Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Chung, Wendy K.; Erion, Karel; Florez, Jose C.; Hattersley, Andrew T.; Hivert, Marie-France; Lee, Christine G.; McCarthy, Mark I.; Nolan, John J.; Norris, Jill M.; Pearson, Ewan R.; Philipson, Louis; McElvaine, Allison T.; Cefalu, William T.; Rich, Stephen S.; Franks, Paul W.

doi:10.1007/s00125-020-05181-w

Cited by 203Diabetes Management and ResearchDiabetes and associated disordersDiabetes Treatment and Management

Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

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Chung, Wendy K., Erion, Karel, Florez, Jose C., Hattersley, Andrew T., Hivert, Marie-France, Lee, Christine G., McCarthy, Mark I., Nolan, John J. +7 more·2020·Diabetologia

DOI 10.1007/s00125-020-05181-wPMC PMC8185455

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Abstract

The convergence of advances in medical science, human biology, data science and technology has enabled the generation of new insights into the phenotype known as 'diabetes'. Increased knowledge of this condition has emerged from populations around the world, illuminating the differences in how diabetes presents, its variable prevalence and how best practice in treatment varies between populations. In parallel, focus has been placed on the development of tools for the application of precision medicine to numerous conditions. This Consensus Report presents the American Diabetes Association (ADA) Precision Medicine in Diabetes Initiative in partnership with the European Association for the Study of Diabetes (EASD), including its mission, the current state of the field and prospects for the future. Expert opinions are presented on areas of precision diagnostics and precision therapeutics (including prevention and treatment) and key barriers to and opportunities for implementation of precision diabetes medicine, with better care and outcomes around the globe, are highlighted. Cases where precision diagnosis is already feasible and effective (i.e. monogenic forms of diabetes) are presented, while the major hurdles to the global implementation of precision diagnosis of complex forms of diabetes are discussed. The situation is similar for precision therapeutics, in which the appropriate therapy will often change over time owing to the manner in which diabetes evolves within individual patients. This Consensus Report describes a foundation for precision diabetes medicine, while highlighting what remains to be done to realise its potential. This, combined with a subsequent, detailed evidence-based review (due 2022), will provide a roadmap for precision medicine in diabetes that helps improve the quality of life for all those with diabetes.

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Controversy remains as to whether latent autoimmune diabetes of adulthood is a discrete subtype, a milder form of type 1 diabetes, or a mixture of type 1 and type 2 diabetes.
“Controversy remains as to whether latent autoimmune diabetes of adulthood (LADA) is a discrete subtype, a milder form of type 1 diabetes, or a mixture of some individuals with type 1 diabetes and others with type 2 diabetes (16,17).”
From The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2021) · cites this paper as [16]
The Precision diagnostics section (Text box 2, ‘Diagnosing latent autoimmune diabetes in adults’) explicitly describes controversy over whether LADA is a discrete subtype or a milder form of type 1 diabetes. It also describes a mixture, but our copy says ‘some patients with type 1 diabetes and others with type 1 diabetes,’ not the claimed mixture of type 1 and type 2 diabetes. (LLM, conf=0.85)
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[8]Riddle MC, Hattersley AT, Rich SS, Carlsson A, Franks PW, Greeley SAW, Nolan JJ, Pearson ER, Zeitler PS. Insights to Population-Based Precise Care, Starting With Monogenic Diabetes: Reflections from a Diabetes Care Editors’ Expert Forum.. Diabetes Care (in press) PMC8162450 33560999
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Tirzepatide for the treatment of adults with type 2 diabetes: An endocrine perspective
De Block, C., Bailey, C., Wysham, C., Hemmingway, A., Allen, S. E., & Peleshok, J. (2023) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.14831 · Cited by 121 · see citing works

Authors: Chung, W. K., Erion, K., Florez, J. C., Hattersley, A. T., Hivert, M.-F., Lee, C. G., McCarthy, M. I., Nolan, J. J., Norris, J. M., Pearson, E. R., Philipson, L., McElvaine, A. T., Cefalu, W. T., Rich, S. S., & Franks, P. W.
Affiliations: Columbia University Irving Medical Center (US)
American Diabetes Association (US)
University of Exeter (GB)
Harvard University (US)
National Institute of Diabetes and Digestive and Kidney Diseases (US)
Centre for Human Genetics (GB)
Trinity College Dublin (IE)
Colorado School of Public Health (US)
University of Dundee (GB)
University of Chicago (US)
Duke University (US)
University of Virginia (US)
Corresponding author: Franks, Paul W.
ORCID: Chung, Wendy K.
Erion, Karel
Hattersley, Andrew T.
Hivert, Marie-France
Lee, Christine G.
McCarthy, Mark I.
Nolan, John J.
Norris, Jill M.
Pearson, Ewan R.
Philipson, Louis
McElvaine, Allison T.
Cefalu, William T.
Rich, Stephen S.
Franks, Paul W.
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2020-06-19
Volume: 63
Issue: 9
Pages: 1671-1693
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-020-05181-w
PMC: PMC8185455
OpenAlex: W3036846551
Cited by: 203
References: 135
Citations by year: 2026: 27 · 2025: 27 · 2024: 45 · 2023: 37 · 2022: 41 · 2021: 24 · 2020: 2
FWCI: 19.61
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
Discovery Research Portal (University of Dundee) (publishedVersion, other-oa)
PubMed Central (acceptedVersion)
Lund University Publications (Lund University) (submittedVersion)
Royal Devon and Exeter Research Repository (Royal Devon and Exeter) (submittedVersion, public-domain)
Funders: American Diabetes Association (1-15-ACE-26)
Eli Lilly and Company
Pfizer
Sanofi
Regeneron Pharmaceuticals
Wellcome Trust (098395/Z/12/Z, 203141, 102820/Z/13/Z, WT098395/Z/12/Z)
National Institute for Health and Care Research (NF-SI-0616-10080)
European Commission
Lunds Universitet
Novo Nordisk
Vetenskapsrådet
Universitetet i Bergen
Servier
National Institutes of Health (5r21ai142483-02, UL1TR001873)
Genentech
Medical Research Council (MR/K005707/1, MR/T032014/1)
National Institute of Allergy and Infectious Diseases (R21-AI142483)
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK104942, R01DK052431, R01DK122586, U01DK105535, DP3DK111906, K23DK114551, R01DK104351, P30DK026687, P30DK020593, U54DK118612, P30DK020595)
National Center for Advancing Translational Sciences
Janssen Pharmaceuticals
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD094150)
University of Colorado School of Medicine, Anschutz Medical Campus
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords: precision medicine, diabetes mellitus, precision diagnostics, precision therapy, monogenic diabetes, diabetes prevention, diabetes treatment, implementation barriers
MeSH terms: Health Equity, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Europe, Female, Humans, Mental Health, Pregnancy, Quality of Life, Societies, Medical, United States, Diabetes, Gestational, Patient-Centered Care, Precision Medicine

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Precision medicine in diabetes: a Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

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