Drug-Class-Oriented Pharmacogenomics in Type 2 Diabetes: Implications for Personalised Therapy

Type 2 Diabetes Mellitus is characterized by insulin resistance and impaired insulin secretion, with considerable interindividual variability in response to antidiabetic therapy. In addition to clinical and lifestyle factors, genetic polymorphisms significantly influence drug efficacy and tolerability. This review summarizes current pharmacogenomic evidence related to major antidiabetic drug classes, including metformin, sulfonylureas, thiazolidinediones, incretin-based therapies, SGLT-2 inhibitors, and insulin. Particular emphasis is placed on key genes such as PPARG, TCF7L2, KCNJ11, ABCC8, and SLC22A1, which have demonstrated clinically relevant associations with drug response. By correlating genetic variability with therapeutic outcomes, this review highlights the potential of pharmacogenomics to advance personalized treatment strategies in Type 2 Diabetes Mellitus.