Pharmacoepigenetics in Type 2 Diabetes Mellitus

Type 2 diabetes (T2D) is a common disease resulting from multiorgan insulin resistance and inadequate pancreatic insulin production. Lifestyle modifications can often reduce glycemia in individuals with recent T2D onset; however, for patients who are significantly insulinopenic, pharmacological intervention is necessary to treat the disease. The repertoire of oral and injected antidiabetic agents has expanded greatly during the past decade; however, the effects of oral antihyperglycemic agents are highly variable, and factors such as age, sex, disease, drug and food interactions, comorbidity, and genetic factors contribute to interindividual differences in drug response. Emerging evidence also suggests that epigenetic factors modulate pharmacological response to antidiabetes drugs. In this chapter we provide an overview of the epidemiology, pathogenesis, and clinical management of T2D and review the current state of pharmacoepigenetics research of antidiabetes medications. Combined with pharmacogenomics, pharmacoepigenetics may lead to the development of individualized approaches in the treatment of T2D.