, Volume 44, Issue 2, pp 343–345

Does personalized diabetology overcome clinical uncertainty and therapeutic inertia in type 2 diabetes?

  • Katherine Esposito
  • Antonio Ceriello
  • Dario Giugliano

DOI: 10.1007/s12020-013-9918-x

Cite this article as:
Esposito, K., Ceriello, A. & Giugliano, D. Endocrine (2013) 44: 343. doi:10.1007/s12020-013-9918-x


Uncertainties abound in clinical management of type 2 diabetes. Sources of uncertainty specific to type 2 diabetes originate from the panoply of glycemic (HbA1c) targets, the complexity of drug therapy, the ideal sequence of drugs after metformin failure, the possible harms of anti-hyperglycemic drugs, the outcomes of treatment (surrogate versus clinical) and the hierarchy of risk factors to treat in order to prevent the vascular complications. Ironically, multiple treatment guidelines and algorithms periodically released to improve guidance may generate confusion into clinicians. Moreover, treatment algorithms cannot be truly evidence-based because of a lack of studies comparing all available treatment combination options. Personalized therapy essentially identifies patients who could have major benefits from the therapy as compared with other patients. Personalized medicine for type 2 diabetic has the potential to improve the quality health-care practice of diabetes management, but specific research is needed.


Type 2 diabetesUncertaintyClinical managementPersonalized medicine

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Katherine Esposito
    • 1
  • Antonio Ceriello
    • 2
  • Dario Giugliano
    • 3
  1. 1.Department of Cardiothoracic and Respiratory SciencesSecond University of NaplesNaplesItaly
  2. 2.Insititut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)BarcelonaSpain
  3. 3.Department of Geriatrics and Metabolic DiseasesSecond University of NaplesNaplesItaly