People with diabetes could benefit from digital ‘risk calculators’ in the future that help healthcare professionals prescribe the best combination of medicine for each person.
Research in the UK into personalised treatments has resulted in a one risk calculator being developed by teams from Exeter, Dundee, Oxford and Glasgow Universities which predicts how well someone’s blood glucose levels will be controlled by two drugs used to treat type 2 diabetes.
Sulfonylureas and thiazolidinedione are second-line treatments for type 2 diabetes, but there is currently little guidance about which therapies work best and for who. The research team at Exeter is also working on a risk calculator that could be used to help people get the right diagnosis of type 1 or type 2 diabetes.
The researchers pointed out that sometimes it can be difficult to classify the type accurately, resulting in delays to treatment or in some cases the wrong treatment. It’s important that people are diagnosed with the correct type of diabetes, as people with type 1 diabetes need insulin therapy as early as possible, while people with type 2 diabetes are best treated with medications or diet and exercise.
Both risk calculators will help doctors prescribe the best possible treatment, as different people respond to treatments in different ways. The researchers say that this should also help to improve people’s health outcomes, as tailored diagnosis and treatments should mean the right therapy is given to the right person sooner, based on more accurate predictions of how someone will respond.
To predict blood glucose control, the researchers used data from more than 70,000 people with type 2 diabetes in clinics together with 2,000 people in clinical trials who were taking either sulfonylureas or thiazolidinedione. They examined how their blood glucose levels were influenced by simple characteristics including gender, age and Body Mass Index (BMI).
Using this information, they created a risk calculator that predicts how well a person’s blood glucose levels will be controlled by each drug. Extending the calculator to include other medication could help clinicians to develop a personalised treatment regime for their type 2 diabetes patients.
The Exeter research team’s type 1 diabetes classification calculator uses clinical information, like age of diagnosis or BMI, together with indicators of type 1 diabetes, such as levels of autoantibodies and a new genetic test of type 1 diabetes risk, to accurately predict the type of diabetes. This helps to decide if a person should receive insulin or tablets at diagnosis. The calculator has been developed using information from 1,187 people who have taken part in previous studies.
‘An accurate diagnosis of type 1 or type 2 diabetes is hugely important, as the treatment of these two conditions is very different. Unfortunately it can be difficult to tell what type of diabetes someone has when they’re first diagnosed, as there’s no single feature that confirms a diabetes type,’ said Dr Angus Jones, lead researcher based at the University of Exeter Medical School.
The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.