Michael P Bancks1, Ramon Casanova2, Edward W Gregg3, Alain G Bertoni4. 1. Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States. Electronic address: mbancks@wakehealth.edu. 2. Department Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States. 3. School of Public Health, Imperial College London, London, England, United Kingdom. 4. Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
Abstract
AIMS: To characterize unique diabetes phenotypes among National Health and Nutrition Examination Survey (NHANES) participants and assess associations with race/ethnicity, cardiovascular disease (CVD) risk factors, and prevalent complications. METHODS: We included participants (age ≥ 20 years) from NHANES exams 2003-04 through 2013-14 with diabetes (self-report of diabetes diagnosis or medication use, fasting glucose ≥7.0 mmol/L, random glucose ≥11.1 mmol/L, and glycated hemoglobin (HbA1c) ≥ 48 mmol/mol). We used k-means clustering to characterize unique diabetes subgroups based on data for age of diabetes diagnosis, body mass index (BMI), waist circumference, HbA1c, and years of insulin use. We estimated subgroup prevalence of CVD risk factors and microvascular complications, accounting for demographics and survey sampling. RESULTS: Among 4300 adults with diabetes, we identified four unique subgroups of diabetes related to aging (AR, 51.3%), severe obesity (SO, 30.3%), severe hyperglycemia (SH, 12.5%), and young adulthood-onset (YA, 5.9%). We observed differences in subgroup proportion by race/ethnicity. Compared to the AR phenotype, all groups had higher HbA1c and BMI, the YA and SO groups had greater blood pressure, and the YA group had greater prevalence of renal, eye, and neuropathy complications. CONCLUSIONS: Whether consideration of diabetes phenotypes with treatment strategies reduce diabetes incidence, morbidity, and mortality merits evaluation.
AIMS: To characterize unique diabetes phenotypes among National Health and Nutrition Examination Survey (NHANES) participants and assess associations with race/ethnicity, cardiovascular disease (CVD) risk factors, and prevalent complications. METHODS: We included participants (age ≥ 20 years) from NHANES exams 2003-04 through 2013-14 with diabetes (self-report of diabetes diagnosis or medication use, fasting glucose ≥7.0 mmol/L, random glucose ≥11.1 mmol/L, and glycated hemoglobin (HbA1c) ≥ 48 mmol/mol). We used k-means clustering to characterize unique diabetes subgroups based on data for age of diabetes diagnosis, body mass index (BMI), waist circumference, HbA1c, and years of insulin use. We estimated subgroup prevalence of CVD risk factors and microvascular complications, accounting for demographics and survey sampling. RESULTS: Among 4300 adults with diabetes, we identified four unique subgroups of diabetes related to aging (AR, 51.3%), severe obesity (SO, 30.3%), severe hyperglycemia (SH, 12.5%), and young adulthood-onset (YA, 5.9%). We observed differences in subgroup proportion by race/ethnicity. Compared to the AR phenotype, all groups had higher HbA1c and BMI, the YA and SO groups had greater blood pressure, and the YA group had greater prevalence of renal, eye, and neuropathy complications. CONCLUSIONS: Whether consideration of diabetes phenotypes with treatment strategies reduce diabetes incidence, morbidity, and mortality merits evaluation.
Authors: Michael P Bancks; Alain G Bertoni; Mercedes Carnethon; Haiying Chen; Mary Frances Cotch; Unjali P Gujral; David Herrington; Alka M Kanaya; Moyses Szklo; Dhananjay Vaidya; Namratha R Kandula Journal: J Clin Endocrinol Metab Date: 2021-04-23 Impact factor: 5.958
Authors: Michael P Bancks; Haiying Chen; Ashok Balasubramanyam; Alain G Bertoni; Mark A Espeland; Steven E Kahn; Scott Pilla; Elizabeth Vaughan; Lynne E Wagenknecht Journal: Diabetes Care Date: 2021-03-11 Impact factor: 19.112
Authors: Haresh T Suppiah; Ee Ling Ng; Jericho Wee; Bernadette Cherianne Taim; Minh Huynh; Paul B Gastin; Michael Chia; Chee Yong Low; Jason K W Lee Journal: Nutrients Date: 2021-11-15 Impact factor: 5.717
Authors: Roderick C Slieker; Louise A Donnelly; Hugo Fitipaldi; Gerard A Bouland; Giuseppe N Giordano; Mikael Åkerlund; Mathias J Gerl; Emma Ahlqvist; Ashfaq Ali; Iulian Dragan; Andreas Festa; Michael K Hansen; Dina Mansour Aly; Min Kim; Dmitry Kuznetsov; Florence Mehl; Christian Klose; Kai Simons; Imre Pavo; Timothy J Pullen; Tommi Suvitaival; Asger Wretlind; Peter Rossing; Valeriya Lyssenko; Cristina Legido-Quigley; Leif Groop; Bernard Thorens; Paul W Franks; Mark Ibberson; Guy A Rutter; Joline W J Beulens; Leen M 't Hart; Ewan R Pearson Journal: Diabetologia Date: 2021-06-10 Impact factor: 10.122