Evidence mapPaperPMID 41995253Full record

Trial reportJournal of diabetes investigation2026

Data-driven cluster analysis of adults with prediabetes: Findings from the Japan diabetes prevention study.

Naoki Sakane, Kaoru Takahashi, Akiko Suganuma, Masayuki Domichi, Kazuyo Tsushita, Hideshi Kuzuya

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Naoki SakaneDivision of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.ORCID https://orcid.org/0000-0002-2625-571X
Kaoru TakahashiDivision of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Akiko SuganumaDivision of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Masayuki DomichiDivision of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.ORCID https://orcid.org/0000-0002-6157-8151
Kazuyo TsushitaGraduate School of Nutrition Sciences, Japan Nutrition University, Saitama, Japan.
Hideshi KuzuyaDivision of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo identify distinct metabolic subtypes among Japanese adults with prediabetes and examine their association with type 2 diabetes (T2D) risk and response to lifestyle interventions.

methodsData from 295 adults with impaired glucose tolerance (mean age 50.4 ± 14.6 years) enrolled in the Japanese Diabetes Prevention Program, a randomized controlled trial with up to 6 years of follow-up, were analyzed. Participants with a history of diabetes, gastrectomy, or exercise contraindications were excluded from the study. K-means clustering (k = 2-5) was applied to baseline indices, including HbA1c, HOMA-β, HOMA-IR, and HDL-cholesterol. Principal component analysis (PCA) was used for interpretation. Incident T2D was defined as a repeat 75-g OGTT. Kaplan-Meier and Cox models were adjusted for baseline HbA1c estimated cumulative incidence and hazard ratios (HRs).

resultsThree clusters emerged at k = 3, and PCA (two components explaining 68.0% of the variance) clearly separated the clusters based on insulin resistance and glycemic indices. Cluster 1, Metabolically Resilient Prediabetes (n = 127, MRP), showed the most favorable metabolic profile and lowest T2D risk. Cluster 2, Insulin-Insufficient Prediabetes (n = 109, IIP), exhibited reduced β-cell function and the highest T2D risk, but derived the greatest benefit from lifestyle intervention (adjusted HR 0.40, 95% CI 0.17-0.95, P < 0.05). Cluster 3, Severe Insulin-Resistant Prediabetes (SIRP; n = 59), displayed obesity-related insulin resistance and an intermediate risk.

conclusionsUnsupervised clustering identified three biologically distinct prediabetic subtypes that differed in diabetes risk and intervention responsiveness, supporting a precision prevention framework for Japanese adults with prediabetes.

Indexed as

Diabetes Mellitus, Type 2Prediabetic StateAdultCluster AnalysisClustering AlgorithmsFemaleFollow-Up StudiesGlycated HemoglobinHumansInsulin ResistanceJapanLife StyleMaleMiddle AgedGlycated HemoglobinCluster analysisLifestyle interventionPrediabetes

Identifiers

PMID41995253
PMCPMC13238897

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.