Opinion | Why a new approach to diabetes treatment is desperately needed

The management of diabetes has barely improved even as its prevalence has become more widespread, with massive impacts on people and healthcare systems. An alternative approach based on individualised precision medicine is desperately needed.

The International Diabetes Foundation estimates almost 540 million adults had diabetes in 2021. In China, only less than 40 per cent receive adequate treatment and of those only 50 per cent achieve good glucose control, according to a 2018 study. Treatment outcomes are bad more often than they are good despite billions of dollars invested in research and a variety of classes of diabetic drugs on the market.

Patients receive prescriptions for the same drugs with little regard for their genetic background or understanding of why they have diabetes. This one-size-fits-all approach to managing and treating the disease is ineffective because the underlying causes can vary from person to person.

Genetic background, changing lifestyles, inexpensive sugar and processed foods, larger portion sizes and sedentary work have all contributed to the spread of diabetes. We have moved away from physical work and natural foods towards office jobs and sugary energy drinks. This is significant because, at the most basic level, diabetes is driven by a poor relationship between the body and food.

China, which is home to about a fifth of the global diabetic population, has taken a leadership role in dealing with diabetes in terms of drug discovery. It has put in place policies that reward innovation and was the first country to approve the first new class of drug in a decade to treat diabetes, dorzagliatin, developed by my company Hua Medicine. It has also put in place aggressive pricing and distribution strategies to make treatments more widely available.

One common cause of diabetes is a reduction in the function of glucokinase, an enzyme that serves as an internal glucose sensor and plays an important role in regulating blood sugar levels by governing the conversion of glucose into energy. Declines in the function of glucokinase are linked to a genetic variation that can be found in people all over the world.