Precision medicine, the tailoring of healthcare based on an individual's genetics, lifestyle and environment, has been used with success in monogenic diabetes but several barriers have prevented its large-scale application throughout diabetes. In the May 2017 issue of Diabetologia, a series of reviews outline previous achievements, current limitations and future promises of precision diabetes: Hattersley and Patel (DOI 10.1007/s00125-017-4226-2) discuss its application in monogenic diabetes, including challenges faced when implementing this approach into clinical care. In terms of diabetes prevention, Giles Yeo (DOI 10.1007/s00125-016-4187-x) describes the use of precision medicine for the management of obesity, whilst Franks and Poveda (DOI 10.1007/s00125-017-4207-5) discuss its use to predict response to deleterious lifestyle factors and, conversely, to lifestyle interventions. Mark McCarthy (DOI 10.1007/s00125-017-4210-x) proposes a new model (the 'palette model') for precision diabetes that accounts for the multifactorial nature of diabetes and the impact of therapeutic agents on diabetes risk and progression. Finally, Jose Florez (DOI 10.1007/s00125-017-4227-1) explains how pharmacogenetics may be used to elucidate new drug targets, uncover pathophysiology, unravel disease heterogeneity and identify genes that contribute to diabetes risk. In summary, this precision medicine series suggests a new horizon in diabetes care but does not dismiss the enormous amount of work that remains necessary for large-scale application of this promising approach. This review set is accompanied by an editorial by Sally Marshall (DOI 10.1007/s00125-017-4244-0).
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|Precision diabetes: learning from monogenic diabetes Andrew T. Hattersley, Kashyap A. Patel||Genetics of obesity: can an old dog teach us new tricks? Giles S. H. Yeo||Lifestyle and precision diabetes medicine: will genomics help optimise the prediction, prevention and treatment of type 2 diabetes through lifestyle therapy? Paul W Franks, Alaitz Poveda|
|Painting a new picture of personalised medicine for diabetes Mark I. McCarthy||Pharmacogenetics in type 2 diabetes: precision medicine or discovery tool? Jose C. Florez||Human genetics as a model for target validation: finding new therapies for diabetes Soren K. Thomsen, Anna L. Gloyn|
|New approaches beyond genetics: towards precision medicine in diabetes Leif Groop||Proteomics for prediction of disease progression and response to therapy in diabetic kidney disease Michelle J. Pena, Harald Mischak, Hiddo J. L. Heerspink||Diabetes at the crossroads: relevance of disease classification to pathophysiology and treatment R. David Leslie, Jerry Palmer, Nanette C. Schloot, Ake Lernmark|