The role of pharmacogenomics in diabetes

Diabetes mellitus has emerged as a major public health epidemic in the 21st century. Type 2 diabetes is the most prevalent form of diabetes in adults, accounting for 90%-95% of cases worldwide. A large pharmacologic treatment arsenal exists for diabetes, but it is difficult to predict which patients will derive the best efficacy or be predisposed to toxicity for a given antidiabetic medication. As such, the potential of pharmacogenomics to aid in the selection of antidiabetic drug therapy has garnered considerable attention in the early 21^st century. This chapter will review major antidiabetic drug classes (biguanides, sulfonylureas, and thiazolidinediones) for which a moderate amount of pharmacogenomics research exists. Within this framework, the most clinically relevant findings from candidate gene studies and/or genome-wide association studies will be highlighted for each drug class. In addition, the challenges and opportunities associated with the potential translation of pharmacogenomics information to the clinical management of diabetes will be described.