Do diabetes phenotypes in US women differ by race/ethnicity? A population-based cluster analysis.

Objective: US women exhibit racial disparities in the lifetime risk of diabetes and related outcomes. Identifying heterogeneity in clinical presentation may assist with reducing racial disparities in diabetes outcomes. We identified clinical phenotypes of diabetes and examined their racial and ethnic distribution in US women. Research design and methods: We conducted cluster analysis based on five factors in US women with diagnosed diabetes assessed in the National Health and Nutrition Examination Surveys 1999-2018 (n = 825). Multinomial logistic regression analysis was performed to identify racial and ethnic differences in the distribution of phenotypes. Results: We identified four distinct clinical phenotypes. Two phenotypes, mild age-related and severe insulin-deficient diabetes, each included approximately a third of women. Mild insulin-resistant and severe insulin-resistant diabetes phenotypes accounted for 19.9% and 13.7%, respectively. The distribution of clusters did not differ by race and ethnicity. Conclusions: The prevalence of four clinically distinct diabetes phenotypes identified in US women did not differ by race and ethnicity.