Personalized therapy algorithms

for type 2 diabetes

A phenotype-based
approach

Type 2 diabetes patients are

heterogeneous.
It is a progressive disease
Pathophysiology is multifactorial & complex
Plethora of available therapeutic agents
Significant portion of patients are poor
responders to available therapeutic agents
Risk of developing late complications

What studies say ?

UKPDS : Intensive glycemic control
- benefits microvascular
complications
- macrovascular
complications ??
ACCORD : more cardiovascular
mortality with
intensive glycemic control

So, treatment should be individualized

Available Personalized
Algorithms
Finnish Guideline
Computer assisted decision support
tool
AMD algorithm

AMD algorithm
Italian algorithm
Last updated in May 2013
Divides patients into different phenotypes on the basis of self
monitoring of blood glucose
Includes new glycemic targets
Proposes treatment plan & glycemic targets according to patient
phenotypes to decrease risk of hypoglycemia
Also includes options of antidiabetic agents including newer ones

Subcategories of
patients

Conclusion
Type 2 diabetes patients are heterogenous
Treatment should be individualized
Personalized algorithms are needed for this
Among the available algorithms, AMD is
most innovative, cost effective & widely
applicable