Novel clusters of type 2 diabetes mellitus and their outcomes: relationship between pharmacological treatment and microvascular complications
Abstract Background Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes in adults being characterized by an ineffective use of insulin or inefficient production by the pancreas. This study aims to study the relationship between microvascular complications and pharmacological treatment for T2DM. Methods 191 participants (EG) with T2DM with the average of 70.3 years (SD = 8.3) and 36 with pre-diabetes (CG) with an average of 62 years (SD = 10.3) who participated in clinical trials at Clinical Research Unit in Cardiology of Coimbra Hospital and Universitary Centre without cognitive difficulties, were divided in 5 different clusters. These were established based on six different variables: body mass index (BMI), age of each individual, age at diagnosis of DMT2, glycated haemoglobin value (HbA1c), homeostatic model that estimates the function of β cells (HOMA2-B) and insulin resistance (HOMA2-IR). Results Cluster 1 presented pre-diabetic individuals (15.9%), while diabetic individuals were divided into clusters 2 (1.8%), 3 (17.6%), 4 (21.1%) and 5 (43.6%). Regarding the study of the prevalence of microvascular complications, it was concluded that only chronic kidney disease (CKD) was found in most different groups. For the prevalence of pharmacological treatment for DMT2, it was found that metformin was the most used drug. It was observed a relationship between previous CKD and metformin administration in clusters 3 (P = 0.0012; P < 0.05), 4 (P = 9.41E-5; P < 0.05) and 5 (P = 0.0004; P < 0.05). Conclusions It was possible to observe the existence of dependency relationships between pharmacological treatment and different microvascular complications for DMT2.