Precision Medicine in Type 2 Diabetes Mellitus: Advances in Continuous Assessment, Subclassification, Personalized Therapies, and Disease Remission: A Comprehensive Review.

Abstract

Precision medicine in type 2 diabetes mellitus (T2DM) shifts from uniform treatment to individualized strategies addressing genetic, metabolic, environmental, and clinical heterogeneity. Key pillars include continuous glucose monitoring (CGM) for dynamic glycemic insights, subtype stratification (e.g., severe insulin-resistant diabetes [SIRD], severe insulin-deficient diabetes [SIDD]), pharmacogenomics-guided therapy, and interventions enabling remission. CGM improves time in range, reduces variability, and supports tailored adjustments beyond HbA1c limitations. Clustering identifies differential complication risks and drug responses, favoring SGLT2 inhibitors in SIRD or GLP- receptor agonists in SIDD. Remission sustained normoglycemia without medication