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Stratification of type 2 diabetes based on routine clinical markers

Safai, Narges ; Ali, Ashfaq LU ; Rossing, Peter and Ridderstråle, Martin LU (2018) In Diabetes Research and Clinical Practice 141. p.275-283
Abstract

AIMS: We hypothesized that patients with dysregulated type 2 diabetes may be stratified based on routine clinical markers.

METHODS: In this retrospective cohort study, diabetes related clinical measures including age at onset, diabetes duration, HbA1c, BMI, HOMA2-β, HOMA2-IR and GAD65 autoantibodies, were used for sub-grouping patients by K-means clustering and for adjusting. Probability of diabetes complications (95% confidence interval), were calculated using logistic regression.

RESULTS: Based on baseline data from patients with type 2 diabetes (n = 2290), the cluster analysis suggested up to five sub-groups. These were primarily characterized by autoimmune β-cell failure (3%), insulin resistance with short disease... (More)

AIMS: We hypothesized that patients with dysregulated type 2 diabetes may be stratified based on routine clinical markers.

METHODS: In this retrospective cohort study, diabetes related clinical measures including age at onset, diabetes duration, HbA1c, BMI, HOMA2-β, HOMA2-IR and GAD65 autoantibodies, were used for sub-grouping patients by K-means clustering and for adjusting. Probability of diabetes complications (95% confidence interval), were calculated using logistic regression.

RESULTS: Based on baseline data from patients with type 2 diabetes (n = 2290), the cluster analysis suggested up to five sub-groups. These were primarily characterized by autoimmune β-cell failure (3%), insulin resistance with short disease duration (21%), non-autoimmune β-cell failure (22%), insulin resistance with long disease duration (32%), and presence of metabolic syndrome (22%), respectively. Retinopathy was more common in the sub-group characterized by non-autoimmune β-cell failure (52% (47.7-56.8)) compared to other sub-groups (22% (20.1-24.1)), adj. p < 0.001. The prevalence of cardiovascular disease, nephropathy and neuropathy also differed between sub-groups, but significance was lost after adjustment.

CONCLUSIONS: Patients with type 2 diabetes cluster into clinically relevant sub-groups based on routine clinical markers. The prevalence of diabetes complications seems to be sub-group specific. Our data suggests the need for a tailored strategy for the treatment of type 2 diabetes.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomarkers/blood, Cohort Studies, Diabetes Mellitus, Type 2/drug therapy, Humans, Retrospective Studies
in
Diabetes Research and Clinical Practice
volume
141
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85047653146
  • pmid:29782936
ISSN
1872-8227
DOI
10.1016/j.diabres.2018.05.014
language
English
LU publication?
no
id
d27abb81-1eb3-4558-a1d8-0d99c77c2736
date added to LUP
2019-01-22 14:09:09
date last changed
2019-12-10 07:53:57
@article{d27abb81-1eb3-4558-a1d8-0d99c77c2736,
  abstract     = {<p>AIMS: We hypothesized that patients with dysregulated type 2 diabetes may be stratified based on routine clinical markers.</p><p>METHODS: In this retrospective cohort study, diabetes related clinical measures including age at onset, diabetes duration, HbA1c, BMI, HOMA2-β, HOMA2-IR and GAD65 autoantibodies, were used for sub-grouping patients by K-means clustering and for adjusting. Probability of diabetes complications (95% confidence interval), were calculated using logistic regression.</p><p>RESULTS: Based on baseline data from patients with type 2 diabetes (n = 2290), the cluster analysis suggested up to five sub-groups. These were primarily characterized by autoimmune β-cell failure (3%), insulin resistance with short disease duration (21%), non-autoimmune β-cell failure (22%), insulin resistance with long disease duration (32%), and presence of metabolic syndrome (22%), respectively. Retinopathy was more common in the sub-group characterized by non-autoimmune β-cell failure (52% (47.7-56.8)) compared to other sub-groups (22% (20.1-24.1)), adj. p &lt; 0.001. The prevalence of cardiovascular disease, nephropathy and neuropathy also differed between sub-groups, but significance was lost after adjustment.</p><p>CONCLUSIONS: Patients with type 2 diabetes cluster into clinically relevant sub-groups based on routine clinical markers. The prevalence of diabetes complications seems to be sub-group specific. Our data suggests the need for a tailored strategy for the treatment of type 2 diabetes.</p>},
  author       = {Safai, Narges and Ali, Ashfaq and Rossing, Peter and Ridderstråle, Martin},
  issn         = {1872-8227},
  language     = {eng},
  pages        = {275--283},
  publisher    = {Elsevier},
  series       = {Diabetes Research and Clinical Practice},
  title        = {Stratification of type 2 diabetes based on routine clinical markers},
  url          = {http://dx.doi.org/10.1016/j.diabres.2018.05.014},
  doi          = {10.1016/j.diabres.2018.05.014},
  volume       = {141},
  year         = {2018},
}