Abstract
A personalized approach for prediabetes and diabetes detection is presented, with its rationale and implications. Type 2 diabetes (T2DM) detection is particularly suitable to a personalized approach since the essence of its diagnosis is the identification of individuals who are at most risk of developing complications of the disease and who may benefit from intervention. Thresholds of glucose parameters for T2DM diagnosis have decreased over the years, as levels considered normal have been found to confer risks of complications. A continuum of glucose parameters, rather than universal thresholds, seems to better reflect the risks of diabetes and its complications. Individual trajectories of progression to diabetes suggest the possibility of establishing personalized profiles based on serial measurements. Demographic, clinical, genetic, and environmental factors need also be considered. Different diagnostic criteria are found to identify different phenotypes of T2DM. A personalized approach is needed to apply the accumulating knowledge to the recognition of individual risk for diabetes complications and effective interventions.
Keywords: High risk, profile, type-2 diabetes, lifestyle, hyperinsulinemia, fasting glucose, trajectories, metabolic syndrome.
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