Cardiorenal Protective Glucose-Lowering Treatment Patterns in Type 2 Diabetes Mellitus Based on a Real-World Study: A Clinical Phenotype Cluster Analysis.

IF 4.7 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2026-10-12 DOI:10.1007/s12325-026-03826-7

Wenjia Yang, Shuzhen Bai, Xiaoling Cai, Ming Liu, Qiuhe Ji, Yanbing Li, Bo Feng, Nanwei Tong, Han Wu, Jingya Yan, Wei Zhao, Linong Ji

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引用次数: 0

Abstract

Introduction: Cardiorenal protective glucose-lowering treatments (CPT), consisting of sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs), are widely applied in clinical management of patients with type 2 diabetes mellitus (T2DM). This study aimed to identify distinct clinical phenotypes linked to CPT prescribing patterns and construct a multilevel correlation framework for standardized CPT clinical application.

Methods: Data were extracted from the baseline dataset of an observational registry cohort study across 61 medical centers between 2023 and 2024. Based on multiple factors, clinical phenotypes of patients were identified via the Partitioning Around Medoids (PAM) clustering algorithm, CPT utilization was compared across different phenotypes.

Results: A total of 9000 patients with T2DM were enrolled [median age 55 (46, 63) years, 60.8% male and 39.2% female, median diabetes duration 5.37 (0.85, 11.44) years]. Three clinically distinct phenotypes were identified: Cluster 1 [older patients with high atherosclerotic cardiovascular disease (ASCVD) risk], Cluster 2 (metabolically stable patients without cardiorenal risk), and Cluster 3 (younger patients with obesity, high metabolic risk and short diabetes duration). The CPT utilization rates of the three clusters were 49.0%, 44.1% and 51.1%, respectively (P < 0.001), with Cluster 3 having the highest rate. Cluster 2 was dominated by SGLT2is monotherapy (73.1%). Cluster 3 showed a marked preference for GLP-1RAs-based regimens (43.6% in total), whereas Cluster 1 had an intermediate proportion of GLP-1RAs-related regimens (31.5%).

Conclusion: Three clinical phenotypes were identified via cluster analysis. The younger obese group with high metabolic risk had the highest CPT utilization rate and preferred GLP-1RAs, while the older group with high ASCVD risk was predominantly treated with SGLT2is alone.

Trial registration: The trial was registered with https://www.chictr.org.cn/ under registration number ChiCTR230007376 on 20 July 2023.

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.