In recent years, new insights have been gained into the heterogeneity of diabetes and its impact on the risk of complications. This is resulting in new ways to prevent and treat diabetes. A new consensus report on precision medicine in diabetes prevention and therapy has now been prepared by international scientists with the participation of DZD researchers and published in the scientific journal 'Nature Medicine'. The report identifies ways in which precision medicine in diabetes can be integrated into clinical practice immediately or in the short term, while highlighting critical knowledge gaps that need to be addressed.

Diabetes is associated with an increased risk of death. As recently as September of this year, this connection was reconfirmed based on an analysis of data from more than 1.5 million people. It was found that, for example, a 50-year-old person has an average of 14 years less to live if type 2 diabetes was diagnosed at the age of 30. However, there are significant differences in these correlations. It is precisely these different manifestations that international scientists have investigated as part of the second International Consensus Report of the Precision Medicine in Diabetes Initiative (PMDI) and have worked on tailored approaches to the prevention, diagnosis and treatment of diabetes.

Under the leadership of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), 200 scientists from 28 countries participated in the compilation of this consensus report. Four DZD scientists from Germany participated: Prof. Norbert Stefan from the Institute of Diabetes Research and Metabolic Diseases of Helmholtz Munich at the University of Tübingen and Prof. Robert Wagner, Dr. Katsiaryna Prystupa and Dr. Martin Schön from the German Diabetes Center in Düsseldorf. The German experts mainly worked out ways of precision diagnosis of type 2 diabetes. These will also be published in detail in one of 15 additional publications in the scientific journal 'Communications Medicine'.
Prof. Norbert Stefan, who has long been involved in the risk assessment of type 2 diabetes and the causes of this disease, especially fat distribution and fatty liver disease, emphasizes: "Similar to cancer medicine, in diabetes research we have identified affected individuals for whom established prevention and therapy options are not sufficient to treat the disease well. The challenge now is to find markers and tailored treatments that can be rapidly implemented in clinical practice."
Prof. Robert Wagner, who together with his colleagues identified subgroups of people at increased risk of diabetes and its associated sequelae in a widely acclaimed study ("Nature Medicine," 2021), explains, "It is important that we focus more on the different causes that mainly underlie the respective subgroups and adversely affect metabolism years before the onset of diabetes when assessing the risk of diabetes and its complications. Different levels of insulin production, insulin action, and genetic risk, as well as age of diabetes manifestation, should be taken more into account in the future."

Within the framework of their research in the DZD, the German scientists have the opportunity to continue working in this important field of research in close scientific exchange with their colleagues at the various DZD sites as well as through international collaborations. Through translational research approaches and associated clinical studies, they can gain new insights that will be part of not only national, but also international approaches to establishing precision medicine in diabetes.

Original publication:
Tobias DK et al., 2nd International Consensus Report on Gaps & Opportunities for the Clinical Translation of Precision Diabetes Medicine. Nature Medicine 2023; DOI: 10.1038/s41591-023-02502-5

Scientific Contact:
Prof. Norbert Stefan
Department Internal Medicine IV      
University Hospital Tübingen
Otfried-Müller-Str. 10
72076 Tübingen
Phone: +49-7071-2980390
norbert.stefan@med.uni-tuebingen.de         

Prof. Robert Wagner
German Diabetes Center (DDZ)
Auf’m Hennekamp 65
40225 Düsseldorf
Phone: +49- 211 3382-277
robert.wagner@ddz.de

Helmholtz Munich is a leading biomedical research center. Its mission is to develop breakthrough solutions for better health in a rapidly changing world. Interdisciplinary research teams focus on environmentally triggered diseases, especially the therapy and prevention of diabetes, obesity, allergies and chronic lung diseases. www.helmholtz-munich.de/en

The German Diabetes Center (DDZ) serves as the German reference center for diabetes. Its objective is to contribute to the improvement of prevention, early detection, diagnosis and treatment of diabetes mellitus. At the same time, the research center aims at improving the epidemiological data situation in Germany. The DDZ coordinates the multicenter German Diabetes Study and is a point of contact for all players in the health sector. In addition, it prepares scientific information on diabetes mellitus and makes it available to the public. The DDZ is part of the Leibniz Association (Wissenschaftsgemeinschaft Gottfried Wilhelm Leibniz, WGL) and is a partner of the German Center for Diabetes Research (DZD e.V.). www.ddz.de/en 

The German Center for Diabetes Research (DZD) is one of six German Centers for Health Research. It brings together experts in the field of diabetes research and combines basic research, translational research, epidemiology and clinical applications. The aim is to develop novel strategies for personalized prevention and treatment of diabetes. www.dzd-ev.de/en