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Pharmacogenomics and the prevention of vascular complications in diabetes mellitus

Dan Farbstein and Andrew P Levy

While the majority of patients benefit from front-line therapies for diabetes and dyslipidemia, others present with diminished responses. These differences in drug efficacy appear to be due, in large part, to genetic polymorphisms affecting pharmacokinetics and drug-target interactions. Many studies have been conducted in an attempt to elucidate the pharmacogenetic relationship between a wide range of polymorphisms and their effects on responsiveness to statins, hypoglycemics, insulin sensitizers, antihypertensives and antioxidants. Regarding most polymorphisms, the results of association studies have not been validated consistently across different population groups. This review will present some of these pharmacogenetic relationships, focusing on the haptoglobin polymorphism and the responsiveness to vitamin E supplementation.