Future individualization medicine in diabetes with different responsive subtypes

Action to Control Cardiovascular Risk in Diabetes (ACCORD) has been diabetic mega study and analyzed cardiovascular disease (CVD) and major adverse cardiovascular events (MACE). Recently, subgroup analyses have showed heterogeneous treatment effects (HTE). Using genome-wide association study (GWAS) and modified dynamic time-warping approach (etwDTW), presence of subgroups (C1-4) was suggested. Four-month strict treatment resulted in HbA1c 6.7%, 7.0%, 7.7% and 6.2%, respectively. The hazard ratio (HR) for C4/C3 showed: MACE 0.27/1.60, total mortality 0.33/2.52, hypoglycemia 0.33/1.66, and microvascular outcome 0.86/1.30. C4 showed suggestive significance of single-nucleotide polymorphism (SNP) for rs220732, in MAS1. Future diabetology may proceed to individualization medicine.

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