Lifestyle precision medicine: the next generation in type 2 diabetes prevention?

BMC Medicine

Review

Giuseppe N. Giordano¹  Pascal M. Mutie¹  Paul W. Franks² 

[1] Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden;Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden;Department of Public Health & Clinical Medicine, Umeå University, Umeå, Sweden;Department of Nutrition, Harvard School of Public Health, Boston, MA, USA;Oxford Center for Diabetes, Endocrinology & Metabolism, Radcliff Department of Medicine, University of Oxford, Oxford, UK;

关键词: Review;    Type 2 diabetes;    Lifestyle factors;    Overweight/obesity;    Precision medicine;    Biomarkers;    Intervention;    Prevention;   

DOI  :  10.1186/s12916-017-0938-x

 received in 2017-05-10, accepted in 2017-08-30,  发布年份 2017

来源: Springer

【 摘 要 】

The driving force behind the current global type 2 diabetes epidemic is insulin resistance in overweight and obese individuals. Dietary factors, physical inactivity, and sedentary behaviors are the major modifiable risk factors for obesity. Nevertheless, many overweight/obese people do not develop diabetes and lifestyle interventions focused on weight loss and diabetes prevention are often ineffective. Traditionally, chronically elevated blood glucose concentrations have been the hallmark of diabetes; however, many individuals will either remain ‘prediabetic’ or regress to normoglycemia. Thus, there is a growing need for innovative strategies to tackle diabetes at scale. The emergence of biomarker technologies has allowed more targeted therapeutic strategies for diabetes prevention (precision medicine), though largely confined to pharmacotherapy. Unlike most drugs, lifestyle interventions often have systemic health-enhancing effects. Thus, the pursuance of lifestyle precision medicine in diabetes seems rational. Herein, we review the literature on lifestyle interventions and diabetes prevention, describing the biological systems that can be characterized at scale in human populations, linking them to lifestyle in diabetes, and consider some of the challenges impeding the clinical translation of lifestyle precision medicine.

【 授权许可】

CC BY   
© The Author(s). 2017