ArticleThe lancet. Diabetes & endocrinology2022
Data-driven subgroups of type 2 diabetes, metabolic response, and renal risk profile after bariatric surgery: a retrospective cohort study.
Article in The lancet. Diabetes & endocrinology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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28 citing papers in PubMed, 59 citations in OpenAlex.
- Prediabetes Subgroups, Type 2 Diabetes Risk, and Differential Effects of Preventive Interventions.The Journal of clinical endocrinology and metabolism · 2025 · on this mapTrial
- The effect of the endothelin receptor antagonist atrasentan on insulin resistance in phenotypic clusters of patients with type 2 diabetes and chronic kidney disease.Diabetes, obesity & metabolism · 2025Trial
- Decision tree-based prediction of 5-year weight trajectories after bariatric surgery in adolescents and young adults: a retrospective cohort study from France and Sweden.International journal of obesity (2005) · 2026Article
- Distinct multi-omics signatures of clinical subgroups of type 2 diabetes define heterogeneous responses to an insulin sensitizer.Nature communications · 2026Article
- Type 2 diabetes subphenotypes are associated with differential outcomes after metabolic and bariatric surgery: An international multicentre retrospective cohort study.Diabetes, obesity & metabolism · 2026Article
- Clustering-based subgroups of type 2 diabetes mellitus and their associations with diabetes remission after bariatric surgery.Chinese medical journal · 2026Article
- Clinical staging to guide management of metabolic disorders and their sequelae: a European Atherosclerosis Society consensus statement.European heart journal · 2025Article
- Subphenotype-Dependent Benefits of Bariatric Surgery for Individuals at Risk for Type 2 Diabetes.Diabetes care · 2025Article
- Unsupervised clustering analysis of treatment strategies for elite female athletes with severe stress urinary incontinence: focusing on competition return and SUI improvement.International urology and nephrology · 2025Article
- Association of Intraindividual Difference in Cystatin C and Creatinine Estimated Glomerular Filtration Rate With Diabetes.Journal of diabetes research · 2025Article
- Association between HOMA2 based beta-cell function or insulin resistance and long-term outcomes in kidney transplant recipients with type 2 diabetes.Scientific reports · 2024Article
- Data-driven cluster analysis identifies distinct types of metabolic dysfunction-associated steatotic liver disease.Nature medicine · 2024Article
- Adipose tissue macrophage infiltration and hepatocyte stress increase GDF-15 throughout development of obesity to MASH.Nature communications · 2024Article
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- Diabetes subgroups and sociodemographic inequalities in Mexico: a cross-sectional analysis of nationally representative surveys from 2016 to 2022.Lancet regional health. Americas · 2024Article
- Remission of type 2 diabetes: always more questions, but enough answers for action.Diabetologia · 2024Review
- A Federated Database for Obesity Research: An IMI-SOPHIA Study.Life (Basel, Switzerland) · 2024Article
- Characteristics of changes in plasma proteome profiling after sleeve gastrectomy.Frontiers in endocrinology · 2024Article
- A second step towards precision medicine in diabetes.Nature metabolism · 2024Article
- Impact of time-restricted feeding on kidney injury in male rats with experimental metabolic syndrome.Experimental physiology · 2023Article
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Authors and funding
20 authors at 9 institutions in 5 countries.
Funding
Abstract
backgroundA novel data-driven classification of type 2 diabetes has been proposed to personalise anti-diabetic treatment according to phenotype. One subgroup, severe insulin-resistant diabetes (SIRD), is characterised by mild hyperglycaemia but marked hyperinsulinaemia, and presents an increased risk of diabetic nephropathy. We hypothesised that patients with SIRD could particularly benefit from metabolic surgery.
methodsWe retrospectively related the newly defined clusters with the response to metabolic surgery in participants with type 2 diabetes from independent cohorts in France (the Atlas Biologique de l'Obésite Sévère [ABOS] cohort, n=368; participants underwent Roux-en-Y gastric bypass or sleeve gastrectomy between Jan 1, 2006, and Dec 12, 2017) and Brazil (the metabolic surgery cohort of the German Hospital of San Paulo, n=121; participants underwent Roux-en-Y gastric bypass between April 1, 2008, and March 20, 2016). The study outcomes were type 2 diabetes remission and improvement of estimated glomerular filtration rate (eGFR).
findingsAt baseline, 34 (9%) of 368 patients, 314 (85%) of 368 patients, and 17 (5%) of 368 patients were classified as having SIRD, mild obesity-related diabetes (MOD), and severe insulin deficient diabetes (SIDD) in the ABOS cohort, respectively, and in the São Paulo cohort, ten (8%) of 121 patients, 83 (69%) of 121 patients, and 25 (21%) of 121 patients were classified as having SIRD, MOD, and SIDD, respectively. At 1 year, type 2 diabetes remission was reported in 26 (81%) of 32 and nine (90%) of ten patients with SIRD, 167 (55%) of 306 and 42 (51%) of 83 patients with MOD, and two (13%) of 16 and nine (36%) of 25 patients with SIDD, in the ABOS and São Paulo cohorts, respectively. The mean eGFR was lower in patients with SIRD at baseline and increased postoperatively in these patients in both cohorts. In multivariable analysis, SIRD was associated with more frequent type 2 diabetes remission (odds ratio 4·3, 95% CI 1·8-11·2; p=0·0015), and an increase in eGFR (mean effect size 13·1 ml/min per 1·73 m
interpretationPatients in the SIRD subgroup had better outcomes after metabolic surgery, both in terms of type 2 diabetes remission and renal function, with no additional surgical risk. Data-driven classification might help to refine the indications for metabolic surgery.
fundingAgence Nationale de la Recherche, Investissement d'Avenir, Innovative Medecines Initiative, Fondation Cœur et Artères, and Fondation Francophone pour la Recherche sur le Diabète.
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