Journal article
Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes: An IMI-DIRECT study
University of Amsterdam1
Aventis Pharma Germany GmbH2
National Research Council of Italy3
Newcastle University4
University of Exeter5
Royal Devon & Exeter NHS Foundation Trust6
Department of Health Technology, Technical University of Denmark7
Bioinformatics, Department of Health Technology, Technical University of Denmark8
University of Geneva9
KTH Royal Institute of Technology10
Technical University of Munich11
Utrecht University12
Harvard University13
Leiden University14
University of Oxford15
Lund University16
University of Eastern Finland17
University of Copenhagen18
University of Southern Denmark19
Eli Lilly GmbH20
University of Dundee21
...and 11 moreAim 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.
Language: | English |
---|---|
Publisher: | Public Library of Science |
Year: | 2020 |
Pages: | e0242360 |
ISSN: | 19326203 , 15537358 and 1553734x |
Types: | Journal article |
DOI: | 10.1371/journal.pone.0242360 |
ORCIDs: | 0000-0002-6788-5232 , 0000-0002-1646-4163 , 0000-0002-2016-7049 , 0000-0003-3771-8537 , 0000-0001-8141-8449 , 0000-0001-5948-8993 , 0000-0001-8748-3831 , 0000-0003-0316-5866 , 0000-0002-3321-3972 and de Masi, Federico |