HCR.20.014 – Personalised Medicine for People with Type 2 Diabetes
People with type 2 diabetes (T2D) have a substantial risk of developing complications. Formerly each diabetes patients was regarded as having about the same risk of developing complications, but recent evidence shows a wide distribution of risk. Still, protocols and guidelines describes a strategy of one size fits all, instead of personalized medicine. To identify patients who benefit most from treatment, accurate risk stratification is essential, but current methods are only moderately accurate.
The questions to answer are: How can we improve diabetes care and health outcomes on an individual basis, and how do we improve the quality of health care while keeping it affordable? Tailored monitoring requires improved risk prediction with advanced modelling on complications and detailed phenotyping. To answer the questions, we propose to develop a consortium and research infrastructure perfectly set up to make such advances in tailored monitoring of diabetes care.
This infrastructure will allow comparative effectiveness research applied to clinical data enriched with phenotyping of myocardial echography, lifestyle, cognitive function and gene-environment interactions.
Facilitation of tailored care requires the following steps:
1) Development of dynamic models to estimate atients’ risk of complications based on changes in time (rather than only baseline values) of traditional risk factors (which is currently ongoing).
2) Investigating the added value of imaging, lifestyle, cognition and genetic markers for the prediction of cardiovascular disease
3) Identification of different observed subgroups of patients based on detailed phenotyping and trajectories of disease progression.
4) Comparison of the effectiveness of different monitoring or screening and therapeutic strategies using advanced statistical methods.
The breakthrough of this approach will be a refined diagnostic testing and integration of patient information to select the best possible and effective treatment.
Personalised Medicine, type 2 diabetes
PHARMO, Philips, University of Tilburg (TiU), Utrecht University (UU)
|Organisation||Amsterdam UMC, VUMC|
|Name||Dr. P. (Petra) Elders|