Evidence map›Paper›PMID 40857122›Full record

ArticleDiabetes care2025

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

Emily Kobayashi, Nathaniel J Linden-Santangeli, Nicholas Chan, Christopher B Toomey, Sunder Mudaliar, Marinella Temprosa, Sharon Edelstein, Ravi Goyal, Padmini Rangamani, Amit R Majithia and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Covert macrovascular disease and early outcome after ischemic cerebrovascular events.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Emily KobayashiBioinformatics and Systems Biology Graduate Program, University of California, San Diego, La Jolla, CA.ORCID 0000-0002-9041-5167
Nathaniel J Linden-SantangeliDepartment of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA.
Nicholas ChanBioinformatics and Systems Biology Graduate Program, University of California, San Diego, La Jolla, CA.
Christopher B ToomeyViterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, La Jolla, CA.
Sunder MudaliarDivision of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA.
Marinella TemprosaDPP/DPPOS Coordinating Center, Biostatistics Center, The George Washington University, Rockville, MD.ORCID 0000-0002-9976-745X
Sharon EdelsteinDPP/DPPOS Coordinating Center, Biostatistics Center, The George Washington University, Rockville, MD.ORCID 0000-0001-8457-4404
Ravi GoyalDivision of Infectious Diseases & Global Public Health, University of California, San Diego, La Jolla, CA.
Padmini RangamaniDepartment of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA.
Amit R MajithiaDivision of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA.ORCID 0000-0001-9978-2644
Diabetes Prevention Program Research Group

Funding

PRIMARY PREVENTION TRIAL--DATA COORDINATING CENTERU01DK048489 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI JABLONSKI, KATHLEEN ANN, TEMPROSA, MARINELLA · 1994 to 2021
$84.8M
SPECIAL ASSAY COREP30DK036836 · NIDDK · JOSLIN DIABETES CENTER · PI ROHIT N. KULKARNI · 1986 to 2026
$50.5M
Post-DDP Follow-up StudyU01DK048413 · NIDDK · UNIVERSITY OF WASHINGTON · PI KAHN, STEVEN EMANUEL · 1994 to 2021
$13.7M
PRIMARY PREVENTION TRIAL (DPT-2)U01DK048397 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI NATHAN, DAVID M · 1994 to 2021
$12.0M
NIDDM PRIMARY PREVENTION TRIAL (DPT 2)U01DK048404 · NIDDK · ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS · PI LAFERRERE, BLANDINE B · 1994 to 2021
$11.6M
PRIMARY PREVENTION TRIAL (DPT-2)U01DK048339 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI ARANETA, MARIA ROSARIO GORREZ, MUDALIAR, SUNDER · 1994 to 2022
$11.4M
NIDDM PRIMARY PREVENTION TRIALU01DK048412 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI VENDITTI, ELIZABETH MARY · 1994 to 2021
$11.4M
PRIMARY PREVENTION TRIALU01DK048387 · NIDDK · MEDSTAR RESEARCH INSTITUTE · PI MAGEE, MICHELLE FISCHMANN · 1994 to 2022
$11.1M
TITLE OMITTEDU01DK048349 · NIDDK · YESHIVA UNIVERSITY · PI CRANDALL, JILL P · 1994 to 2021
$11.0M
PRIMARY PREVENTION TRIALU01DK048443 · NIDDK · UNIVERSITY OF SOUTHERN CALIFORNIA · PI WATSON, KAROL E · 1994 to 2021
$10.2M
Post-DPP Follow-up StudyU01DK048375 · NIDDK · UNIVERSITY OF COLORADO DENVER · PI DABELEA, DANA · 1994 to 2022
$10.0M
Post-Diabetes Prevention Program (DPP)U01DK048381 · NIDDK · UNIVERSITY OF CHICAGO · PI EHRMANN, DAVID A · 1994 to 2021
$9.6M
BLRD VA I01 BX006293Division of Diabetes, Endocrinology, and Metabolic Diseases R01DK123422Division of Diabetes, Endocrinology, and Metabolic Diseases R01DK129840NEI NIH HHS K08 EY035322NEI NIH HHS R21 EY037260NIBIB NIH HHS T32 EB009380NIBIB NIH HHS T32EB9380NIDDK NIH HHS P30 DK036836NIDDK NIH HHS R01 DK123422NIDDK NIH HHS R01 DK129840NIDDK NIH HHS U01 DK048339NIDDK NIH HHS U01 DK048349NIDDK NIH HHS U01 DK048375NIDDK NIH HHS U01 DK048377NIDDK NIH HHS U01 DK048380NIDDK NIH HHS U01 DK048381NIDDK NIH HHS U01 DK048387NIDDK NIH HHS U01 DK048397NIDDK NIH HHS U01 DK048400NIDDK NIH HHS U01 DK048404NIDDK NIH HHS U01 DK048406NIDDK NIH HHS U01 DK048407NIDDK NIH HHS U01 DK048411NIDDK NIH HHS U01 DK048412NIDDK NIH HHS U01 DK048413NIDDK NIH HHS U01 DK048434NIDDK NIH HHS U01 DK048437NIDDK NIH HHS U01 DK048443NIDDK NIH HHS U01 DK048468NIDDK NIH HHS U01 DK048485NIDDK NIH HHS U01 DK048489NIDDK NIH HHS U01 DK048514NIGMS NIH HHS T32 GM145449Veterans Affairs San Diego Healthcare System 1I01BX006293
6 · The paper itself

Abstract

objectiveType 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

methodsClinical 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.

resultsFour clusters emerged. Clusters 1 and 2 (73% of participants) maintained stable glycemia, blood pressure, and lipids. Although 49% and 71%, respectively, developed T2D, cumulative micro- and macrovascular events remained low. Cluster 3 (12%) showed the steepest rise in insulin resistance and hyperglycemia, with 92% of the subgroup progressing to T2D and a markedly higher rate of retinopathy (odds ratio [OR] 8.8, 95% CI 3.9-20.1) and neuropathy (OR 3.4, 95% CI 2.1-5.5). Cluster 4 (15%) presented with baseline microalbuminuria often prior to the development of T2D (73%). It was distinguished by progressive estimated glomerular filtration rate decline and a doubling of cardiovascular events (hazard ratio 2.0, 95% CI 1.4-3.0), despite serum lipids comparable with other groups.

conclusionsTwo-thirds of individuals with prediabetes follow metabolically resilient trajectories, whereas distinct insulin-resistant or renal-dysfunction trajectories precede micro- or macrovascular complications, respectively. The optimal window for macrovascular complication prevention in individuals with prediabetes microalbuminuria may precede progression to T2D.

Indexed as

Diabetes Mellitus, Type 2Diabetic AngiopathiesAgedFemaleHumansInsulin ResistanceLongitudinal StudiesMaleMiddle AgedPrediabetic StateRisk Factors

Identifiers

PMID40857122
PMCPMC12451836

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.