized medicine in diabetes management

T2D significantly impacts patient health outcomes, particularly in relation to CV risk and loss of life expectancy, which can be 14-16 years and is largely influenced by the age at diagnosis.⁶ Research indicates that common risk factors, such as elevated cholesterol and blood pressure further exacerbate mortality risks, potentially doubling or tripling the likelihood of CV death.⁷ “Hypoglycemia by itself is an independent risk factor for CV disease”, Prof. De Galan stated. Interestingly, while controlling hyperglycemia is critical, intensive glucose-lowering treatments have shown a neutral effect on CV outcomes.⁸ A holistic and personalized approach is essential to effectively manage diabetes, addressing multiple health aspects such as glucose control, weight management, and CV risk factors.⁹ New medications such as SGLT2 inhibitors and GLP-1 receptor agonists, have emerged as valuable tools in reducing CV risk, with the former notably improving renal function and heart failure (HF) outcomes.^3,4

Curious about pharmacologic aspects of personalized T2D medicine according to Prof. De Galan? You can watch the session in video below.

Deep dive in subpopulations

Prof. Eliasson highlighted the complexity of T2D management, particularly the concept of clustering patients based on their characteristics. In 2018, it was assessed whether distinct clusters of diabetes subpopulations could be formed using computational methods. Although clustering was found to be feasible, it lacked clinical utility because there was no evidence supporting a fixed number of clusters.¹⁰ The findings suggest that while patients can be categorized into various groups based on factors like HbA1c levels and insulin secretion, the variations within these clusters were significant, making it challenging to draw meaningful conclusions.^10,11 “Accurate diagnosis is therefore highly important, especially in atypical cases where patients may not fit the traditional profiles of T1D or T2D”, Prof. Eliasson said. Management strategies for diabetes must consider individual patient history and characteristics, including the presence of other comorbidities. According to the guidelines, SGLT2-inhibitors and GLP-1 receptor agonists are suitable for a large number of subpopulations.⁹

Learn what Prof. Eliasson has to say on managing subpopulations in the video below.

Don't miss this insightful discussion on tailoring care to individual need in the pursuit for a better glycemic control for T2D. Watch the 15 min discussion here: