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Clinical profiles of post-load glucose subgroups and their association with glycaemic traits over time : An IMI-DIRECT study

Obura, M. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam
Beulens, J. W.J. (author)
University Medical Center Utrecht,Amsterdam UMC - Vrije Universiteit Amsterdam
Slieker, R. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam,Leiden University Medical Centre
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Koopman, A. D.M. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam
Hoekstra, T. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam,Vrije Universiteit Amsterdam
Nijpels, G. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam
Elders, P. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam
Dekker, J. M. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam
Koivula, R. W. (author)
Lund University,Lunds universitet,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups,University of Oxford
Kurbasic, A. (author)
Lund University,Lunds universitet,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups
Laakso, M. (author)
Kuopio University Hospital,University of Eastern Finland
Hansen, T. H. (author)
University of Copenhagen,Slagelse Hospital
Ridderstråle, M. (author)
University of Copenhagen
Hansen, T. (author)
University of Copenhagen,University of Southern Denmark
Pavo, I. (author)
Eli Lilly Regional Operations G.m.b.H.
Forgie, I. (author)
University of Dundee
Jablonka, B. (author)
Sanofi-Aventis Deutschland GmbH
Ruetten, H. (author)
Sanofi-Aventis Deutschland GmbH
Mari, A. (author)
Institute of Neuroscience, Università di Padova
McCarthy, M. I. (author)
Wellcome Trust Centre for Human Genetics,University of Oxford
Walker, M. (author)
University of Newcastle upon Tyne
McDonald, T. J. (author)
University of Exeter,Royal Devon and Exeter NHS Foundation Trust
Perry, M. H. (author)
Royal Devon and Exeter NHS Foundation Trust
Pearson, E. R. (author)
University of Dundee
Franks, P. W. (author)
Lund University,Lunds universitet,Genetisk och molekylär epidemiologi,Forskargrupper vid Lunds universitet,Genetic and Molecular Epidemiology,Lund University Research Groups,University of Oxford,Harvard University
‘t Hart, L. M. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam,Leiden University Medical Centre
Rutters, F. (author)
Amsterdam UMC - Vrije Universiteit Amsterdam
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 (creator_code:org_t)
 
2020-11-03
2021
English.
In: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 38:2
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Aim: To examine the hypothesis that, based on their glucose curves during a seven-point oral glucose tolerance test, people at elevated type 2 diabetes risk can be divided into subgroups with different clinical profiles at baseline and different degrees of subsequent glycaemic deterioration. Methods: We included 2126 participants at elevated type 2 diabetes risk from the Diabetes Research on Patient Stratification (IMI-DIRECT) study. Latent class trajectory analysis was used to identify subgroups from a seven-point oral glucose tolerance test at baseline and follow-up. Linear models quantified the associations between the subgroups with glycaemic traits at baseline and 18 months. Results: At baseline, we identified four glucose curve subgroups, labelled in order of increasing peak levels as 1–4. Participants in Subgroups 2–4, were more likely to have higher insulin resistance (homeostatic model assessment) and a lower Matsuda index, than those in Subgroup 1. Overall, participants in Subgroups 3 and 4, had higher glycaemic trait values, with the exception of the Matsuda and insulinogenic indices. At 18 months, change in homeostatic model assessment of insulin resistance was higher in Subgroup 4 (β = 0.36, 95% CI 0.13–0.58), Subgroup 3 (β = 0.30; 95% CI 0.10–0.50) and Subgroup 2 (β = 0.18; 95% CI 0.04–0.32), compared to Subgroup 1. The same was observed for C-peptide and insulin. Five subgroups were identified at follow-up, and the majority of participants remained in the same subgroup or progressed to higher peak subgroups after 18 months. Conclusions: Using data from a frequently sampled oral glucose tolerance test, glucose curve patterns associated with different clinical characteristics and different rates of subsequent glycaemic deterioration can be identified.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

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art (subject category)
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