In the era of precision medicine, a personalized approach to type 2 diabetes could improve patient care. With the advent of new therapeutic classes that have proven beneficial effects on the cardiovascular and renal complications, such as glucagon-like peptide-1 analogues and sodium-glucose cotransporter-2 inhibitors, the two main questions currently are: is there a way to predict or even prevent the onset of degenerative complications? And when should insulin therapy be introduced into the treatment process? Indeed, the main criterion for evaluating treatments is no longer solely the reduction in HbA1c, but also tolerance and the long-term risk of microvascular and macrovascular complications. A personalized therapeutic approach to type 2 diabetes would aim to target hypoglycemic treatments tailored to each patient based on their metabolic status and likely progression profile. Our study demonstrates clear potential for the targeted prescription of treatments to people with type 2 diabetes based on their clinical characteristics in order to improve glycemic outcomes and tolerance and reduce or even prevent the onset of microvascular and macrovascular complications. This represents a significant advance over current recommendations for type 2 diabetes, which only recommend prescribing these protective treatments preferentially to people who already have or are at high risk of cardio-renal disease. Personalized prescribing of antidiabetic drugs based on commonly available patient characteristics could make precision diabetology a reality worldwide in the near future, with informed therapeutic decisions tailored to each diabetic patient in order to improve their prognosis.

Ahmed Anas Guerboub is a healthcare professional affiliated with the Mohammed V Military Training Hospital in Morocco.