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Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes: An IMI-DIRECT study.

Authors :
Obura M
Beulens JWJ
Slieker R
Koopman ADM
Hoekstra T
Nijpels G
Elders P
Koivula RW
Kurbasic A
Laakso M
Hansen TH
Ridderstråle M
Hansen T
Pavo I
Forgie I
Jablonka B
Ruetten H
Mari A
McCarthy MI
Walker M
Heggie A
McDonald TJ
Perry MH
De Masi F
Brunak S
Mahajan A
Giordano GN
Kokkola T
Dermitzakis E
Viñuela A
Pedersen O
Schwenk JM
Adamski J
Teare HJA
Pearson ER
Franks PW
't Hart LM
Rutters F
Source :
PloS one [PLoS One] 2020 Nov 30; Vol. 15 (11), pp. e0242360. Date of Electronic Publication: 2020 Nov 30 (Print Publication: 2020).
Publication Year :
2020

Abstract

Aim: 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.<br />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.<br />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.<br />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.<br />Competing Interests: The authors have read the journal’s policy and have the following competing interests: IP is employed by Eli Lilly Regional Operations GmbH, Vienna, Austria and BJ and HR are employees of Sanofi-Aventis Deutschland GmbH, R&D, Frankfurt am Main, Germany. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.

Details

Language :
English
ISSN :
1932-6203
Volume :
15
Issue :
11
Database :
MEDLINE
Journal :
PloS one
Publication Type :
Academic Journal
Accession number :
33253307
Full Text :
https://doi.org/10.1371/journal.pone.0242360