New tool to match treatment to individuals with T2D

Hailed as possibly the ‘most significant advance in type 2 diabetes care in more than a decade,’ a new tool will enable healthcare professionals to predict the most effective treatment option for individuals with the condition.

By predicting which drug will lead to the largest reduction in blood glucose levels, the easy-to-use tool could benefit millions of people with type 2 diabetes, according to research presented at the Diabetes UK Professional Conference 2025 and published in The Lancet.

The tool was developed by researchers at the University of Exeter, funded by the Medical Research Council, Wellcome and NIHR Exeter Biomedical Research Centre, and supported by Diabetes UK.

Only about a third of people with type 2 diabetes meet blood glucose targets, putting them at risk of diabetes-related complications that cost the NHS £6.2 billion every year.

While metformin is the most common firstline treatment, five other major types of glucose-lowering drugs are available. However, their effectiveness varies widely from person to person, and until now it has not been possible to determine the best glucose-lowering treatment for each patient.

Starting people on the drug recommended by the new tool could lead to marked reductions in blood glucose levels (HbA1c) at one year, of around 5mmol/mol on average, and almost double the time until people need to start taking further diabetes medications. The tool’s use was also predicted to lower risks of developing serious long-term diabetes complications including heart attacks, strokes and kidney disease.

Professor Andrew Hattersley from the University of Exeter, said: ‘Our model can be implemented in clinical care immediately and at no additional cost. This is because it uses simple measures such as sex, weight and standard blood tests that are performed routinely.’

The tool is available at https://www.diabetesgenes.org/t2-treatment/.

Dennis JM, et al. The Lancet February 2025. https://doi.org/10.1016/S0140-6736(24)02617-5