Heterogeneity of glycaemic phenotypes in type 1 diabetes
Authors' conclusion
Our study advances the current understanding of the complex glycaemic profile in people with type 1 diabetes and suggests that strategies based on isolated glycaemic metrics might not capture the complexity of the glycaemic phenotypes in real life. Relying on these phenotypes could improve patient stratification in type 1 diabetes care and personalise disease management.
Study context
- Population
- People with T1D in the SFDT1 study; 52.9% men, mean age 40.6 years (SD 14.1)
- Participants
- 618 people
- Outcome
- Glycaemic phenotype heterogeneity from HbA1c, TIR, TBR, CV, Gold score and GRI
Methodological detailsphenotypic tree (Discriminative Dimensionality Reduction with Trees (DDRTree) algorithm), clustering analysis for comparison
- Phenotypic tree (DDRTree algorithm)
- Clustering analysis for comparison
Main finding
As reported in the abstract
Glycaemic phenotypes (DDRTree phenotypic tree)
- Glycaemic phenotypes identified
- 7
- Dimension 1 association with glycaemia risk index (GRI)
- 0.54 [0.52, 0.57] (coefficient [95% CI])
- Dimension 1 association with HbA1c
- 0.39 [0.35, 0.42]
- Dimension 1 association with CV
- 0.24 [0.19, 0.28]
- Dimension 1 association with time below range (TBR)
- 0.11 [0.06, 0.15]
- Dimension 1 association with time in range (TIR)
- −0.52 [−0.54, −0.49]
- Vertical dimension association with TBR
- 0.41 [0.38, 0.44]
- Vertical dimension association with CV
- 0.40 [0.37, 0.43]
- Vertical dimension association with TIR
- 0.16 [0.12, 0.20]
- Vertical dimension association with Gold score
- 0.10 [0.06, 0.15]
- Vertical dimension association with GRI
- 0.06 [0.02, 0.11]
- Vertical dimension association with HbA1c
- −0.21 [−0.25, −0.17]
Observational data: associations, not effects.
Further findings
Determinants of glycaemic phenotype diversity
- Socioeconomic factors, CV risk indicators, retinopathy and treatment strategy were significant determinants
Phenotypic tree vs traditional clustering
- Phenotypic tree enabled more granularity than traditional clustering in revealing clinically relevant subgroups
Original publication
Heterogeneity of glycaemic phenotypes in type 1 diabetes. Diabetologia. Published 23 May 2024. doi:10.
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