{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:31:14Z","timestamp":1788359474368,"version":"build-2803163510"},"reference-count":35,"publisher":"American Diabetes Association","issue":"7","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Hong Kong Genome Institute Fellowship"},{"name":"RGC Research Impact Fund"},{"name":"Innovation and Technology Commission Research Talent Hub"},{"name":"Health and Medical Research Fund Commissioned Research Grant","award":["CFS-CUHK2"],"award-info":[{"award-number":["CFS-CUHK2"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Young-onset type 2 diabetes (YOD) results from complex causes, calling for precision management.<\/jats:p>\n <\/jats:sec>\n \n RESEARCH DESIGN AND METHODS<\/jats:title>\n The Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes (PRISM) study was a single-center, two-arm, 3-year randomized controlled trial in which Chinese individuals aged 18 to 50 years with non\u2013type 1 diabetes diagnosed at age \u226440 years were randomly assigned to intervention (Joint Asia Diabetes Evaluation [JADE]\u2013PRISM) or usual clinic-based care (JADE only). The intervention included technologically guided assessment and use of biogenetic markers (autoantibodies, C-peptide, and common and rare genetic variants) to classify diabetes for 1-year intensified, algorithm-based treatment followed by two annual reviews by an endocrinologist-led multidisciplinary team. The primary end point was a composite of incident or progression of all diabetes-related complications. Secondary end points included attainment of three or more treatment targets (HbA1c &lt;6.2%, blood pressure &lt;120\/75 mmHg, LDL cholesterol &lt;1.2 mmol\/L, triglycerides &lt;1.2 mmol\/L, and waist circumference &lt;80 [women] or &lt;85 cm [men]), proxies of \u03b2-cell function, and patient-reported outcome measures (PROMs).<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n During 2020 to 2021, 884 participants (mean [SD] age 40.7 [6.5] years; mean [SD] age at diagnosis 32.5 [6.8] years; autoantibody positivity [n = 46]; monogenic diabetes [n = 23]; C-peptide &lt;200 pmol\/L [n = 82]; central obesity [n = 699]; dyslipidemia [n = 669]; hypertension [n = 588]; albuminuria [n = 313]; insulin treated [n = 250]) were randomly assigned to the JADE-PRISM (n = 441) or JADE-only group (n = 443). During the 3-year study, the primary end point developed in 116 participants (26.3%) in the JADE-PRISM group versus 125 (28.2%) in the JADE-only group (odds ratio 0.908 [95% CI 0.675\u20131.221]). In the JADE-PRISM group, 104 participants (23.8%) versus 54 in the JADE-only group (12.2%; P &lt; 0.001) reached three or more treatment targets, with improved proxies of \u03b2-cell function and reduced emotional distress.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n A 3-year technology-enhanced, multicomponent program improved cardiometabolic status, proxies of \u03b2-cell function, and PROMs in individuals with YOD but did not reduce complications.<\/jats:p>\n <\/jats:sec>","DOI":"10.2337\/dc26-0114","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:17:14Z","timestamp":1778602634000},"page":"1202-1212","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":3,"title":["Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes (PRISM): A Randomized Controlled Trial in Chinese Patients With Young-Onset Diabetes"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5244-6069","authenticated-orcid":false,"given":"Andrea O.Y.","family":"Luk","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong Special Administrative Region 1 , People\u2019s Republic of China"},{"name":"Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong Special Administrative Region 2 , People\u2019s Republic of China"},{"name":"Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong Special Administrative Region 3 , People\u2019s Republic of China"},{"name":"Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong Special Administrative Region 4 , People\u2019s Republic of 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