Precision Medicine for Endocrinology: Application in diabetes

Nowadays personalized medicine is commonly defined as a combination of molecular profiling and traditional diagnostic and therapeutic strategies precisely adapted to the individual requirements of patients. The success of precision medicine faces many challenges such as establishment of frameworks for organizing, compiling, and elucidating the influx of data, shift toward a deeper understanding of disease, based on molecular biology which necessitates reclassification of disease, handling of multi-parametric data and some proficiency in interpreting omics data, dealing with the anticipated complexity and volume of new information. Finally, addressing these challenges will require effective clinical decision support tools and new educational models. The concept of precision medicine should be extended to endocrine disorders such as diabetes. With increasing knowledge of the molecular causes of diabetes, we need to increase and update our tools for identifying patients at very early stages, even before prediabetes, to begin early preventive measures to abort or delay the onset of disease. Regardless of availability of several classes of drugs for diabetes, both oral and insulin preparations, treatment is often on a trial and error basis or on the availability or affordability of medications, rather than the underlying pathophysiology; hence most diabetics do not achieve proper blood glucose control. The advent of precision medicine for diabetes will require handling, incorporation and interpretation of massive amounts of genomic, metabolic, lifestyle, environmental, and clinical and para-clinical data, all of which need comprehensive investigations, progressive education and manpower training.