It remains unclear whether Southeast Asian patients with type 2 diabetes can be subtyped to identify new subgroups with different genetic and lipidomic profiles and different cardiorenal risks.

A study from DIABETOLOGIA identifies new subgroups among Asian patients with recent-onset type 2 diabetes using a novel cluster analysis of clinical variables.

Research methods:

The study included 687 patients with recent onset diabetes in Singapore and performed k-means algorithm analysis. Different methods were used to evaluate and study the genetic risk of β-cell dysfunction, lipidomics, and risk of cardiorenal complications. .

Main research conclusions:

Four main findings:

1. Cluster analysis identified three new diabetes subgroups, namely mild obesity-related diabetes (MOD, 45%), mild age-related diabetes with insulin deficiency (MARD-II, 36%), and severe insulin-resistant diabetes with Relative insulin insufficiency (SIRD-RII, 19%).

2. MARD-II had a higher polygenic risk score for β-cell dysfunction compared with the MOD subgroup.

3. The SIRD-RII subgroup has higher levels of sphingomyelin (ceramide and sphingomyelin) and glycerophospholipids (phosphatidylethanolamine and phosphatidylcholine), while the MARD-II subgroup has higher levels of sphingomyelin and glycerophospholipids. Low, but levels of lysophosphatidylcholine are higher.

4. Over a median follow-up of 7.3 years, the SIRD-RII subgroup had the highest risk of heart failure and kidney disease progression, while the MARD-II subgroup had a moderately elevated risk of kidney disease progression.

In summary, cluster analysis of clinical variables identified novel subgroups with distinct genetic, liposome, group characteristics and different cardiorenal risks among Southeast Asian participants with type 2 diabetes. This easy-to-implement method can be adapted to other ethnic groups to stratify the heterogeneous type 2 diabetes population for precision medicine.