Explore preference heterogeneity for treatment among people with Type 2 diabetes: A comparison of random-parameters and latent-class estimation techniques

ObjectiveThis study aimed to investigate the association between the trajectories of energy consumption at dinner versus breakfast and the risk of type 2 diabetes (T2D).DesignCohort study.SettingThe study was conducted in China.ParticipantsA total of 10 727 adults, including 5239 men and 5488 women, with a mean age of 42.7±11.2 years and a mean follow-up time of 9.1 years, met the study criteria and completed a questionnaire about energy intake and diabetes status from the China Health and Nutrition Survey in 1997–2011.Primary outcome measuresParticipants were divided into subgroups based on the trajectories of the ratio of energy consumption at dinner versus breakfast. Cox multivariate regression models were used to explore the associations between different trajectories and the risk of T2D after adjustment for confounders and their risk factors. Mediation analysis was performed to explore the intermediary effect of triacylglycerol (TG), total cholesterol (TC), uric acid (UA) and apolipoprotein B (ApoB) between the trajectories and the risk of T2D.ResultsFor energy consumption at dinner versus breakfast, compared with a low-stable trajectory, the adjusted HR of T2D in low-increasing from early-stage trajectory was 1.29 (95% CI 1.04 to 1.60). TG, TC, UA and ApoB were significantly higher in low-increasing from early-stage trajectory than other trajectories and play partial regulation roles between trajectories and T2D.ConclusionsThis study emphasised the harmful effect of a gradual increase in the ratio of energy consumption at dinner versus breakfast from early stage on the development of T2D and partially mediated by TG, TC, UA and ApoB, highlighting that it is necessary to intake more energy at breakfast compared with dinner to prevent T2D in adults.

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Not all type-2-diabetes patients increase BMI after initiating insulin - Results of latent class analysis from the DPV registry

Diabetes Technology & Therapeutics ◽

10.1089/dia.2021.0144 ◽

2021 ◽

Author(s):

Nicole Prinz ◽

Anke Schwandt ◽

Bernadette Borgert ◽

Bettina Hartmann ◽

Hans-Peter Kempe ◽

...

Keyword(s):

Type 2 Diabetes ◽

Latent Class Analysis ◽

Latent Class ◽

Class Analysis ◽

Diabetes Patients

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Day-Time Patterns of Carbohydrate Intake in Adults by Non-Parametric Multi-Level Latent Class Analysis—Results from the UK National Diet and Nutrition Survey (2008/09–2015/16)

Nutrients ◽

10.3390/nu11102476 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2476

Author(s):

Wang ◽

Almoosawi ◽

Palla

Keyword(s):

Type 2 Diabetes ◽

Latent Class Analysis ◽

Total Energy ◽

Energy Intake ◽

Latent Class ◽

Eating Patterns ◽

Class Analysis ◽

Nutrition Survey ◽

The Uk

This study aims at combining time and quantity of carbohydrate (CH) intake in the definition of eating patterns in UK adults and investigating the association of the derived patterns with type 2 diabetes (T2D). The National Diet and Nutrition Survey (NDNS) Rolling Program included 6155 adults in the UK. Time of the day was categorized into 7 pre-defined time slots: 6–9 am, 9–12 noon, 12–2 pm, 2–5 pm, 5–8 pm, 8–10 pm, and 10 pm–6 am. Responses for CH intake were categorized into: no energy intake, CH <50% or ≥50% of total energy. Non-parametric multilevel latent class analysis (MLCA) was applied to identify eating patterns of CH consumption across day-time, as a novel method accounting for the repeated measurements of intake over 3–4 days nested within individuals. Survey-designed multivariable regression was used to assess the associations of CH eating patterns with T2D. Three CH eating day patterns (low, high CH percentage and frequent CH intake day) emerged from 24,483 observation days; based on which three classes of CH eaters were identified and characterized as: low (28.1%), moderate (28.8%) and high (43.1%) CH eaters. On average, low-CH eaters consumed the highest amount of total energy intake (7985.8 kJ) and had higher percentages of energy contributed by fat and alcohol, especially after 8 pm. Moderate-CH eaters consumed the lowest amount of total energy (7341.8 kJ) while they tended to have their meals later in the day. High-CH eaters consumed most of their carbohydrates and energy earlier in the day and within the time slots of 6–9 am, 12–2 pm and 5–8 pm, which correspond to traditional mealtimes. The high-CH eaters profile had the highest daily intake of CH and fiber and the lowest intake of protein and fat. Low-CH eaters had greater odds than high-CH eaters of having T2D in self-reported but not in previously undiagnosed diabetics. Further research using prospective longitudinal studies is warranted to ascertain the direction of causality in the association of CH patterns with type 2 diabetes.

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Long-term BMI change trajectories in Chinese adults and its association with the hazard of type 2 diabetes: evidence from a 20-year China Health and Nutrition Survey

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000879 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000879

Author(s):

Baibing Mi ◽

Chenlu Wu ◽

Xiangyu Gao ◽

Wentao Wu ◽

Jiaoyang Du ◽

...

Keyword(s):

Type 2 Diabetes ◽

Latent Class ◽

Chinese Adults ◽

Change Trajectories ◽

Nutrition Survey ◽

Health And Nutrition ◽

Increased Risk

IntroductionTo investigate the relationship between long-term change trajectory in body mass index (BMI) and the hazard of type 2 diabetes among Chinese adults.Research design and methodsData were obtained from the China Health and Nutrition Survey (CHNS). Type 2 diabetes was reported by participants themselves in each survey wave. The duration of follow-up was defined as the period from the first visit to the first time self-reported type 2 diabetes, death, or other loss to follow-up from CHNS. The patterns of change trajectories in BMI were derived by latent class trajectory analysis method. The Fine and Gray regression model was used to estimate HRs with corresponding 95% CIs for type 2 diabetes.ResultsFour patterns of the trajectories of change in BMI were identified among Chinese adults, 42.7% of participants had stable BMI change, 40.8% for moderate BMI gain, 8.9% for substantial BMI gain and 7.7% for weight loss. During the follow-up with mean 11.2 years (158 637 person-years contributed by 14 185 participants), 498 people with type 2 diabetes (3.7%) occurred. Risk of type 2 diabetes was increased by 47% among people who gained BMI more substantially and rapidly (HR: 1.47, 95% CI 1.08 to 2.02, p=0.016) and increased by 20% among those in people with the moderate BMI gain (HR: 1.20, 95% CI 0.98 to 1.48, p=0.078), compared with those with stable BMI change.ConclusionsLong-term substantial gain of BMI was significantly associated with an increased risk of type 2 diabetes in the Chinese adults.

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Analysis of dietary patterns and cross-sectional and longitudinal associations with hypertension, high BMI and type 2 diabetes in Peru

Public Health Nutrition ◽

10.1017/s1368980019002313 ◽

2019 ◽

Vol 23 (6) ◽

pp. 1009-1019

Author(s):

Carmelia Alae-Carew ◽

Pauline Scheelbeek ◽

Rodrigo M Carrillo-Larco ◽

Antonio Bernabé-Ortiz ◽

William Checkley ◽

...

Keyword(s):

Type 2 Diabetes ◽

Dietary Patterns ◽

Latent Class ◽

Urban Setting ◽

Rural Setting ◽

Processed Foods ◽

Lower Prevalence ◽

Cross Sectional ◽

High Bmi

AbstractObjective:To determine if specific dietary patterns are associated with risk of hypertension, type 2 diabetes mellitus (T2DM) and high BMI in four sites in Peru.Design:We analysed dietary patterns from a cohort of Peruvian adults in four geographical settings using latent class analysis. Associations with prevalence and incidence of hypertension, T2DM and high BMI were assessed using Poisson regression and generalised linear models, adjusted for potential confounders.Setting:Four sites in Peru varying in degree of urbanisation.Participants:Adults aged ≥35 years (n 3280).Results:We identified four distinct dietary patterns corresponding to different stages of the Peruvian nutrition transition, reflected by the foods frequently consumed in each pattern. Participants consuming the ‘stage 3’ diet, characterised by high proportional consumption of processed foods, animal products and low consumption of vegetables, mostly consumed in the semi-urban setting, showed the highest prevalence of all health outcomes (hypertension 32·1 %; T2DM 10·7 %; high BMI 75·1 %). Those with a more traditional ‘stage 1’ diet characterised by potato and vegetables, mostly consumed in the rural setting, had lower prevalence of hypertension (prevalence ratio; 95 CI: 0·57; 0·43, 0·75), T2DM (0·36; 0·16, 0·86) and high BMI (0·55; 0·48, 0·63) compared with the ‘stage 3’ diet. Incidence of hypertension was highest among individuals consuming the ‘stage 3’ diet (63·75 per 1000 person-years; 95 % CI 52·40, 77·55).Conclusions:The study found more traditional diets were associated with a lower prevalence of three common chronic diseases, while prevalence of these diseases was higher with a diet high in processed foods and low in vegetables.

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Depression symptoms are persistent in Type 2 diabetes: risk factors and outcomes of 5-year depression trajectories using latent class growth analysis

Diabetic Medicine ◽

10.1111/dme.13372 ◽

2017 ◽

Vol 34 (8) ◽

pp. 1108-1115 ◽

Cited By ~ 7

Author(s):

S. R. Whitworth ◽

D. G. Bruce ◽

S. E. Starkstein ◽

W. A. Davis ◽

T. M. E. Davis ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Growth Analysis ◽

Latent Class ◽

Diabetes Risk ◽

Depression Symptoms ◽

Latent Class Growth Analysis ◽

Diabetes Risk Factors ◽

Latent Class Growth

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Clinical Trajectories, Healthcare Resource Use, and Costs of Diabetic Nephropathy Among Patients with Type 2 Diabetes: A Latent Class Analysis

Diabetes Therapy ◽

10.1007/s13300-018-0410-8 ◽

2018 ◽

Vol 9 (3) ◽

pp. 1021-1036 ◽

Cited By ~ 3

Author(s):

Ruixuan Jiang ◽

Ernest Law ◽

Zhou Zhou ◽

Hongbo Yang ◽

Eric Q. Wu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Nephropathy ◽

Latent Class Analysis ◽

Resource Use ◽

Latent Class ◽

Healthcare Resource ◽

Class Analysis ◽

Healthcare Resource Use

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Intraglomerular Dysfunction Predicts Kidney Failure in Type 2 Diabetes

10.2337/figshare.14932734.v1 ◽

2021 ◽

Author(s):

Pierre J Saulnier ◽

Helen C Looker ◽

Michael Mauer ◽

Behzad Najafian ◽

Elise Gand ◽

...

Keyword(s):

Type 2 Diabetes ◽

Latent Class ◽

Renal Plasma Flow ◽

Rapid Decline ◽

Data Link ◽

Arteriolar Tone ◽

End Stage ◽

Intraglomerular Pressure

No longitudinal data link intraglomerular hemodynamic dysfunction with end-stage kidney disease (ESKD) in people with type 2 diabetes (T2D). Afferent (RA) and efferent (RE) arteriolar tone and intraglomerular pressure (PGLO) are not directly measurable in humans but are estimable from glomerular filtration rate (GFR), renal plasma flow (RPF), blood pressure, hematocrit, and plasma oncotic pressure. We examined the association of the RA/RE ratio and PGLO with ESKD incidence in 237 Pima Indian persons with T2D who underwent serial measures of GFR (iothalamate) and RPF (p-aminohippurate). Their association with kidney structural lesions was also examined in a subset of 111 participants. Of the 237 participants (mean age 42 years, diabetes duration 11 years, GFR 153 ml/min, median ACR 36 mg/g), 69 progressed to ESKD during median follow-up of 17.5 years. In latent class analysis, distinct trajectories characterized by increasing RA/RE ratio (HR: 4.60, 95% CI 2.55-8.31) or elevated PGLO followed by a rapid decline (HR: 2.96, 95% CI 1.45-6.02) strongly predicted incident ESKD. PGLO (R2=21%, p<0.0001) and RA/RE (R2=15%, p<0.0001) also correlated with mesangial fractional volume, a structural predictor of DKD progression. In conclusion, intraglomerular hemodynamic parameters associated strongly with incident ESKD and correlated with structural lesions of DKD.

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