Implications for the prevention of type 2 diabetes
The Centers for Disease Control and Prevention (CDC) recently reported that approximately 88 million adults in the United States have prediabetes, a condition that comes with an increased risk of heart disease and stroke, not to mention the eventual development of type 2 diabetes.
But it’s not that easy. People with prediabetes don’t always fall neatly into the same group in terms of risk factors and comorbidities. In fact, a recent study at various institutions in Germany identified six broad categories with critical differences in terms of outlook and the interventions that could delay or prevent diabetes.
Researchers representing the University of Tübingen and the German Center for Diabetes Research in Neuherberg conducted the study, which was published in Nature Medicine.
Tracking changes in the metabolism of almost 900 enrolled participants in the Tübingen Family Study and Tübingen Lifestyle Program, researchers used repeated scans and tests to conduct cluster analysis that yielded six distinct categories of prediabetes, based on core metabolic features including blood glucose levels, the amount of fat in the liver, fat distribution, blood lipid levels, and the genetic risk of diabetes.
According to Medical News Today, people in the six clusters have these profiles:
- Clusters 1, 2, and 4 have a low risk of developing diabetes and low mortality, compared with the other three clusters.
- Most people in cluster 2 are slim and have a very low risk of developing diabetes complications.
- People in cluster 4 have overweight, but their metabolism is relatively healthy.
- Cluster 3 produce too little insulin and have genetic risk factors for diabetes. They have a high risk of developing diabetes, cardiovascular complications, and kidney disease. Their mortality risk is moderate.
- Cluster 5 have high levels of fat in their livers, their tissues are resistant to insulin, and they have high risks of diabetes, cardiovascular complications, and nephropathy. Their mortality rate is higher than that of cluster 3.
- Cluster 6 have high levels of fat in their kidneys and abdominal cavities, which is known as visceral fat. Compared with clusters 3 and 5, their risk of diabetes is relatively low, but their risk of nephropathy and mortality are high.