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‘Personalised prescription approach’ could improve type 2 outcomes

By Editor
3rd August 2018
Care planning, Research Type 2 diabetes

Gender and BMI can be used to determine the correct medication for people with type 2 diabetes, according to new research.

A study by the University of Exeter Medical School has found taking into account those simple characteristics could help avoid diabetes-related complications by finding the right drug for each person with the lifestyle-reated condition.

Although Metformin is usually the first drug prescribed to people who have been unable to control their type 2 diabetes with diet and exercise, many require additional medication to help manage their condition.

At the moment healthcare professionals are required to make prescribing decisions on these additional drug options based on limited available guidance. But the Exeter research team say they have found evidence to suggest there is a huge regional variation across the UK when it comes to administering these additional drugs.

This simple personalised approach could be implemented immediately within the NHS without any additional cost. John Dennie, lead author

The latest study involved using anonymous data from more than 29,000 people, who had either taken part in trials or were treated in UK GP practices. Compiling the data showed some interesting trends, such as obese females were far more likely to have good blood glucose control on thiazolidinediones than sulfonylureas. Alternatively, they discovered non-obese males seemed to have better blood glucose control if they were given sulfonylureas instead of thiazolidinediones.

Lead author John Dennis, from the University of Exeter Medical School, said: “Our findings are important as they provide the first evidence that personalised or ‘precision’ medicine approaches in diabetes can be based on simple patient characteristics available to any doctor, rather than expensive genetics or other technology. This simple personalised approach could be implemented immediately within the NHS without any additional cost.

“The study is also a powerful demonstration of how the sharing of patient data can meaningfully benefit patients – in this case helping to make sure individual patients get the best drug for them.”

The findings of the study, which was funded by the Medical Research Council (MRC), has been published in the journal Diabetes Care.

Professor Andrew Hattersley, a consultant in diabetes at the Royal Devon and Exeter Hospital and research professor at the University of Exeter Medical School, added: “At the moment, clinicians are in the difficult position of making decisions that impact on health in type 2 diabetes based on very little evidence. Now, we can create clear guidelines to enable much more informed conversations about what these treatments will mean for people, in order to get better health outcomes and avoid harmful side effects.”

Dr Richard Evans, programme manager for Stratified Medicine and Molecular Pathology at the MRC, said: “This research used shared clinical trial data from a large number of patients to show that simple patient characteristics can help inform the choice of therapy in diabetes; the results are likely to show real impact, and significant benefits to patients when they are implemented in patient care.

“Diabetes afflicts one in 17 people in the UK – research into precision or stratified approaches to this condition is crucial to getting patients the most appropriate treatment in the most efficient way, underpinned by solid evidence.”

To read the study, click here.

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