Type 2 diabetes sub-groups could guide future treatment approaches in primary care

In this episode we talk to Dr Rohini Mathur who is an associate professor of epidemiology at the London School of Hygiene and Tropical Medicine and Dr Sally Hull who is a GP and a member of the Clinical Effectiveness Group at QMUL. Paper: Characterisation of type 2 diabetes subgroups and their association with ethnicity and clinical outcomes: a UK real-world data study using the East London Databasehttps://doi.org/10.3399/BJGP.2021.0508Previous studies of predominantly White European populations have identified four type 2 diabetes subgroups. In the UK the clinical measures necessary to replicate these subgroups are only available in secondary care data, limiting their usefulness for diabetes management in primary care settings. The current study demonstrated how clinically meaningful type 2 diabetes subgroups can be pragmatically generated using real-world primary care data. Furthermore, it highlighted important differences between type 2 diabetes subgroups with respect to vascular outcomes, treatment initiation, and glycated haemoglobin control. Diabetes subgroups are a useful heuristic for assisting decision making by clinicians that, in turn, can lead to a more personalised design of diabetes care focused on more intensive management of subgroups most at risk of complications, such as those with severe hyperglycaemia at time of diagnosis.