Cluster analysis of adult individuals with type 1 diabetes : Treatment pathways and complications over a five-year follow-up period
Somolinos-Simón, F.J. (Universidad Politécnica de Madrid)
García-Sáez, G. (Instituto de Salud Carlos III)
Tapia-Galisteo, J. (Instituto de Salud Carlos III)
Corcoy i Pla, Rosa (Institut de Recerca Sant Pau)
Elena Hernando, M. (Instituto de Salud Carlos III)
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	To identify subgroups of adults with type 1 diabetes and analyse their treatment pathways and risk of diabetes-related complications over a 5-year follow-up. We performed a k-means cluster analysis using the T1DExchange Registry (n = 6,302) to identify subgroups based on demographic and clinical characteristics. Annual reassessments linked treatment trajectories with these clusters, considering drug and technology use. Complication risks were analysed using Cox regression. Five clusters were identified: 1) A favourable combination of all variables (31. 67 %); 2) Longer diabetes duration (22. 63 %); 3) Higher HbA1c levels (13. 28 %); 4) Higher BMI (15. 25 %); 5) Older age at diagnosis (17. 17 %). Two-thirds of patients remained in their initial cluster annually. Technology adoption showed improved glycaemic control over time. Cox proportional hazards showed different risk patterns: Cluster 1 had low complication risk; Cluster 2 had the highest risk for retinopathy, coronary artery disease and autonomic neuropathy; Cluster 3 had the highest risk for albuminuria, depression and diabetic ketoacidosis; Cluster 4 had increased risk for multiple complications; Cluster 5 had the highest risk for hypertension and severe hypoglycaemia, with elevated coronary artery disease risk. Clinical characteristics can identify subgroups of patients with T1DM showing differences in treatment and complications during follow-up.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	And pharmacologic treatment ; Clustering ; Complications ; Diabetes ; Glycaemic control
Publicado en:	Diabetes research and clinical practice, Vol. 215 (september 2024) , p. 111803, ISSN 1872-8227

DOI: 10.1016/j.diabres.2024.111803
PMID: 39089589

10 p, 2.1 MB

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