Identification of subtypes of type I and II diabetes mellitus in the INDIAN population - men and women
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Diagnosis of diabetes mellitus' subtypes
SIDD - Severe Insulin Deficient Diabetes - included 26.2% of clustered patients and was characterized by the lowest BMI and waist circumference, as well as the lowest C peptide (fasting and stimulated) levels. HOMA- B and HOMA- IR were both low in this cluster. These individuals had the highest HbA1c values and were more likely to be using insulin compared with the other clusters.
CIRDD - Combined Insulin Resistant and Deficient Diabetes - constitutes 12.1% of the study population. This group was characterized by the lowest age at onset. BMI and waist circumference were intermediate between SIDD and IROD. CIRDD had the highest triglyceride and lowest HDL cholesterol levels of all the four groups. C peptide levels were higher than SIDD, but lower than IROD. HOMA- B and HOMA- IR values were also intermediate between SIDD and IROD, indicating coexistence of insulin deficiency and insulin resistance. Metabolic control tended to be poor; however, only 15% were on insulin.
IROD - Insulin Resistant Obese Diabetes - This comprised 25.9% of clustered patients. These individuals had the highest BMI and waist circumference and the highest C peptide levels. HOMA- B and HOMA- IR were also the highest for this cluster. Metabolic control was inter- mediate and individuals were more likely to be on metformin.
MARD - Mild Age-Related Diabetes - represented the most frequent cluster in this population (35.8%) and was characterized by later age at onset than other clusters. They were characterized by the highest HDL cholesterol, fairly preserved C peptide values and the best metabolic control of all the four groups. This group had the least use of insulin.
References
Anjana, R. M. et al. Novel subgroups of type 2 diabetes and their association with microvascular outcomes in an Asian Indian population: A data-driven cluster analysis:
the INSPIRED study. BMJ Open Diabetes Res. Care 8, e001506 (2020). Available here