Anne-margreeth Krijger-Dijkema


pharmacist at Academic pharmacy Stevenshof and SIR institute for Pharmacy Practice and Policy Leiden. Project manager of the pilot ‘ Diabetes subtyping and Lifestyle as Medicine (DLAM)’. Other activities: Diabetes education pharmacy-students, pharmacists, general and nurse practitioners; workgroup member several Dutch diabetes guidelines; board member NDF (Dutch Diabetes Federation); member of the scientific advice council of the Dutch Diabetes Fonds.

Diabetes-2-subtyping: a useful tool in personalizing diabetes treatment?

When a person is diagnosed with type-2- diabetes, we assume that they have a combination of insulin resistance and/or insufficient insulin secretion. We don’t know the individual differences in insulin resistance and secretion and treat them as a homogeneous group, with variable success. However, diabetes type 2 is in fact a very heterogeneous group. In 2019 we’ve conducted a pilot study among 15 diabetes type 2 patients, in which we used subtyping (=diabetypering) to identify these differences. Diabetypering gave valuable information about the functioning of their beta cells and the degree of insulin resistance. The participants received subsequently a personalized life-style intervention, where their subtype was taken into account. Diabetypering was used at baseline of and during the pilot study to monitor the changes in betacelfunctioning and insulin resistance. It also gave direction to the medical treatment of type 2 diabetes: which medications would benefit or deteriorate the underlying pathofysiology. The patients in our pilot were very eager to see their results and found it motivating to continue their lifestyle intervention by seeing the changes in their degree of insulin resistance and betacelfunctioning. The results of the pilot will be shared in this presentation. These results lead to interesting challenges and questions: Is diabetypering scalable? When and for which patients is it profitable? How reliable and reproducible is the used method? Is it still acceptable to start insulin treatment without knowing the diabetes-2-subtype? Join the conversation.

Ik steun het Manifest voor Leefstijlgeneeskunde en werk en vind dat leefstijlgeneeskunde een plek moet krijgen in de werkcontext