Introduction & Objective:The description of prediabetes subphenotypes could improve the detection of individuals at increased risk for the onset of diabetes and/or related complications. The aim of this study was to assess the prevalence of diabetes-associated complications in newly established clusters of prediabetes and to compare them with the current classification of prediabetes.

Methods: People with prediabetes (n=118: 57/61 women/men, HbA1c 5.6±0.3%, age 57.4±9.8 y, BMI 29.7±5.7 kg/m2) were identified either using classical clinical parameters (increased HbA1c levels: HbA1c, impaired fasting glucose: IFG, impaired glucose tolerance: IGT) or using a novel pathophysiology-based subphenotyping of prediabetes (cluster 1-6, according to Wagner et al., Nature medicine 2021 ). Study participants were screened for diabetes-associated complications such as nephropathy, neuropathy, retinopathy, and pneumopathy, with a focus on liver steatosis and fibrosis according to liver stiffness measurement.

Results: Individuals allocated to the new prediabetes clusters 5 and 6 showed more often at least 2 diabetes-associated complications (70.6% vs. 52.2%) compared to prediabetes individuals identified using the classical parameters HbA1c, IFG and IGT (44.3% vs. 37.3% vs. 16.7%), all p=0.026. Elevated markers for liver steatosis were more common in cluster 3, 4, 5 and 6 (76% vs. 91% vs. 100% vs. 83%) compared to classical cluster HbA1c (74%), whereas for liver fibrosis in cluster 5 and 6 (50% vs. 41%) compared to 26% in the IFG cluster. Further analyses showed that 83% and 73% of people in cluster 5 and 6 with liver steatosis had at least one additional diabetes-associated complication compared to 63%/56% in cluster HbA1c/IFG.

Conclusion: The novel pathophysiology-based clusters of prediabetes help to better identify people with increased risk of diabetes-associated complications, allowing the design of early targeted preventive measures.

Disclosure

M. Ansmann: None. E. Kliemank: None. E.V. Rauchhaupt: None. L. Schimpfle: None. L. Seebauer: Other Relationship; Springer Medizin Verlag GmbH. M. Roshan: None. Z. Kender: None. S. Kopf: Speaker's Bureau; Lilly Diabetes, Bayer Inc. J. Szendroedi: None. A. Sulaj: None.

© 2024 by the American Diabetes Association
2024
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