Subtypes of type 2 diabetes and their association with outcomes in Korean adults - A cluster analysis of community-based prospective cohort

• Published in: Metabolism, clinical and experimental clinical and experimental, 2023-04, Vol.141, p.155514-155514, Article 155514
• Main Authors: Hwang, You-Cheol, Ahn, Hong-Yup, Jun, Ji Eun, Jeong, In-Kyung, Ahn, Kyu Jeung, Chung, Ho Yeon
• Format: Article
• Language: English
• Subjects: Adult; Asian; Cluster Analysis; Diabetes Mellitus, Type 2 - drug therapy; Heterogeneity; Humans; Insulin - therapeutic use; Insulin Resistance; Prospective Studies; Republic of Korea; Type 2 diabetes
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2023.155514

Little is known about the subtypes of type 2 diabetes (T2D) and their association with clinical outcomes in Asians. We performed data-driven cluster analysis in patients with newly diagnosed drug-naive T2D (n = 756) from the Korean Genome and Epidemiology Study. Clusters were based on five variables (age at diagnosis, BMI, HbA1c, and HOMA2 β-cell function, and insulin resistance). We identified four clusters of patients with T2D according to k-means clustering: cluster 1 (22.4 %, severe insulin-resistant diabetes [SIRD]), cluster 2 (32.7 %, mild age-related diabetes [MARD]), cluster 3 (32.7 %, mild obesity-related diabetes [MOD]), and cluster 4 (12.3 %, severe insulin-deficient diabetes [SIDD]). During 14 years of follow-up, individuals in the SIDD cluster had the highest risk of initiation of glucose-lowering therapy compared to individuals in the other three clusters. Individuals in the MARD and SIDD clusters showed the highest risk of chronic kidney disease and cardiovascular disease, and individuals in the MOD clusters showed the lowest risk after adjusting for other risk factors (P