Precision Medicine and Epigenetics: Personalized Diabetes Care

Introduction

Setting the Stage for Precision Medicine in Diabetes

The emergence of Precision Medicine has signified a paradigm shift in the field of diabetes care. This transformative approach is a shift from traditional, broad treatments to a more individualised, nuanced approach. With the use of cutting-edge research and scientific ideas, our goal in this exploration is to establish the foundation for the application of precision medicine to the treatment of diabetes.

Diabetes, characterized by its heterogeneity among individuals, necessitates a departure from traditional, uniform treatment methodologies. Precision medicine emerges as a promising avenue, recognizing the inherent diversity in diabetes manifestations and tailoring interventions to the specific genetic and epigenetic characteristics of each patient.

Technological developments are essential to this trip because they offer instruments for the detailed examination of genetic and epigenetic components. By enabling healthcare professionals to understand the genetic landscape, these state-of-the-art technologies enable a more customised and focused approach to treating diabetes.

As we continue our investigation, we explore the real-world uses of precision medicine, including lifestyle modifications, real-time monitoring, and diagnostics. The symposium concludes with a discussion of the critical role that patient engagement plays, acknowledging that informed and involved patients are essential to attaining the best possible results.

Figure 1.

Applications and principles of precision medicine

Understanding Diabetes

Hyperglycaemia is a defining feature of diabetes mellitus (DM), commonly referred to as diabetes. A chronic and diverse condition characterized by persistently increased blood glucose levels is a physiologically abnormal state that presents as metabolic dysfunctions of fat, protein, and carbohydrates (Banday Mz et al.,2020).

The American Diabetes Association defines diabetes as a collection of metabolic disorders marked by elevated blood sugar levels brought on by deficiencies in insulin secretion, insulin action, or both. The World Health Assembly approved five worldwide goals for diabetes treatment and coverage in May 2022, with a target date of 2030(American Diabetes Association,2010). The World Health Organization (WHO) 2023 estimates that 422 million people worldwide have diabetes, with the majority of those affected living in low- and middle-income nations.

A glycated haemoglobin (A1c) of 6.0% to 6.4%, impaired glucose tolerance (IGT), or impaired fasting glucose (IFG) combined put a person at high risk of developing diabetes and its complications. These conditions are collectively referred to as prediabetes, a phrase that is both practical and convenient.

The distinction between type 1 and type 2 diabetes was established in 1936.The most prevalent kind of diabetes mellitus (DM) is type 2, also referred to as non-insulin-dependent DM (Olokoba et al., 2012). If diabetes is not managed, it can lead to major health problems such as heart disease, stroke, chronic kidney disease, ulcers on the feet, damage to the eyes, and chronic kidney disease. Diabetes sufferers must rely on a healthy lifestyle and appropriate medicine as there is currently no permanent solution for the condition. Type 1, type 2, and gestational diabetes—diabetes during pregnancy—are the three primary forms of the disease.

It is believed that a combination of multiple lifestyle factors, medical conditions, genetics, psycho-social factors, and demographic risk factors—such as elevated serum uric acid levels, sleep patterns, smoking, depression, cardiovascular disease, dyslipidaemia, hypertension, aging, ethnicity, diabetes in the family history, physical inactivity, and obesity (Ismail et al.,2021).

Figure 2.

Illustrating etiopathogenesis of Diabetes Mellitus