Unnikrishnan Ranjit, Radha Venkatesan, Mohan Viswanathan
Department of Diabetology, Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India.
Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai, India.
Pharmgenomics Pers Med. 2021 Mar 16;14:327-333. doi: 10.2147/PGPM.S271582. eCollection 2021.
Diabetes is a heterogenous disorder, and patients with this disorder vary considerably in their clinical presentation, response to therapy and risk of complications. Expanding knowledge about the pathophysiology of various forms of diabetes has raised the possibility that diagnostic and therapeutic modalities can be tailored to the individual patient in a personalized manner. The recent publication of a Consensus Statement on precision diabetes care underlines the major strides made in this field in the recent past. However, while personalized diabetes care has the potential to significantly improve outcomes in patients with diabetes in a safe and cost-effective manner, its wider application presents several challenges, especially in resource-strained settings. These challenges pertain equally to precision diagnostics, precision therapeutics and precision monitoring. This article discusses some of the important challenges that care providers are likely to face in applying the personalized approach in caring for their patients with diabetes, in the context of diagnosis and management of type 1 diabetes, type 2 diabetes and monogenic forms of diabetes. Suggestions are also presented for overcoming some of these challenges.
糖尿病是一种异质性疾病,患有这种疾病的患者在临床表现、对治疗的反应以及并发症风险方面差异很大。对各种形式糖尿病病理生理学的认识不断扩展,增加了以个性化方式为个体患者量身定制诊断和治疗方法的可能性。最近发表的一份关于精准糖尿病护理的共识声明强调了该领域近期取得的重大进展。然而,虽然个性化糖尿病护理有可能以安全且具有成本效益的方式显著改善糖尿病患者的治疗效果,但其更广泛的应用面临若干挑战,尤其是在资源紧张的环境中。这些挑战同样适用于精准诊断、精准治疗和精准监测。本文在1型糖尿病、2型糖尿病和单基因糖尿病的诊断与管理背景下,讨论了护理人员在采用个性化方法照顾糖尿病患者时可能面临的一些重要挑战。还针对克服其中一些挑战提出了建议。