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.
- Endokrinologi och diabetes
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Dag Ahrén (Manager), Markus Ringnér (Manager), Fredrik Levander (Manager), Ashfaq Ali (Manager), Lokeshwaran Manoharan (Manager), Nikolay Oskolkov (Manager), Louella Judy Antonio Vasquez (Manager), Paul Theodor Pyl (Manager), Juliana Assis Geraldo (Manager) & Prasoon Agarwal (Manager)Biologiska institutionen