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Giuseppe Giordano

Research team manager

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Post-load glucose subgroups and associated metabolic traits in individuals with type 2 diabetes : An IMI-DIRECT study


  • Morgan Obura
  • Joline W.J. Beulens
  • Roderick Slieker
  • Anitra D.M. Koopman
  • Trynke Hoekstra
  • Giel Nijpels
  • Petra Elders
  • Robert W. Koivula
  • Azra Kurbasic
  • Markku Laakso
  • Tue H. Hansen
  • Martin Ridderstråle
  • Torben Hansen
  • Imre Pavo
  • Ian Forgie
  • Bernd Jablonka
  • Hartmut Ruetten
  • Andrea Mari
  • Mark I. McCarthy
  • Mark Walker
  • Alison Heggie
  • Timothy J. McDonald
  • Mandy H. Perry
  • Federico De Masi
  • Søren Brunak
  • Anubha Mahajan
  • Giuseppe N. Giordano
  • Tarja Kokkola
  • Emmanouil Dermitzakis
  • Ana Viñuela
  • Oluf Pedersen
  • Jochen M. Schwenk
  • Jurek Adamski
  • Harriet J.A. Teare
  • Ewan R. Pearson
  • Paul W. Franks
  • Leen M. 't Hart
  • Femke Rutters

Summary, in English

AIM: Subclasses of different glycaemic disturbances could explain the variation in characteristics of individuals with type 2 diabetes (T2D). We aimed to examine the association between subgroups based on their glucose curves during a five-point mixed-meal tolerance test (MMT) and metabolic traits at baseline and glycaemic deterioration in individuals with T2D. METHODS: The study included 787 individuals with newly diagnosed T2D from the Diabetes Research on Patient Stratification (IMI-DIRECT) Study. Latent class trajectory analysis (LCTA) was used to identify distinct glucose curve subgroups during a five-point MMT. Using general linear models, these subgroups were associated with metabolic traits at baseline and after 18 months of follow up, adjusted for potential confounders. RESULTS: At baseline, we identified three glucose curve subgroups, labelled in order of increasing glucose peak levels as subgroup 1-3. Individuals in subgroup 2 and 3 were more likely to have higher levels of HbA1c, triglycerides and BMI at baseline, compared to those in subgroup 1. At 18 months (n = 651), the beta coefficients (95% CI) for change in HbA1c (mmol/mol) increased across subgroups with 0.37 (-0.18-1.92) for subgroup 2 and 1.88 (-0.08-3.85) for subgroup 3, relative to subgroup 1. The same trend was observed for change in levels of triglycerides and fasting glucose. CONCLUSIONS: Different glycaemic profiles with different metabolic traits and different degrees of subsequent glycaemic deterioration can be identified using data from a frequently sampled mixed-meal tolerance test in individuals with T2D. Subgroups with the highest peaks had greater metabolic risk.


  • Genetic and Molecular Epidemiology
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year










Document type

Journal article


Public Library of Science (PLoS)


  • Endocrinology and Diabetes



Research group

  • Genetic and Molecular Epidemiology


  • ISSN: 1932-6203