Trajectories of clinical characteristics, complications and treatment choices in data-driven subgroups of type 2 diabetes
Authors' conclusion
Data-driven subgroup allocations were generally consistent over follow-up and captured significant differences in risk factor trajectories, medication patterns and complication risks. Subgroups serve better as a complement rather than as a basis for compressing clustering indicators.
Study context
- Population
- Individuals with T2D in Dutch and Scottish primary care diabetes cohorts; subgroups defined by age at baseline, BMI, HbA1c, HDL-cholesterol and C-peptideN=3054 and 6145 in two cohorts
- Exposure
- Five data-driven T2D subgroups defined by k-means clustering
- Outcome
- MI risk by subgroup
Methodological detailstwo primary care registries (the Netherlands and Scotland), k-means clustering, median follow-up=11.2 and 12.3 years, respectively
- Two primary care registries (the Netherlands and Scotland)
- K-means clustering
- Median follow-up=11.2 and 12.3 years, respectively
Main finding
As reported in the abstract
Severe insulin resistance vs Mild diabetes with high HDL-cholesterolHazard ratio (95% CI)
Before adjusting for age effect
1.65(1.40–1.94)
After adjusting for age effect
1.72(1.46–2.02)
Observational data: associations, not effects.
Further findings
| Outcome | Relative risk factor for using insulin relative to no common treatment (95% CI) | |
|---|---|---|
| Insulin prescription · 10 years of diagnosisSevere insulin-deficient diabetesvs Mild diabetes | 3.07 (2.73–3.44) | |
| 0.20.5125Relative risk factor for using insulin relative to no common treatment (log scale) |
- Insulin prescription — Severe insulin-deficient diabetes most intensively treated, with insulin prescribed
- >25%
Prediction of progression
- Clustering indicators were better predictors of progression variation than subgroups; accuracy may improve combining both
Cluster consistency · 8 years
- Accuracy of cluster consistency
- 59% to 72%
Original publication
Trajectories of clinical characteristics, complications and treatment choices in data-driven subgroups of type 2 diabetes. Diabetologia. Published 16 April 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →