PMID- 35581905
OWN - NLM
STAT- MEDLINE
DCOM- 20220803
LR  - 20221207
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Linking)
VI  - 24
IP  - 9
DP  - 2022 Sep
TI  - Type 2 diabetes subgroups and response to glucose-lowering therapy: Results from 
      the EDICT and Qatar studies.
PG  - 1810-1818
LID - 10.1111/dom.14767 [doi]
AB  - AIM: To examine the efficacy of glucose-lowering medications in subgroups of 
      patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: 
      Cluster analysis was performed in participants in the Efficacy and Durability of 
      Initial Combination Therapy for Type 2 Diabetes (EDICT) study and the Qatar study 
      using age, body mass index (BMI), glycated haemoglobin (HbA1c), and homeostatic 
      model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-beta). 
      Participants also underwent an oral glucose tolerance test with measurement of 
      plasma glucose, insulin and C-peptide concentrations to derive independent 
      measures of insulin secretion and insulin sensitivity. The response to 
      glucose-lowering therapies (change in HbA1c) was measured in each participant 
      cluster for 3 years. RESULTS: Three distinct and comparable clusters/groups of 
      T2DM patients were identified in both the EDICT and Qatar studies. Participants 
      in Group 1 had the highest HbA1c and manifested severe insulin deficiency. 
      Participants in Group 3 had comparable insulin sensitivity to those in Group 1 
      but better beta-cell function and better glucose control. Participants in Group 2 
      had the highest BMI with severe insulin resistance accompanied by marked 
      hyperinsulinaemia, which was primarily attributable to decreased insulin 
      clearance. Unexpectedly, participants in Group 1 had better response to 
      combination therapy with pioglitazone plus exenatide than with insulin therapy or 
      metformin sequentially followed by glipizide and basal insulin, while 
      participants in Group 2 responded equally well to both therapies despite very 
      severe insulin resistance. CONCLUSION: Distinct metabolic phenotypes characterize 
      different T2DM clusters and differential responses to glucose-lowering therapies. 
      Participants with severe insulin deficiency respond better to agents that 
      preserve beta-cell function, while, surprisingly, patients with severe insulin 
      resistance did not respond favourably to insulin sensitizers.
CI  - (c) 2022 John Wiley & Sons Ltd.
FAU - Abdul-Ghani, Tamam
AU  - Abdul-Ghani T
AD  - Division of Diabetes, University of Texas Health Science Center and Texas 
      Diabetes Institute, San Antonio, Texas, USA.
FAU - Puckett, Curtiss
AU  - Puckett C
AD  - Division of Diabetes, University of Texas Health Science Center and Texas 
      Diabetes Institute, San Antonio, Texas, USA.
FAU - Migahid, Osama
AU  - Migahid O
AD  - Hamad General Hospital, Doha, Qatar.
FAU - Abdelgani, Siham
AU  - Abdelgani S
AD  - Division of Diabetes, University of Texas Health Science Center and Texas 
      Diabetes Institute, San Antonio, Texas, USA.
FAU - Migahed, Ayman
AU  - Migahed A
AD  - Hamad General Hospital, Doha, Qatar.
FAU - Adams, John
AU  - Adams J
AD  - Division of Diabetes, University of Texas Health Science Center and Texas 
      Diabetes Institute, San Antonio, Texas, USA.
FAU - Triplitt, Curtis
AU  - Triplitt C
AD  - Division of Diabetes, University of Texas Health Science Center and Texas 
      Diabetes Institute, San Antonio, Texas, USA.
FAU - DeFronzo, Ralph
AU  - DeFronzo R
AUID- ORCID: 0000-0003-3839-1724
AD  - Division of Diabetes, University of Texas Health Science Center and Texas 
      Diabetes Institute, San Antonio, Texas, USA.
FAU - Jayyousi, Amin
AU  - Jayyousi A
AD  - Hamad General Hospital, Doha, Qatar.
FAU - Abdul-Ghani, Muhammad
AU  - Abdul-Ghani M
AUID- ORCID: 0000-0003-4556-1787
AD  - Division of Diabetes, University of Texas Health Science Center and Texas 
      Diabetes Institute, San Antonio, Texas, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220629
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Blood Glucose/metabolism
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - Glucose/therapeutic use
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/metabolism
MH  - *Insulin Resistance
MH  - Qatar/epidemiology
OTO - NOTNLM
OT  - cluster analysis
OT  - glucose-lowering therapy
OT  - type 2 diabetes subgroups
EDAT- 2022/05/19 06:00
MHDA- 2022/08/04 06:00
CRDT- 2022/05/18 01:23
PHST- 2022/04/20 00:00 [revised]
PHST- 2022/02/28 00:00 [received]
PHST- 2022/05/08 00:00 [accepted]
PHST- 2022/05/19 06:00 [pubmed]
PHST- 2022/08/04 06:00 [medline]
PHST- 2022/05/18 01:23 [entrez]
AID - 10.1111/dom.14767 [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2022 Sep;24(9):1810-1818. doi: 10.1111/dom.14767. Epub 2022 
      Jun 29.