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

oleh: Morgan Obura, Joline W J Beulens, Roderick Slieker, Anitra D M Koopman, Trynke Hoekstra, Giel Nijpels, Petra Elders, Robert W Koivula, Azra Kurbasic, Markku Laakso, Tue H Hansen, Martin Ridderstråle, Torben Hansen, Imre Pavo, Ian Forgie, Bernd Jablonka, Hartmut Ruetten, Andrea Mari, Mark I McCarthy, Mark Walker, Alison Heggie, Timothy J McDonald, Mandy H Perry, Federico De Masi, Søren Brunak, Anubha Mahajan, Giuseppe N Giordano, Tarja Kokkola, Emmanouil Dermitzakis, Ana Viñuela, Oluf Pedersen, Jochen M Schwenk, Jurek Adamski, Harriet J A Teare, Ewan R Pearson, Paul W Franks, Leen M 't Hart, Femke Rutters, IMI-DIRECT Consortium

Format: Article
Diterbitkan: Public Library of Science (PLoS) 2020-01-01

Deskripsi

<h4>Aim</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.