Longitudinal Metabolic Trajectories in Diabetes Prevention Program Participants Reveal Subgroups With Varying Micro- and Macrovascular Complication Risks.

ABSTRACT:

Objective

Type 2 diabetes (T2D) and its associated complications develop heterogeneously over decades, but few studies span the progression from prediabetes to clinical events. We investigated whether long-term metabolic trajectories beginning in prediabetes delineate subgroups with differential complication risk.

Research design and methods

Clinical data from 1,732 Diabetes Prevention Program/Outcomes Study participants (follow-up 19 years) were analyzed across 12 phenotypes. Tensor decomposition was used to capture longitudinal patterns, and Gaussian mixture modeling was used to define longitudinal clusters. Cluster-specific complications were quantified with Cox and logistic regression.

Results

Four clusters emerged. Clusters 1 and 2 (73% of participants) maintaine

SUBMITTER: Kobayashi E 

PROVIDER: S-EPMC12451836 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature