Project 452825

There are several drugs available for the treatment of patients with type 2 diabetes (T2D) which have different mechanisms of action and provide variable benefits between patients. In T2D patients who do not have a history of heart disease, it is difficult to choose among the different treatment options. Here, we propose to conduct a precision medicine research project using the genetic information from patients with the aim to optimize treatment options and individualize therapy. The project is linked to an ongoing clinical study (COLCOT-T2D) conducted in T2D patients who do not have a history of heart disease. We will measure variation in the DNA of participants and construct genetic scores that can inform on the underlying biological pathways involved in T2D for each patient. We will assess the ability of these genetic scores to predict which patients derive more cardiovascular protection from which medication, in consideration of 5 classes of diabetes medication and for the anti-inflammatory drug colchicine. The study includes an evaluation of the role of sex (biological) and gender (social) on the benefit of each medication, on adherence to medication, and on willingness to take part in the genetic study. Genomics can be used to identify who will benefit more from diabetes medication. The huge burden of diabetes, the vast choice of therapies, and the costs of treatment are critical societal and economic reasons to identify which patients should be treated with which medication for optimal outcomes.