Novel clusters of adult-onset Diabetes: Casuistic from an Endocrinology Department

Duarte, Vitória; Ivo, Catarina; Veríssimo, David; Silva, Joao; Lopes, Luís; Passos, Dolores; Jacome, de Castro Joao; Marcelino, Mafalda

doi:10.1530/endoabs.63.p185

Cited by 2 publications

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“…Efforts have been made in various populations to identify distinct "clusters" of phenotypic characteristics and laboratory markers in individuals diagnosed with T2D, and to assess whether these clusters correlate with differential risk of diabetes complications [2,3]. A pioneering study by Ahlquist et al [2] in a Scandinavian population, led to the identification of five major subtypes of T2D termed as Severe Autoimmune Diabetes (SAID), Severe Insulin Deficient Diabetes (SIDD), Severe Insulin Resistant Diabetes (SIRD), Mild Obesity-related Diabetes (MOD) and Mild Age-Related Diabetes (MARD).This was also reproduced in several other ethinic groups [4][5][6].…”

Section: Introductionmentioning

confidence: 97%

Prescribing Patterns and Response to Antihyperglycemic Agents Among Novel Clusters of Type 2 Diabetes in Asian Indians

Anjana

Siddiqui

Jebarani

et al. 2022

Diabetes Technology & Therapeutics

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AIM:To assess the prescribing patterns and response to different classes of antihyperglycemic agents in novel clusters of type 2 diabetes (T2D) described in India. MATERIALS AND METHODS: We attempted to replicate the earlier described clusters of T2D In 32,867 individuals with new-onset T2D (within 2 years of diagnosis) registered between October 2013 and December 2020 at 15 diabetes clinics located across India, by means of k-means clustering utilising six clinically relevant variables. Individuals who had followup HbA1c upto 2 years were included for the drug response analysis (n=13,247). RESULTS: Among the 32,867 participants included in the study, 20779 (63.2%) were males. The average age at diagnosis was 45 years and mean HbA1c at baseline was 8.9 %. The same four clusters described in India earlier were replicated. Forty percent of the study participants belonged to the Mild Age-Related Diabetes [MARD] cluster, followed by Insulin Resistant Obese Diabetes [IROD] (27%), Severe Insulin Deficient Diabetes [SIDD] (21%) and Combined Insulin Resistant and Deficient Diabetes [CIRDD] (12%) clusters. The most frequently used antihyperglycemic agents were sulphonylureas, metformin and dipeptidyl peptidase-4 inhibitors apart from insulin.While there were significant differences in HbA1c reduction between drugs across clusters, these were largely driven by differences in the baseline (pre-treatment) HbA1c. CONCLUSIONS:In this new cohort we were able to reliably replicate the four subtypes of T2D earlier described in Asian Indians. Prescribing patterns show limited usage of newer antihyperglycemic agents across all clusters. Randomized clinical trials are required to establish differential drug responses between clusters.

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Section: Introductionmentioning

confidence: 97%

Prescribing Patterns and Response to Antihyperglycemic Agents Among Novel Clusters of Type 2 Diabetes in Asian Indians

Anjana

Siddiqui

Jebarani

et al. 2022

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

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“…In recent years, efforts have been made for identifying "clusters" or subgroups of individuals with diabetes mellitus using different clinical and biochemical variables, which exhibit diverse phenotypic, clinical, and risk of complications behaviors. (4)(5)(6)(7) Trials for new classification of diabetes of the adults In 2015, Li.L et al attempted to categorize various sub-types from diabetes mainly type 2 patients using topological analysis of patient cohort. (8) This was the beginning of recent trials for discovering new categorizations of type 2 DM.…”

Section: Introductionmentioning

confidence: 99%

Novel Classification of Diabetes of the Adults; Using METS-IR as a Metabolic Indicator for Insulin Resistance

Refaie,

El-Sayed,

Sabet

et al. 2023

Sohag Medical Journal

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Diabetes mellitus (DM) has been considered recently as a heterogeneous metabolic disorder. Numerous intricate etiological processes that can differ between people can contribute to hyperglycaemia. Clinical traits, progression, treatment response, and the emergence of complications are all impacted by these mechanisms. Unfortunately, current diabetes guidelines of treatment are unable to foretell which patients will need intensified or specialized treatment before the incidence of poor metabolic control and subsequent complications. As a result, the division of T2DM (Type 2 DM) patients into different unique subgroups (clusters) can aid in the development of our approach to precision diabetes, the planning of appropriate therapies based on their pathophysiology, and the prognosis of complications with methods of their prevention. Insulin resistance state (IR) is considered essential in new clustering system, however, using fasting C-peptide or fasting insulin to calculate HOMA-IR and HOMA-B is costly. Searching for alternative methods for assessing the level of insulin resistance or beta-cell activity is important for clustering of different populations. A metabolic risk score called "The Metabolic Score for Insulin Resistance (METS-IR)" was prescribed to measure peripheral insulin sensitivity in mankind. It was initially introduced as METS-IR by Bello-Chavolla. et al in 2018(2). They reported that METS-IR is a new score that combines anthropometric measurements that can be performed easily during a brief evaluation with non-insulin fasting laboratory studies to assess insulin sensitivity and identify states of insulin resistance. In this paper we will try to give an overview on the use of METS-IR as an indicator for insulin resistance state and its importance in novel classification of diabetes in the adults.

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Novel clusters of adult-onset Diabetes: Casuistic from an Endocrinology Department

Cited by 2 publications

References 0 publications

Prescribing Patterns and Response to Antihyperglycemic Agents Among Novel Clusters of Type 2 Diabetes in Asian Indians

Prescribing Patterns and Response to Antihyperglycemic Agents Among Novel Clusters of Type 2 Diabetes in Asian Indians

Novel Classification of Diabetes of the Adults; Using METS-IR as a Metabolic Indicator for Insulin Resistance

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