Phenotypic and genetic classification of diabetes

Deutsch, Aaron J.; Ahlqvist, Emma; Udler, Miriam S.

doi:10.1007/s00125-022-05769-4

Cited by 46 publications

(24 citation statements)

References 69 publications

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“…Some risk factors were assumed as negative when not recorded in the hospital charts, thus potentially underestimating their impact. We used clinical features to label type 2 diabetes, despite the current trend to include genetic and metabolic testing to refine diabetes subtypes classification [ 30 ]. Therefore, women with MODY could had been labelled as having type 2 diabetes, since genetic tests were not available at the two hospitals.…”

Section: Discussionmentioning

confidence: 99%

Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study

Oppermann

Campos

Hirakata

et al. 2022

Diabetol Metab Syndr

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Background Women with diabetes first diagnosed during pregnancy (overt diabetes) may be at the same risk level of adverse outcomes as those with known pregestational diabetes. We compared pregnancy outcomes between these groups. Methods We evaluated pregnant women with type 2 diabetes, pregestational or overt diabetes, attending high risk antenatal care in two public hospitals in Southern Brazil, from May 20, 2005 to June 30, 2021. Outcomes were retrieved from electronic medical records. Risk of adverse outcomes, expressed as relative risk (RR) and 95% confidence interval (CI), were calculated using Poisson regression with robust estimates. Results Of 618 women, 33% were labelled as having overt diabetes and 67%, pregestational diabetes. Baseline maternal characteristics were similar: there was a slight, non-clinically relevant, difference in maternal age (33 ± 5.7 years in women with pregestational diabetes vs. 32 ± 6.0 years in women with overt diabetes, p = 0.004); and women with overt diabetes reported smoking almost twice compared to those with pregestational diabetes (12.3% vs. 6.5%, p = 0.024). There were no relevant differences between the groups regarding pregnancy outcomes, although there was a trend of higher neonatal intensive care admission in the group of women with pregestational diabetes (45.2% vs. 36.1%, p = 0.051). Conclusions Overt diabetes was diagnosed in one third of this cohort of pregnant women with hyperglycemia. Their pregnancy outcomes were similar to those of women with pregestational diabetes and were mostly related to maternal demographic characteristics and metabolic control. A call to action should be made to identify women of childbearing age at risk for pre-pregnancy diabetes; to detect hyperglycemia before conception; and to implement timely preconception care to all women with diabetes.

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Section: Discussionmentioning

confidence: 99%

Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study

Oppermann

Campos

Hirakata

et al. 2022

Diabetol Metab Syndr

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“…A fasting blood glucose level ≥ 126 mg/dL was also an indicator of DM. HS patients with DM were subdivided according to the clusters of the All New Diabetics In Scania (ANDIS) study [ 11 , 36 ]. The cluster classification was based on the presence of antibodies, age at diagnosis of DM, BMI and HbA1c [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Screening for Diabetes Mellitus in Patients with Hidradenitis Suppurativa—A Monocentric Study in Germany

Rached

Gambichler

Ocker

et al. 2023

IJMS

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Hidradenitis suppurativa (HS) is a chronic skin disease that is often associated with metabolic disorders. Diabetes mellitus (DM) is a frequent comorbidity in HS. There is currently no established screening for DM in HS patients. The aim of our study was to identify high-risk groups of HS patients that develop DM and to assess the frequency of different types of DM present in HS patients. To do so, we conducted a monocentric study in 99 patients with HS. All patients underwent detailed clinical and laboratory assessments, including the determination of glycated hemoglobin. Among the 20.2% of patients that presented with DM, type 2 was by far the most prevalent (19 out of 20 patients). Moreover, male gender, age, BMI, Hurley stage, modified Hidradenitis Suppurativa Score (mHSS), DLQI and hypertension all correlated with the glycated hemoglobin levels in the HS patients. In the multivariable analysis, Hurley stage III, older age, and higher BMI were significantly associated with DM. Specifically, patients at Hurley stage III were at a 5.3-fold increased risk of having DM type II compared to patients at earlier Hurley stages. Since many of the HS patients had not been diagnosed, our study reveals shortcomings in the screening for DM and suggest that this should be routinely performed in HS patients at high risk to avoid secondary complications.

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“…10 Further evaluation of the present approaches and novel integrated methods to redefine diabetes subtypes will be required to determine when and how best to introduce these approaches into clinical practice. 11 More recently, a first such effort has been undertaken in persons carrying an increased risk of type 2 diabetes (history of prediabetes [overall 41.2%: IFG 18.7%, IGT 10.9%, IFG + IGT 11.6], family history of diabetes or gestational diabetes, or body mass index (BMI) >27 kg/m 2 ) from the TUEF/TULIP study. Six distinct subphenotypes (clusters) were identified using deep phenotyping, including body fat distribution, liver fat content and genetic risk: (1.)…”

Section: Prediabetes: Classification Epidemiology Impact and Screenin...mentioning

confidence: 99%

“…It remains to be established whether novel subphenotyping approaches are helpful to elucidate the metabolic heterogeneity prior to the development of type 2 diabetes. Their further validation and fine tuning could represent one step forward towards precision medicine in clinical practice 11 . More research is needed to define the exact prevalence of DSPN and CAN in the various categories of prediabetes and to decipher the natural history of these conditions in clearly defined metabolic subpopulations and the corresponding determinants of their development and progression.…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Neuropathy in prediabetes

Ziegler

Herder

Παπάνας

2023

Diabetes Metabolism Res

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Diabetic neuropathies are the most frequent complications of diabetes, contributing to high morbidity, excess mortality, reduced quality of life, and increased healthcare costs. Prediabetes is characterised by glucose levels within an intermediate range above normoglycaemia yet below the diagnostic threshold for diabetes. In 2021, 10.6% and 6.2% of adults worldwide were estimated to have impaired glucose tolerance and impaired fasting glucose, respectively, the majority of whom are unaware of having prediabetes. Evidence has accumulated suggesting that prediabetes is a predictor of cardiovascular disease (CVD) and increased mortality. The past 2 decades have witnessed an extensive debate, particularly among diabetologists and neurologists, as to whether prediabetes is associated with peripheral neuropathy. In this review, we elaborate on the current evidence, particularly from population‐based studies supporting an increased risk of distal sensorimotor polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) in people with prediabetes. Moreover, we discuss whether lifestyle interventions showing efficacy in preventing or delaying the transition from prediabetes to diabetes in persons with prediabetes may also exert favourable effects on the development and progression of DSPN and CAN. This review should help in raising the awareness of and translating the current knowledge on neuropathies in people with prediabetes into clinical practice and public health. The current recommendation that adults who are overweight or obese should be screened for prediabetes and referred to or offered preventive interventions should ultimately culminate in preventing not only CVD but also prediabetic neuropathy.

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Phenotypic and genetic classification of diabetes

Cited by 46 publications

References 69 publications

Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study

Overt diabetes imposes a comparable burden on outcomes as pregestational diabetes: a cohort study

Screening for Diabetes Mellitus in Patients with Hidradenitis Suppurativa—A Monocentric Study in Germany

Neuropathy in prediabetes

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