Subtypes of type 2 diabetes and their association with outcomes in Korean adults - A cluster analysis of community-based prospective cohort

You Cheol Hwang, Hong Yup Ahn, Ji Eun Jun, In Kyung Jeong, Kyu Jeung Ahn, Ho Yeon Chung

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Little is known about the subtypes of type 2 diabetes (T2D) and their association with clinical outcomes in Asians. Methods: We performed data-driven cluster analysis in patients with newly diagnosed drug-naive T2D (n = 756) from the Korean Genome and Epidemiology Study. Clusters were based on five variables (age at diagnosis, BMI, HbA1c, and HOMA2 β-cell function, and insulin resistance). Results: We identified four clusters of patients with T2D according to k-means clustering: cluster 1 (22.4 %, severe insulin-resistant diabetes [SIRD]), cluster 2 (32.7 %, mild age-related diabetes [MARD]), cluster 3 (32.7 %, mild obesity-related diabetes [MOD]), and cluster 4 (12.3 %, severe insulin-deficient diabetes [SIDD]). During 14 years of follow-up, individuals in the SIDD cluster had the highest risk of initiation of glucose-lowering therapy compared to individuals in the other three clusters. Individuals in the MARD and SIDD clusters showed the highest risk of chronic kidney disease and cardiovascular disease, and individuals in the MOD clusters showed the lowest risk after adjusting for other risk factors (P < 0.05). Conclusions: Patients with T2D can be categorized into four subgroups with different glycemic deterioration and risks of diabetes complications. Individualized management might be helpful for better clinical outcomes in Asian patients with different T2D subgroups.

Original languageEnglish
Article number155514
JournalMetabolism: Clinical and Experimental
Volume141
DOIs
StatePublished - Apr 2023

Keywords

  • Asian
  • Cluster analysis
  • Heterogeneity
  • Type 2 diabetes

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