Prototype of an evidence‐based tool to aid individualized treatment for type 2 diabetes

Abstract

Data-driven tools are needed to inform individualized treatment decisions for people with type 2 diabetes (T2D). To show how treatment might be individualized, an interactive outline tool was developed to predict treatment outcomes. Individualized predictions were generated for change in HbA1c and body weight after initiation of newer antidiabetes drugs recommended by current guidelines. These predictions were based on data from randomized controlled trials of glucose-lowering drugs. The data included patient demographics and clinical characteristics (sex, age, body mass index, weight, diabetes duration, HbA1c level, current diabetes treatment and renal function).Predicted outcomes were determined using prespecified statistical models from original trial protocols and estimated coefficients for selected baseline characteristics. This prototype illustrates how evidence-based individualized treatment might be facilitated in the clinic for people with T2D. Further and ongoing development is required to improve the tool's prognostic value, including the addition of disease co-morbidities and patient-orientated outcomes. Patient engagement and data-sharing by sponsors of clinical trials, as well as real-world evidence, are needed to provide reliable predicted outcomes to inform shared patient-physician decision-making.

Understanding the place for GLP‐1RA therapy: Translating guidelines for treatment of type 2 diabetes into everyday clinical practice and patient selection

“…Data included in this algorithm‐based support tool could be laboratory work (eg, HbA1c, lipid profile, kidney function), blood pressure, body weight, medical history, comorbidities, other patient‐specific factors, and data embedded within medical devices and apps. Recently, a prototype of an interactive tool has been developed to assist clinicians in individualized treatment for T2D 103 . The prototype predicts change in HbA1c levels and body weight based on randomized controlled trials, patient data, and person‐specific information.…”

“…¶¶Limited data available on the safety and efficacy of GLP‐1 RA in patients with hepatic impairment (AST:ALT ratio >1). †††Semaglutide should be prescribed with caution in people with background retinopathy who have long‐standing diabetes duration and are on insulin therapy (SUSTAIN‐6 trial) 103 . ‡‡‡Symptoms of HF at rest.…”

Generalized edema and heart failure caused from hypothyroidism and ferrous agent for hypochromic anemia

“…1 Furthermore, to take appropriate management for the patients with various diseases and health problems in daily clinical care. 2 The authors have continued adequate medical practice in a wide range of fields in our hospital. 3 They include Atherosclerotic Cardiovascular Disease (ASCVD), chronic heart failure (CHF), chronic kidney disease (CKD), cerebrovascular accident (CVA), metabolic syndrome, diabetes, and others.…”