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Clinical profiles of post-load glucose subgroups and their association with glycaemic traits over time : An IMI-DIRECT study

Obura, M. ; Beulens, J. W.J. ; Slieker, R. ; Koopman, A. D.M. ; Hoekstra, T. ; Nijpels, G. ; Elders, P. ; Dekker, J. M. ; Koivula, R. W. LU and Kurbasic, A. LU , et al. (2021) In Diabetic Medicine 38(2).
Abstract

Aim: To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration. Methods: We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months. Results: At baseline, we identified four glucose curve... (More)

Aim: To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration. Methods: We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months. Results: At baseline, we identified four glucose curve subgroups, labelled in order of increasing peak levels as 1–4. Participants in Subgroups 2–4, were more likely to have higher insulin resistance (homeostatic model assessment) and a lower Matsuda index, than those in Subgroup 1. Overall, participants in Subgroups 3 and 4, had higher glycaemic trait values, with the exception of the Matsuda and insulinogenic indices. At 18 months, change in homeostatic model assessment of insulin resistance was higher in Subgroup 4 (β = 0.36, 95% CI 0.13–0.58), Subgroup 3 (β = 0.30; 95% CI 0.10–0.50) and Subgroup 2 (β = 0.18; 95% CI 0.04–0.32), compared to Subgroup 1. The same was observed for C-peptide and insulin. Five subgroups were identified at follow-up, and the majority of participants remained in the same subgroup or progressed to higher peak subgroups after 18 months. Conclusions: Using data from a frequently sampled oral glucose tolerance test, glucose curve patterns associated with different clinical characteristics and different rates of subsequent glycaemic deterioration can be identified.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetic Medicine
volume
38
issue
2
publisher
Wiley-Blackwell
external identifiers
  • scopus:85096717458
  • pmid:33067862
ISSN
0742-3071
DOI
10.1111/dme.14428
language
English
LU publication?
yes
id
f94ba062-1244-4b13-b412-e2d88439d9ce
date added to LUP
2020-12-09 10:09:36
date last changed
2021-04-16 15:49:21
@article{f94ba062-1244-4b13-b412-e2d88439d9ce,
  abstract     = {<p>Aim: To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration. Methods: We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months. Results: At baseline, we identified four glucose curve subgroups, labelled in order of increasing peak levels as 1–4. Participants in Subgroups 2–4, were more likely to have higher insulin resistance (homeostatic model assessment) and a lower Matsuda index, than those in Subgroup 1. Overall, participants in Subgroups 3 and 4, had higher glycaemic trait values, with the exception of the Matsuda and insulinogenic indices. At 18 months, change in homeostatic model assessment of insulin resistance was higher in Subgroup 4 (β = 0.36, 95% CI 0.13–0.58), Subgroup 3 (β = 0.30; 95% CI 0.10–0.50) and Subgroup 2 (β = 0.18; 95% CI 0.04–0.32), compared to Subgroup 1. The same was observed for C-peptide and insulin. Five subgroups were identified at follow-up, and the majority of participants remained in the same subgroup or progressed to higher peak subgroups after 18 months. Conclusions: Using data from a frequently sampled oral glucose tolerance test, glucose curve patterns associated with different clinical characteristics and different rates of subsequent glycaemic deterioration can be identified.</p>},
  author       = {Obura, M. and Beulens, J. W.J. and Slieker, R. and Koopman, A. D.M. and Hoekstra, T. and Nijpels, G. and Elders, P. and Dekker, J. M. and Koivula, R. W. and Kurbasic, A. and Laakso, M. and Hansen, T. H. and Ridderstråle, M. and Hansen, T. and Pavo, I. and Forgie, I. and Jablonka, B. and Ruetten, H. and Mari, A. and McCarthy, M. I. and Walker, M. and McDonald, T. J. and Perry, M. H. and Pearson, E. R. and Franks, P. W. and ‘t Hart, L. M. and Rutters, F.},
  issn         = {0742-3071},
  language     = {eng},
  number       = {2},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Clinical profiles of post-load glucose subgroups and their association with glycaemic traits over time : An IMI-DIRECT study},
  url          = {http://dx.doi.org/10.1111/dme.14428},
  doi          = {10.1111/dme.14428},
  volume       = {38},
  year         = {2021},
}