Pharmacoepidemiology in Diabetes Mellitus and its Complications: Focus on Response to Medications, Volume I

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About this Research Topic

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Background

Diabetes mellitus (DM) is an increasingly prevalent metabolic disorder associated with chronic debilitating complications. Although glycemic control plays an important role in the pathogenesis of diabetes-related complications, not all diabetic patients maintain normal glucose levels despite using glucose-lowering medications. Excess blood glucose increases long-standing vascular damages, including micro and macrovascular diseases, which leads to increased treatment costs and mortality. Albeit there are studies on glucose-lowering medications, there is a lack of understanding of how these medications may play a role towards risk or protection to complications. This gap may be overcome by exploring novel biomarkers associated with response to medications. There is also limited evidence concerning drug metabolism (Pharmacokinetics: PK, concentration vs. time, and Pharmacodynamics: PD, effect vs. time) effects. PK/PD could explain failures in response to medications. Nevertheless, it has been observed that the PK/PD of a specific drug are variable in people with DM. Further, these could be attributed to variations in drug (i) absorption; (ii) distribution, (iii) biotransformation, and (iv) excretion. Pharmacoepidemiological studies, with a focus on precision medicine, can improve treatment efficacy and safety. Knowledge of factors associated with response to medications leads to the discovery and development of new drugs, dose selection, and effective evaluation of medications' efficacy and safety.
Considering that millions of DM individuals on glucose-lowering medications that do not have an adequate therapeutic response suffer from complications such as cardiovascular diseases (CVD) and nephropathy, improving response to medications could yield significant health, promotion in quality of life and life expectancy, and economic benefits. Improved therapeutic efficacy helps individuals in keeping their societal position, e.g., profession and social life. Therefore, studies on exploring factors associated with medication response in the DM population are crucial to achieving this. The project goals are:
- Personalized medicine in diabetes; a sex-tailored prevention and treatment approach.
- Identifying novel factors associated with response to medications in a population with diabetes.
- Improving in response to medications, health, promotion, quality of life, and life expectancy in population with diabetes.

The current Research Topic aims to cover novel, promising, and most recent findings related to medication response in individuals with DM. Areas to be covered may include, but are not limited to:
1) Studies on factors associated with response to glucose-lowering medications: mainly focus on assessing novel markers (biological and genetic) associated with medication treatment response in individuals with DM and its complications.
2) PK/PD studies in glucose-lowering medications in individuals with DM.
3) PK/PD studies in various drugs among the population with DM.

Keywords: Diabetes mellitus, Pharmacoekinetics, Pharmacodynamics, markers, efficacy, glucose control

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