NEXT-GENERATION DIABETES CARE: INTEGRATING GENETICS, BIOMARKERS, AND PRECISION MEDICINE
Abstract
Prediabetes represents a critical yet heterogeneous metabolic state affecting more than 100 million individuals worldwide, characterized by elevated glucose levels that fall below the threshold for type 2 diabetes (T2D). Although lifestyle interventions such as dietary modification, physical activity, and weight management significantly reduce T2D incidence at the population level, substantial inter-individual variability exists in both disease susceptibility and response to these interventions. This variability limits the effectiveness of conventional “one-size-fits-all” prevention strategies and highlights the need for a precision-based approach to lifestyle medicine.This review synthesizes evidence from large randomized controlled trials and prospective cohort studies demonstrating that intensive lifestyle modification can reduce T2D risk by approximately 50–60% and delay disease onset by several years. However, the persistence of progression in many individuals despite optimal lifestyle change underscores underlying biological heterogeneity driven by genetic, metabolic, and molecular factors. We examine emerging molecular biomarkers-including microRNAs, metabolites, inflammatory proteins, and lipid species-that offer earlier detection of dysglycemia, stratification of diabetes risk, prediction of therapeutic response, and identification of individuals prone to complications. We further explore advances in genomic medicine, including genome-wide association studies, polygenic risk scores, and pharmacogenomics, which provide insight into individual susceptibility and therapeutic responsiveness.The integration of multi-omics technologies with lifestyle data presents a transformative opportunity to personalize diabetes prevention and management. However, major challenges remain, including biomarker validation, assay standardization, clinical utility, cost-effectiveness, and ethical considerations surrounding genetic data. Overall, lifestyle precision medicine, supported by molecular and genomic profiling, offers a promising pathway to more targeted, effective, and sustainable strategies for preventing and managing type 2 diabetes.
Keywords:
Type 2 Diabetes, Prediabetes, Lifestyle Precision Medicine, Molecular Biomarkers, Genomic MedicineDOI
https://doi.org/10.22376/ijpbs.v17i1.140References
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