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Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes : An IMI-DIRECT study

Obura, Morgan ; Beulens, Joline W.J. ; Slieker, Roderick ; Koopman, Anitra D.M. ; Hoekstra, Trynke ; Nijpels, Giel ; Elders, Petra ; Koivula, Robert W. LU ; Kurbasic, Azra LU and Laakso, Markku , et al. (2020) In PLoS ONE 15(11).
Abstract

AIM: Subclasses of different glycaemic disturbances could explain the variation in characteristics of individuals with type 2 diabetes (T2D). We aimed to examine the association between subgroups based on their glucose curves during a five-point mixed-meal tolerance test (MMT) and metabolic traits at baseline and glycaemic deterioration in individuals with T2D. METHODS: The study included 787 individuals with newly diagnosed T2D from the Diabetes Research on Patient Stratification (IMI-DIRECT) Study. Latent class trajectory analysis (LCTA) was used to identify distinct glucose curve subgroups during a five-point MMT. Using general linear models, these subgroups were associated with metabolic traits at baseline and after 18 months of... (More)

AIM: Subclasses of different glycaemic disturbances could explain the variation in characteristics of individuals with type 2 diabetes (T2D). We aimed to examine the association between subgroups based on their glucose curves during a five-point mixed-meal tolerance test (MMT) and metabolic traits at baseline and glycaemic deterioration in individuals with T2D. METHODS: The study included 787 individuals with newly diagnosed T2D from the Diabetes Research on Patient Stratification (IMI-DIRECT) Study. Latent class trajectory analysis (LCTA) was used to identify distinct glucose curve subgroups during a five-point MMT. Using general linear models, these subgroups were associated with metabolic traits at baseline and after 18 months of follow up, adjusted for potential confounders. RESULTS: At baseline, we identified three glucose curve subgroups, labelled in order of increasing glucose peak levels as subgroup 1-3. Individuals in subgroup 2 and 3 were more likely to have higher levels of HbA1c, triglycerides and BMI at baseline, compared to those in subgroup 1. At 18 months (n = 651), the beta coefficients (95% CI) for change in HbA1c (mmol/mol) increased across subgroups with 0.37 (-0.18-1.92) for subgroup 2 and 1.88 (-0.08-3.85) for subgroup 3, relative to subgroup 1. The same trend was observed for change in levels of triglycerides and fasting glucose. CONCLUSIONS: Different glycaemic profiles with different metabolic traits and different degrees of subsequent glycaemic deterioration can be identified using data from a frequently sampled mixed-meal tolerance test in individuals with T2D. Subgroups with the highest peaks had greater metabolic risk.

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type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
15
issue
11
article number
e0242360
publisher
Public Library of Science
external identifiers
  • scopus:85097034291
  • pmid:33253307
ISSN
1932-6203
DOI
10.1371/journal.pone.0242360
language
English
LU publication?
yes
id
5122f7f3-ccf3-49b6-ba5b-e88f3459ee7e
date added to LUP
2020-12-14 13:46:32
date last changed
2021-06-08 04:16:25
@article{5122f7f3-ccf3-49b6-ba5b-e88f3459ee7e,
  abstract     = {<p>AIM: Subclasses of different glycaemic disturbances could explain the variation in characteristics of individuals with type 2 diabetes (T2D). We aimed to examine the association between subgroups based on their glucose curves during a five-point mixed-meal tolerance test (MMT) and metabolic traits at baseline and glycaemic deterioration in individuals with T2D. METHODS: The study included 787 individuals with newly diagnosed T2D from the Diabetes Research on Patient Stratification (IMI-DIRECT) Study. Latent class trajectory analysis (LCTA) was used to identify distinct glucose curve subgroups during a five-point MMT. Using general linear models, these subgroups were associated with metabolic traits at baseline and after 18 months of follow up, adjusted for potential confounders. RESULTS: At baseline, we identified three glucose curve subgroups, labelled in order of increasing glucose peak levels as subgroup 1-3. Individuals in subgroup 2 and 3 were more likely to have higher levels of HbA1c, triglycerides and BMI at baseline, compared to those in subgroup 1. At 18 months (n = 651), the beta coefficients (95% CI) for change in HbA1c (mmol/mol) increased across subgroups with 0.37 (-0.18-1.92) for subgroup 2 and 1.88 (-0.08-3.85) for subgroup 3, relative to subgroup 1. The same trend was observed for change in levels of triglycerides and fasting glucose. CONCLUSIONS: Different glycaemic profiles with different metabolic traits and different degrees of subsequent glycaemic deterioration can be identified using data from a frequently sampled mixed-meal tolerance test in individuals with T2D. Subgroups with the highest peaks had greater metabolic risk.</p>},
  author       = {Obura, Morgan and Beulens, Joline W.J. and Slieker, Roderick and Koopman, Anitra D.M. and Hoekstra, Trynke and Nijpels, Giel and Elders, Petra and Koivula, Robert W. and Kurbasic, Azra and Laakso, Markku and Hansen, Tue H. and Ridderstråle, Martin and Hansen, Torben and Pavo, Imre and Forgie, Ian and Jablonka, Bernd and Ruetten, Hartmut and Mari, Andrea and McCarthy, Mark I. and Walker, Mark and Heggie, Alison and McDonald, Timothy J. and Perry, Mandy H. and De Masi, Federico and Brunak, Søren and Mahajan, Anubha and Giordano, Giuseppe N. and Kokkola, Tarja and Dermitzakis, Emmanouil and Viñuela, Ana and Pedersen, Oluf and Schwenk, Jochen M. and Adamski, Jurek and Teare, Harriet J.A. and Pearson, Ewan R. and Franks, Paul W. and 't Hart, Leen M. and Rutters, Femke},
  issn         = {1932-6203},
  language     = {eng},
  number       = {11},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes : An IMI-DIRECT study},
  url          = {http://dx.doi.org/10.1371/journal.pone.0242360},
  doi          = {10.1371/journal.pone.0242360},
  volume       = {15},
  year         = {2020},
}