Objectives and Methods: To stratify type 2 diabetes (T2DM) patients into subgroups (clusters) according to clinical and laboratory data from 80 adults including body composition analyses by Dual X-ray absorptiometry (DXA) and multi-frequency bio-electrical impedance (BIA).
Results: Four subgroups were identified. Cluster 1: Severe insulin deficiency (recruited by C-peptide <0.8 ng/ml): 17.5% of patients; age 62.57 ± 8.23 years, diabetes duration 17.07 ± 7.60 years (longer than the other clusters; p <0.001), BMI 22.68 ± 1.95 kg/m2 (lower than the other clusters; p<0.001), HbA1c 9.64 ± 1.30% (higher than the other clusters; p <0.001), HOMA2-IR 0.68 ± 0.14. Cluster 2: Severe insulin resistance (recruited by the presence of metabolic syndrome): 35.0% of patients; age 58.32 ± 5.94 years, diabetes duration 8.50 ± 5.07 years, BMI: 26.39 ± 2.38 kg/m2, HbA1c 7.53 ± 0.96%, HOMA2-IR 3.10 ± 0.43(higher than the other clusters; p <0.001). Cluster 3: Obesity-related (recruited by BMI > 30 kg/m2): 21.25 % of patients; age 59.76 ± 8.86 years, diabetes duration 8.35 ± 3.97 years, BMI: 35.95 ± 4.51 kg/m2 (higher than the other clusters; p <0.001), HbA1c 7.33 ± 1.04%, HOMA2-IR 1.77 ± 0.48. Cluster 4: Age-related (recruited by age > 65 years): 26.25% of patients; age 72.38 ± 5.06 years (older than the other clusters; p <0.001); diabetes duration 4.90 ± 2.81 years, BMI 27.21 ± 1.76 kg/m2, HbA1c 6.91 ± 0.69%; HOMA2-IR: 0.99 ± 0.47. Although significantly younger cluster 1 patients had significantly lower values for lean mass parameters by both DXA and BIA in comparison with cluster 4: Fat Free Mass Index (BIA)/Apendicular Skeletal Mass index (DXA) (16.39 kg/m2/6.66 kg/m2; p <0.001 vs. 17.19 kg/m2/7.31 kg/m2; p <0.001).
Conclusion: Our data demonstrated the heterogeneity of T2DM presentation in adults with marked differences between them. Insulinopenic diabetes had more sarcopenia than age-related diabetes.
I. Dantas: None. F. Bandeira: None.
