Table 1.

Recommendations for future impact in precision diabetes medicine

Domain	Milestones/priorities	Stakeholders
Benchmarking and technology	Establishing mechanisms of research to identify novel and improved risk markers to form the basis for future clinical guidelines	Research to translation (researchers, healthcare providers)
	Developing and testing new assays for commonly used analytes with respect to sensitivity, specificity, the cost for implementation, cost of the assay to patient/ practice	Research to translation (researchers)
	Standardization and sharing of laboratory technologies, assays and pipelines for biomarker assessment and quantification within healthcare systems and in point-of-care settings	Research to translation (researchers, healthcare providers)
	Standard reporting definitions and transparency in computational algorithms and artificial intelligence approaches to enhance access, reproducibility and transparency	Research to translation (researchers)
	Creating systems for routine assessment of heterogeneity in diabetes and revision to the current classification of diabetes across the life course concerning diagnosis, treatment, prognosis and prevention	Research to translation (researchers, healthcare providers)
	Improved estimation of the costs and benefits above current practice to translate precision medicine into approaches consistent with ‘simple clinical measures’	Translation to implementation (healthcare providers, regulators, policymakers)
Policy, implementation and liabilities	A framework optimized to the target population will be necessary for moving precision diabetes research from evidence generation to clinical implementation	Research to translation to implementation (all stakeholders)
	Decision-support systems for healthcare practitioners will need to be developed, specifically for those making first contact with patients, likely in the setting of primary care	Translation to implementation (healthcare providers, regulators, policymakers)
	Forging alliances with regulatory and healthcare agencies to facilitate the coverage of precision medicine tools and decision-support aids, making them accessible and affordable, ideally with free global access	Translation to implementation (healthcare providers, regulators, policymakers, patients/relatives)
	Learning precision diabetes medicine from the MDM perspective, where rare forms may be most clinically ready but not yet widely implemented	Translation to implementation (healthcare providers, regulators, policymakers, the public, patients/relatives)
Equity and community engagement	Increase ethnic, geographic and sociodemographic diversity in biomedical research and healthcare access by addressing language barriers, cultural biases and geographical constraints	Research to translation (researchers, clinicians, the public, patients/relatives)
	Defining context-specific surveillance programs, systems and strategies to identify vulnerable and minority groups experiencing the highest burden of diabetes and related complications	Research to translation to implementation (all stakeholders)
	Evaluation of the impact of precision diabetes medicine approaches should involve patient advisory groups for impact and utility	Translation to implementation (healthcare providers, regulators, policymakers, the public, patients/relatives)
	National and international societies and advocacy groups should play an increasing and supportive role in the promotion, educational and research approaches to increase the implementation of 'standards of care’ and access to precision medicine tools	Translation to implementation (healthcare providers, regulators, policymakers, the public, patients/relatives)
Commercialization and access	Generate a therapeutical framework optimized to the target populations, accessible to those in need, cost-effective and safe	Research to translation to implementation (all stakeholders)
	Recognition of the impact of precision diabetes from a ‘patient journey’ perspective, especially the impact of research on people living with diabetes	Translation to implementation (healthcare providers, regulators, policymakers, patients/relatives)
	Establishing open lines of communication, involving community stakeholders in decision-making processes and ensuring data privacy and security are crucial to building trust and maintaining engagement	Research to translation to implementation (all stakeholders)
Education	Establish programs to ensure that individuals are equipped with the knowledge and education to understand their personal risk factors, make informed decisions about preventive measures and actively engage in appropriate interventions for effective diabetes management	Translation to implementation (healthcare providers, regulators, policymakers, the public, patients/relatives)
	Combating digital health illiteracy. Efforts should be made to bridge the digital divide by providing resources, training and infrastructure to underserved populations, ensuring access to telemedicine, digital health tools and genetic testing services	Translation to implementation (healthcare providers, regulators, policymakers, the public, patients/relatives)
	Develop training programs for healthcare providers to equip them with the knowledge and skills necessary to effectively implement precision diabetes medicine approaches	Translation to implementation (healthcare providers, regulators, policymakers)