Diabetes is increasing rapidly from 415 million patients in 2015 to 642 million patients by 2040. As a result, it will become the leading disease worldwide, affecting 1 out of 10 persons globally and 3 out of 4 in low and middle income countries according to the International Diabetes Federation.
With increasing age in the population, adequate treatment of chronic diabetes becomes more and more important to avert the increasing illness and the societal burden. About half of the diabetic patients are at risk for renal and cardiovascular complications associated with an increased disease burden and death rate, the latter even surpassing the death rate in all treated cancer patients. To avoid this, current practice is to treat the patient for factors that increase the risk of that patient for bad outcome by lowering risk factors such as life style (high salt and protein intake, sedentary life etc), lowering of high blood glucose, high blood pressure, high cholesterol, and protein leakage in urine. Despite the successful treatment of these risk factors, most diabetic patients still show marked long-term effects of the disease such as a progressive loss of multiple organ function, in particular in the cardiovascular and renal systems.The major reason for the lack of treatment efficacy is the large variation in individual response to the treatment. Consequently, there is a huge unmet need in the treatment of this chronic disease.
Studies indicate that approximately half of the patients do not benefit from new registered drugs. Drugs are however registered for a disease (after doing clinical trials in large homogeneous patient group) and not for an individual patient with very different characteristics. Hence, chronic diabetic disease management is in need of increased attention for a more individual and dedicated approach of care. A huge step forward in chronic diabetes disease management is personalised/precision medicine. Personalised/precision medicine is defined as a medical approach which is tailored to the patient for prevention, prediction and treatment of disease using information about the patient’s genes, proteins and environment.
The largest hurdles in switching from a one treatment fits all concept to a one fit for each patient concept, is not only to define individual mechanisms of disease and find a drug for each mechanism, but also to implement the concept in practice. The latter is particularly difficult since multiple stakeholders are involved: academia, (pharma) industry, legislators, payers/Health Technology Assessors, doctors and not to forget patients. The COFUND PROMINENT programme brings prevention, prediction, and treatment together and aims to introduce personalized/precision medicine in chronic diabetes disease management. The programme therefore includes training 16 fellows distributed over the different stakeholder domains, and having them interact together and being trained together, so to understand each others' domain "problems" of introducing personalized/precision medicine. PROMINENT aims to educate the next-generation employers, who can perform high quality research, and who can subsequently have a major impact on scientific breakthroughs that foster the European society and economy.
