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BACKGROUND. Older patients with type 2 diabetes mellitus represent a heterogeneous group in terms of metabolic profile. It makes glucose-lowering-therapy (GLT) complex to manage, as it needs be individualized to patient’s profile. This study aimed to characterize subgroups existing among older diabetic patients. METHODS. Retrospective study of an observational cohort of outpatients followed in a Belgian diabetes clinic. Included patients (n=147; median age=80 years; female=37.4%) were all aged ≥75years, diagnosed with type 2 diabetes, and benefited of a Homeostasis Model Assessment (HOMA2). A latent profile analysis was conducted using HOMA variables (including HOMA2%-βxS as a measure of residual β-cell function) and age at diabetes diagnosis to classify patients. GLT was expressed in daily-defined dose (DDD) RESULTS. The resulting model classified patients into 6 distinct subgroups. Groups 1 and 2, with a median age of 70 years at diabetes diagnosis, had lower values of BMI, HOMA2%-βxS decrease, GLT DDD and HbA1c. Groups 3, 4 and 5 had moderate decrease of HOMA2%-βxS, intermediate GLT DDD and HbA1c. Group 6 had the largest decrease of HOMA2%-βxS and the highest GLT DDD and HbA1c values. Other metabolic differences were found between groups. CONCLUSION. This study identified 6 clinically different subgroups in terms of metabolic profile severity among older patients with type 2 diabetes. Intensity and choice of GLT should be adapted on this basis, in addition to other existing recommendations for treatment individualization.
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Christiaens, A., Hermans, M., Boland, B., & Henrard, S. (2018). Latent Profile Analysis of the metabolic phenotype classified patients ≥75 years with type 2 diabetes into six distinct groups. Doctoral day – Thematic doctoral school SPSS 2018, Liège. https://hdl.handle.net/2078.5/26458