Precision subclassification of type 2 diabetes: a systematic review
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Precision subclassification of type 2 diabetes : a systematic review. / Misra, Shivani; Wagner, Robert; Ozkan, Bige; Schön, Martin; Sevilla-Gonzalez, Magdalena; Prystupa, Katsiaryna; Wang, Caroline C; Kreienkamp, Raymond J; Cromer, Sara J; Rooney, Mary R; Duan, Daisy; Thuesen, Anne Cathrine Baun; Wallace, Amelia S; Leong, Aaron; Deutsch, Aaron J; Andersen, Mette K; Billings, Liana K; Eckel, Robert H; Sheu, Wayne Huey-Herng; Hansen, Torben; Stefan, Norbert; Goodarzi, Mark O; Ray, Debashree; Selvin, Elizabeth; Florez, Jose C; Meigs, James B; Udler, Miriam S; ADA/EASD PMDI.
In: Communications Medicine, Vol. 3, 138, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Precision subclassification of type 2 diabetes
T2 - a systematic review
AU - Misra, Shivani
AU - Wagner, Robert
AU - Ozkan, Bige
AU - Schön, Martin
AU - Sevilla-Gonzalez, Magdalena
AU - Prystupa, Katsiaryna
AU - Wang, Caroline C
AU - Kreienkamp, Raymond J
AU - Cromer, Sara J
AU - Rooney, Mary R
AU - Duan, Daisy
AU - Thuesen, Anne Cathrine Baun
AU - Wallace, Amelia S
AU - Leong, Aaron
AU - Deutsch, Aaron J
AU - Andersen, Mette K
AU - Billings, Liana K
AU - Eckel, Robert H
AU - Sheu, Wayne Huey-Herng
AU - Hansen, Torben
AU - Stefan, Norbert
AU - Goodarzi, Mark O
AU - Ray, Debashree
AU - Selvin, Elizabeth
AU - Florez, Jose C
AU - Meigs, James B
AU - Udler, Miriam S
AU - ADA/EASD PMDI
N1 - © 2023. Springer Nature Limited.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Heterogeneity in type 2 diabetes presentation and progression suggests that precision medicine interventions could improve clinical outcomes. We undertook a systematic review to determine whether strategies to subclassify type 2 diabetes were associated with high quality evidence, reproducible results and improved outcomes for patients.METHODS: We searched PubMed and Embase for publications that used 'simple subclassification' approaches using simple categorisation of clinical characteristics, or 'complex subclassification' approaches which used machine learning or 'omics approaches in people with established type 2 diabetes. We excluded other diabetes subtypes and those predicting incident type 2 diabetes. We assessed quality, reproducibility and clinical relevance of extracted full-text articles and qualitatively synthesised a summary of subclassification approaches.RESULTS: Here we show data from 51 studies that demonstrate many simple stratification approaches, but none have been replicated and many are not associated with meaningful clinical outcomes. Complex stratification was reviewed in 62 studies and produced reproducible subtypes of type 2 diabetes that are associated with outcomes. Both approaches require a higher grade of evidence but support the premise that type 2 diabetes can be subclassified into clinically meaningful subtypes.CONCLUSION: Critical next steps toward clinical implementation are to test whether subtypes exist in more diverse ancestries and whether tailoring interventions to subtypes will improve outcomes.
AB - BACKGROUND: Heterogeneity in type 2 diabetes presentation and progression suggests that precision medicine interventions could improve clinical outcomes. We undertook a systematic review to determine whether strategies to subclassify type 2 diabetes were associated with high quality evidence, reproducible results and improved outcomes for patients.METHODS: We searched PubMed and Embase for publications that used 'simple subclassification' approaches using simple categorisation of clinical characteristics, or 'complex subclassification' approaches which used machine learning or 'omics approaches in people with established type 2 diabetes. We excluded other diabetes subtypes and those predicting incident type 2 diabetes. We assessed quality, reproducibility and clinical relevance of extracted full-text articles and qualitatively synthesised a summary of subclassification approaches.RESULTS: Here we show data from 51 studies that demonstrate many simple stratification approaches, but none have been replicated and many are not associated with meaningful clinical outcomes. Complex stratification was reviewed in 62 studies and produced reproducible subtypes of type 2 diabetes that are associated with outcomes. Both approaches require a higher grade of evidence but support the premise that type 2 diabetes can be subclassified into clinically meaningful subtypes.CONCLUSION: Critical next steps toward clinical implementation are to test whether subtypes exist in more diverse ancestries and whether tailoring interventions to subtypes will improve outcomes.
U2 - 10.1038/s43856-023-00360-3
DO - 10.1038/s43856-023-00360-3
M3 - Journal article
C2 - 37798471
VL - 3
JO - Communications Medicine
JF - Communications Medicine
SN - 2730-664X
M1 - 138
ER -
ID: 379656931