Personalized treatment of type 2 diabetes based on treatment results from the Type 2 Clinic

The prevalence of type 2 diabetes is increasing worldwide. Although detailed knowledge of the underlying pathogenic mechanisms necessary to tailor individual treatment is lacking, there is a wealth of available data on seemingly relatively effective treatment programs. This project will optimize the effective use of this information to patients, providers, and society, and potentially lead to more personalized treatment recommendations.

Our hypothesis is that patients with diabetes may be recommended treatment based on how patients with different profiles have responded to multifactorial treatment programs in general, and to metformin treatment in particular.

Design and method
In a retrospective cohort study the following areas will be covered to test the hypothesis in four specific steps:

1) Describe the heterogeneity of patients with T2D referred to the Steno Diabetes Center (SDC) T2 Clinic with dysregulated diabetes between 2001 and 2014.

2) Describe changes in metabolic control for the same group of patients after completing a six to nine month evidence based multifactorial treatment program.

3) Identify predictors; anthropometric or clinical parameters, or plasma biomarkers including lipids, for clinically relevant treatment outcomes and critical success factors in diabetes care delivery based on treatment outcome to be able to recommend and evaluate best practice treatment.

4) Investigate how the plasma metabolome responds to common treatments; metformin/placebo plus three different insulin analogue combinations in the CIMT trial.

Expected ending and outcome
In addition to identifying retrospectively based treatment recommendations and potential predictors upon which to build such recommendations, the project will also provide the opportunity to estimate expected effect of the intervention, and thereby also to evaluate its success. 

Martin Ridderstråle
MD, PhD, MBA, Adjunct Professor
Clinical Pharmacology
Novo Nordisk A/S

Henrik Vestergaard
MD, DMSc, Associate Professor
Department of Novo Nordisk Foundation Centre for Basic Metabolism

Sidst opdateret 14-02-2017

Narges Safai
MD, PhD student
Steno Clinic Research