Characterizing the weight-glycemia phenotypes of type 1 diabetes in youth and young adulthood
| Autor: | Giuseppina Imperatore, Shivani Agarwal, Xiaotong Jiang, Beth A Reboussin, Anna R. Kahkoska, Kyle S. Burger, Lawrence M. Dolan, Crystal T. Nguyen, Catherine Pihoker, Linda A Adair, Jean M. Lawrence, Dana Dabelea, John B. Buse, Katherine A. Sauder, Allison E. Aiello, Michael R. Kosorok, Santica M. Marcovina, Elizabeth J. Mayer-Davis |
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| Rok vydání: | 2019 |
| Předmět: |
Insulin pump
Blood Glucose Male obesity Adolescent phenotype Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Overweight Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences Young Adult 0302 clinical medicine Diabetes mellitus Medicine Humans 030212 general & internal medicine pediatric Type 1 diabetes clusters Epidemiology/Health Services Research Glycemic 2. Zero hunger Glycated Hemoglobin Type 1 diabetes business.industry Body Weight RC648-665 medicine.disease Obesity Diabetes Mellitus Type 1 Cohort Female medicine.symptom business Body mass index Demography |
| Zdroj: | BMJ Open Diabetes Research & Care BMJ Open Diabetes Research & Care, Vol 8, Iss 1 (2020) |
| ISSN: | 2052-4897 |
| Popis: | IntroductionIndividuals with type 1 diabetes (T1D) present with diverse body weight status and degrees of glycemic control, which may warrant different treatment approaches. We sought to identify subgroups sharing phenotypes based on both weight and glycemia and compare characteristics across subgroups.Research design and methodsParticipants with T1D in the SEARCH study cohort (n=1817, 6.0–30.4 years) were seen at a follow-up visit >5 years after diagnosis. Hierarchical agglomerative clustering was used to group participants based on five measures summarizing the joint distribution of body mass index z-score (BMIz) and hemoglobin A1c (HbA1c) which were estimated by reinforcement learning tree predictions from 28 covariates. Interpretation of cluster weight status and glycemic control was based on mean BMIz and HbA1c, respectively.ResultsThe sample was 49.5% female and 55.5% non-Hispanic white (NHW); mean±SD age=17.6±4.5 years, T1D duration=7.8±1.9 years, BMIz=0.61±0.94, and HbA1c=76±21 mmol/mol (9.1±1.9)%. Six weight-glycemia clusters were identified, including four normal weight, one overweight, and one subgroup with obesity. No cluster had a mean HbA1c ConclusionsThere are distinct subgroups of youth and young adults with T1D that share weight-glycemia phenotypes. Subgroups may benefit from tailored interventions addressing differences in clinical care, health behaviors, and underlying health inequity. |
| Databáze: | OpenAIRE |
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