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Can ‘ personalized diagnostics ’ promote earlier intervention for dysglycaemia? Hypothesis ready for testing
Author(s) -
Dankner Rachel,
Danoff Ann,
Roth Jesse
Publication year - 2010
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.1039
Subject(s) - intervention (counseling) , medicine , diabetes mellitus , population , basal insulin , basal (medicine) , type 2 diabetes , intensive care medicine , endocrinology , environmental health , psychiatry
The risk associated with progression to diabetes as well as for cardiovascular complications increases along a continuum, rather than being threshold‐dependent. How can we identify those with glucose levels in the upper reaches of normal who are most in need of a preventive intervention? With present criteria, we are likely excluding many individuals who have heightened risk. We introduce here the possibility of using a “personalized” glucose profile to encourage early intervention in subjects in whom glucose metabolism is deteriorating (on an individual level) but not yet abnormal on a population‐based norm. We further suggest that “personalized profiles” of hemoglobin A1c and basal plasma insulin may also help encourage appropriately early intervention. That the first line therapies are so effective, safe and simple make these more sensitive approaches very attractive. Copyright © 2010 John Wiley & Sons, Ltd.