Personalized medicine in diabetes

Type 2 diabetes (T2D) is a heterogeneous disease, with genetic background, underlying pathogenic mechanisms and clinical features markedly varying among patients and with an ascending trend in both the developed and developing countries. In the Islamic Republic of Iran, the estimated diabetes population has increased from 3.6 million in 2005 to 4.5 million in 2011; corresponding figures for pre-diabetics have been 4.4 and 5.8 million, respectively. Personalized medicine in diabetes refers to the utility of genomics data of a patient with diabetes to provide the most effective diagnosis strategies and treatment plans.The current guidelines for the treatment of T2D do not include any genomics information. Diet, exercise and metformin are recommended as first-line therapy, although there is considerable variability in patients’ responses to them. By considering common variations in certain genes, in the form of single nucleotide polymorphisms (SNPs) in an individual’s genetic architecture, pharmacogenomics can promise new drug selection process in order to optimize pharmacokinetics and pharmacodynamics to eventually increase drug efficacy and decrease adverse drug reactions.Moreover, type 2 diabetes mellitus encompass microvascular and macrovascular complications. Studies of human genetics offer powerful tools for delivering robust mechanistic insights into diabetic complications, which have a substantial genetic component. Identification of genetic variants with robust effects on the risk of developing diabetic complications will accelerate efforts to develop more effective strategies for treatment and prevention.Personalized medicine is growing and gnomics data together with the potential of other Omics and clinical evidence-based data will lead to diabetes care improvement in the context of personalized medicine in the future.