TY - JOUR
T1 - Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes: An IMI-DIRECT study
T2 - An IMI-DIRECT study
AU - Obura, Morgan
AU - Beulens, Joline W. J.
AU - Slieker, Roderick
AU - Koopman, Anitra D. M.
AU - Hoekstra, Trynke
AU - Nijpels, Giel
AU - Elders, Petra
AU - Koivula, Robert W.
AU - Kurbasic, Azra
AU - Laakso, Markku
AU - Hansen, Tue H.
AU - Ridderstråle, Martin
AU - Hansen, Torben
AU - Pavo, Imre
AU - Forgie, Ian
AU - Jablonka, Bernd
AU - Ruetten, Hartmut
AU - Mari, Andrea
AU - McCarthy, Mark I.
AU - Walker, Mark
AU - Heggie, Alison
AU - McDonald, Timothy J.
AU - Perry, Mandy H.
AU - de Masi, Federico
AU - Brunak, S. ren
AU - Mahajan, Anubha
AU - Giordano, Giuseppe N.
AU - Kokkola, Tarja
AU - Dermitzakis, Emmanouil
AU - Viñuela, Ana
AU - Pedersen, Oluf
AU - Schwenk, Jochen M.
AU - Adamski, Jurek
AU - Teare, Harriet J. A.
AU - Pearson, Ewan R.
AU - Franks, Paul W.
AU - IMI-DIRECT Consortium
AU - 't Hart, Leen M.
AU - Rutters, Femke
PY - 2020/11
Y1 - 2020/11
N2 - 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. 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. 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. 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.
AB - 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. 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. 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. 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.
UR - http://www.scopus.com/inward/record.url?scp=85097034291&partnerID=8YFLogxK
U2 - https://doi.org/10.1371/journal.pone.0242360
DO - https://doi.org/10.1371/journal.pone.0242360
M3 - Article
C2 - 33253307
SN - 1932-6203
VL - 15
SP - e0242360
JO - PLOS ONE
JF - PLOS ONE
IS - 11 November
M1 - e0242360
ER -