Trial reportThe Journal of clinical endocrinology and metabolism2025
Prediabetes Subgroups, Type 2 Diabetes Risk, and Differential Effects of Preventive Interventions.
Trial report in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Prediabetes Subgroups, Type 2 Diabetes Risk, and Differential Effects of Preventive Interventions.The Journal of clinical endocrinology and metabolism · 2025 · on this mapTrial
- Subphenotyping Obesity in Pursuit of Personalized Medicine: The Devil is in the Details.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivePrior studies have subclassified type 2 diabetes using statistical clustering approaches with clinical data, but few have subclassified prediabetes and assessed the effects of preventive interventions. Our objective was to derive prediabetes subgroups based on clinical biomarkers and assess risk for incident diabetes and differential preventive intervention effects within the derived subgroups, with comparison to more simple modeling approaches.
methodsBaseline data for 3145 participants in the Diabetes Prevention Program trial were used to derive prediabetes subgroups using K-means clustering with data for 22 clinical biomarkers (sex-standardized). Cox proportional hazards regression was used to estimate hazard ratios (HRs) for diabetes and differential intervention effects (intensive lifestyle, metformin, or placebo) by prediabetes subgroups and to compare the clustering strategy to a model with clinical variables.
resultsWe identified 2 prediabetes subgroups characterized by severe insulin resistance with severe obesity (subgroup 1, 31% of sample) and moderate insulin resistance with overweight or obesity (subgroup 2, 69%). Subgroup 1 had a 58% higher risk for diabetes (HR: 1.58, 95% confidence interval: 1.31, 1.91) compared to subgroup 2. Randomization to lifestyle (compared to placebo) halved diabetes risk for both subgroups, while metformin provided greater benefit to subgroup 1 vs subgroup 2 (P for interaction <.05). A clinical variable model discriminated diabetes risk better than the clustering strategy.
conclusionPathophysiologically distinct prediabetes subgroups differ in risk for diabetes and preventive benefit from metformin. These results support distinct mechanisms of diabetes susceptibility; however, the use of clinical prediction models to guide treatment decisions may provide adequate risk profiling.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.