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Efforts to prevent DM in the future will be tailored to high-risk individuals rather
than populations and will be based on genetic and other new biomarker tests.
Accurate biomarker tests to identify people at risk for diabetes could enable targeted
and individualized prevention efforts. DNA variants conferring higher risk for
T2DM have been identifi ed, but these account for only a small fraction of genetic
risk, which limits their practical predictive value (Spiegel and Hawkins 2012 ).
Identifi cation of these variants has not yet led to new, individualized prevention
methods. Further research is needed to identify genomic and other types of bio-
markers that could accurately predict risk and facilitate targeted prevention.
T2DM is commonly treated with more than one type of therapy, including oral
antidiabetic drugs (OADs) and agents used in the treatment of diabetic complica-
tions. Several pharmacological classes of OADs are currently available for the treat-
ment of T2DM, of which insulin secretagogues (i.e. sulphonylureas and
meglitinides), insulin sensitizers (thiazolidinediones) and biguanides are the most
commonly prescribed. Although many of these OADs have been used for more than
half a century in the treatment of T2DM, the pharmacogenomic characteristics of
these compounds have only recently been investigated, primarily in retrospective
studies. Advances in pharmacogenomics have led to the identifi cation of polymor-
phisms that affect the expression and function of drug-metabolizing enzymes and
drug transporters, as well as drug targets and receptors. Pharmacogenomic data
obtained from studies of T2DM treatment, with a focus on polymorphisms in genes
affecting pharmacokinetics, pharmacodynamics and treatment outcome of the most
commonly prescribed OADs throws some light on the therapeutic response to and
side effects associated with OADs (Emami-Riedmaier et al. 2014 ). Novel ‘omics’
technologies and might aid in the personalized management of T2DM.
Personalized Management of Gastrointestinal Disorders
I n fl ammatory Bowel Disease
Infl ammatory bowel disease (IBD) refers primarily to two diseases − ulcerative colitis
and Crohn’s disease − but the cause remains unknown. The incidence and prevalence
of IBD varies widely throughout the world; they are considerably higher in the US
and Europe than in Asia and Africa. Most studies indicate a range of 4-8 new cases
per 100,000 population per year in the US and Europe. IBD patients are treated by
sulfonamides, steroids and immunosuppressants. For diffi cult cases, leukocytapher-
esis, beclomethasone dipropionate, anticytokines and other new therapies are tried.
IBD First Step SM and IBD Diagnostic System (Prometheus Laboratories)
have the potential to decrease the number of diagnostic procedures (including
colonoscopies and radiographs) currently used to identify and subtype IBD from
non-IBD disorders. Imuran immunosuppressive therapy can be optimized with
PRO- PredictRx (Prometheus Laboratories).
18 Personalized Approaches to Miscellaneous Problems in Healthcare