Personalized Medicine: Monogenic Diabetes

Personalized medicine in diabetes is a topic which has gained significant momentum in recent years (Raz et al. 2013). A rapid rise in the number and combinations of diabetes therapies coupled with an unprecedented rise in diabetes prevalence rates has necessitated diabetes guidelines which emphasize the need for personalized patient-centered care (ADA 2014). There are many questions regarding the role genetics may be able to play in guiding therapy. Recent pharmacogenetic research has revealed polymorphisms that may impact patient response to metformin (Dong et al 2011) and glucagon-like-polypeptide-1 therapies (Smushkin et al. 2012). This may hold promise for helping identify patients who will better respond to specific agents and in the longer-term may help ensure a smooth journey along the therapeutic pathway. Monogenic or "single-gene" diabetes comprises nearly 2% of all cases of type 2 diabetes and provides a model for individualizing care. This review will discuss the diagnosis and treatment of this condition.