title: Lifestyle and precision diabetes medicine: will genomics help optimise the prediction, prevention and treatment of type 2 diabetes through lifestyle therapy?
abstract: Precision diabetes medicine, the optimisation of therapy using patient-level biomarker data, has stimulated enormous interest throughout society as it provides hope of more effective, less costly and safer ways of preventing, treating, and perhaps even curing the disease. While precision diabetes medicine is often framed in the context of pharmacotherapy, using biomarkers to personalise lifestyle recommendations, intended to lower type 2 diabetes risk or to slow progression, is also conceivable. There are at least four ways in which this might work: (1) by helping to predict a person's susceptibility to adverse lifestyle exposures; (2) by facilitating the stratification of type 2 diabetes into subclasses, some of which may be prevented or treated optimally with specific lifestyle interventions; (3) by aiding the discovery of prognostic biomarkers that help guide timing and intensity of lifestyle interventions; (4) by predicting treatment response. In this review we overview the rationale for precision diabetes medicine, specifically as it relates to lifestyle; we also scrutinise existing evidence, discuss the barriers germane to research in this field and consider how this work is likely to proceed.
authors.affiliation: Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Skåne University Hospital, Malmö, SE-20502, Sweden. paul.franks@med.lu.se.|Department of Public Health and Clinical Medicine, Section for Medicine, Umeå University, Umeå, Sweden. paul.franks@med.lu.se.|Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. paul.franks@med.lu.se.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Franks
authors.affiliation: Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Skåne University Hospital, Malmö, SE-20502, Sweden.
authors.forename: Alaitz
authors.initials: A
authors.lastname: Poveda
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000235:genetics* / Q000628:therapy; D023281:Genomics / Q000379:methods*; D006801:Humans; D008019:Life Style; D057285:Precision Medicine / Q000379:methods*
chemical_list: D015415:Biomarkers
keywords: Biomarkers; Lifestyle; Precision medicine; Review; Type 2 diabetes