Personalized Medicine for Diabetes: a Viable Solution?By Miriam Bello | Mon, 06/21/2021 - 14:55
Medical advances have created novel treatments for some of today’s largest healthcare burdens. But there is a long way to go before these treatments are available to the general public.
Personalized medicine allows medical professionals to “identify patients who are most likely to benefit from a specific treatment and other patients who are unlikely to respond or likely to experience side events,” describes NCBI. In the long term, personalized medicine has the potential to reduce costs for healthcare organizations as it aims to replace the current “one-size-fits-all” model, in which therapies are developed for the “average” person, with a model that tailors care to each patient’s unique biology and life circumstances, explains the University of California San Francisco.
Personalized medicine has become especially attractive for the treatment of diseases that the world has been unable to manage, such as diabetes. Approximately 12 percent of the world's healthcare expenditure is used to treat diabetes and its complications, which include cerebrovascular disease, retinopathy, neuropathy, nephropathy and cardiovascular disease. Diabetes is highly prevalent in Mexico, leading to a health epidemic that has hoarded a significant amount of the country’s healthcare budget. About 8.7 million people suffer from diabetes in Mexico, but there might be 12 million more who have not been diagnosed. The economic burden of diabetes in 2017 was estimated to be of US$3.87 billion, according to ENSANUT. Mexico spends about 2.5-5.6 percent of its GDP on treating diabetes directly or indirectly through attention to overweight and obesity. For the out-of-pocket patient, which represents a large percentage of patients in the country, diabetes means an expenditure between MX$2,000 (US$98.36) and MX$6,000 (US$295.08) per month.
To personalize a diabetes treatment, it is necessary to take into account whether the recipient is presents autoimmunity problems, pregnancy, pancreatic disease or injury and rare syndromes or genetic forms of diabetes, says Diabetes Journals. A profile must also consider age, family history, ethnicity, mental health, medications, biochemical profile, lifestyle and body weight to understand the nature of the disease and in turn to help optimize the treatment.
A personalized medicine approach would address more precisely the factors that continue to enhance morbidity among diabetic patients, argues a study by Future Medicine. “In complex patients, management decisions must be made to address not only the patient’s diabetes but also their concurrent comorbid conditions,” the report states. In personalized care, decisions must also be made considering how drugs interact with each other, “which risk factors need to be addressed most aggressively, how to balance symptoms with risk reduction and how to balance multiple guideline recommendations with patient preferences,” stressed Future Medicine.
Despite of its potential benefits, it is still too soon to predict the direct cost-effectiveness of using personalized medicine to treat diabetes, says a study by Diabetes Journals. But because characterizing variation in a patient’s nuclear genome is inexpensive and easily achieved and DNA variation remains constant across the life course, “it is likely that genetic sequences will feature in most patients’ clinical records.” This genetic data could be used to develop better treatments in the future.