Integration of Novel Measures for Improved Classification of Type 2 Diabetes

May 2022 Council

Lead Division/Office

DEM

Point(s) of Contact

Norann Zaghloul, Ph.D.

Executive Summary

Type 2 Diabetes (T2D) is a heterogeneous disease that encompasses individuals who are hyperglycemic, but lack specific markers of other forms of diabetes. As a result, T2D represents a “catch-all” diagnosis in which patients are grouped according to relatively simple measures of glycemia, irrespective of the underlying pathophysiology driving elevated blood glucose. Given that hyperglycemia can result from dysfunction in a number of organs and/or tissues, defining patients based on their specific defects will greatly improve understanding and management of disease. Emerging T2D clustering approaches have been based on limited clinical variables or molecular markers. To better define the heterogeneity of T2D and stratify patients based on underlying mechanisms, more comprehensive approaches are needed that would integrate markers of organ- or system-specific dysfunction with clinical and molecular phenotyping. This initiative proposes to bring together investigators that have identified reliable measures of organ- or system-specific dysfunction in T2D with patient cohorts that have extensive clinical and/or molecular data. Development of novel markers of organ function in T2D will also be incorporated. Through integration of available and exploratory markers, the outcome of this approach will be: 1) better understanding of the heterogeneity of T2D pathophysiology, and 2) a classification strategy that defines T2D patients based on their specific mechanisms of disease.