Department of Diabetes and Metabolic Diseases, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Clinical Center of Diabetes, Nutrition and Metabolic Disease, Cluj-Napoca, Romania.
Drug Metab Rev. 2019 Nov;51(4):408-427. doi: 10.1080/03602532.2019.1656226. Epub 2019 Aug 28.
Diabetes is a major health problem worldwide. Glycemic control is the main goal in the management of type 2 diabetes. While many anti-diabetic drugs and guidelines are available, almost half of diabetic patients do not reach their treatment goal and develop complications. The glucose-lowering response to anti-diabetic drug differs significantly between individuals. Relatively little is known about the factors that might underlie this response. The identification of predictors of response to anti-diabetic drugs is essential for treatment personalization. Unfortunately, the evidence on predictors of drugs response in type 2 diabetes is scarce. Only a few trials were designed for specific groups of patients (e.g. patients with renal impairment or older patients), while subgroup analyses of larger trials are frequently unreported. Physicians need help in picking the drug which provides the maximal benefit, with minimal side effects, in the right dose, for a specific patient, using an omics-based approach besides the phenotypic characteristics.
糖尿病是全球范围内的一个主要健康问题。血糖控制是 2 型糖尿病管理的主要目标。虽然有许多抗糖尿病药物和指南可用，但几乎一半的糖尿病患者未达到治疗目标并出现并发症。个体对抗糖尿病药物的降糖反应差异很大。对于导致这种反应的因素，我们知之甚少。确定抗糖尿病药物反应的预测因素对于治疗个体化至关重要。不幸的是，关于 2 型糖尿病药物反应预测因素的证据很少。只有少数试验是针对特定患者群体设计的（例如肾功能损害或老年患者），而大型试验的亚组分析常常未报告。医生需要帮助，除了表型特征外，还需要使用基于组学的方法，为特定患者选择提供最大益处、最小副作用、合适剂量的药物。
