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

Obura, Morgan; Beulens, Joline W. J.; Slieker, Roderick; Koopman, Anitra D. M.; Hoekstra, Trynke; Nijpels, Giel; Elders, Petra; Koivula, Robert W.; Kurbasic, Azra; Laakso, Markku; Hansen, Tue H.; Ridderstråle, Martin; Hansen, Torben; Pavo, Imre; Forgie, Ian; Jablonka, Bernd; Ruetten, Hartmut; Mari, Andrea; McCarthy, Mark I.; Walker, Mark

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.

TYPE 2 diabetes; GLUCOSE; GLYCEMIC index; GLYCOSYLATED hemoglobin; BETA (Finance)

PLoS ONE, 2020, Vol 15, Issue 11, p1

1932-6203

Academic Journal

10.1371/journal.pone.0242360