Classification of Older age patients with type 2 diabetes mellitus in terms of severity and glucose lowering therapy needs using latent class analysis

Introduction: Older patients with Type 2 Diabetes Mellitus (T2DM) represent a heterogeneous group regarding their metabolic profile. It complicates glucose-lowering-therapy’s (GLT) choice and management, as it should be adjusted to this severity of T2DM. This study aimed to identify subgroups existing among older patients with T2DM. Methods: Retrospective study of an observational cohort of outpatients followed in a Belgian diabetic clinic. Included patients (n=147; age=80.16±3.97; female=37%) were all diagnosed with T2DM, age ≥75years and benefited of a Homeostasis Model Assessment (HOMA). A latent class analysis was conducted using HOMA variables (Insulin sensitivity (S), β-cell function (β) and hyperbolic product (βxS)) and age at diagnosis to classify patients. Results: The resulting model classified patients into 6 subgroups. Patients in groups 1 (10.9%) and 6 (9.5%) had the oldest age at diagnosis with a preserved βxS. From Groups 3 to 5, insulin sensitivity decreased, but β-cell function increased inversely, resulting in a moderate decrease in βxS in all 3 groups. Group 2 (25.2%) had an impaired β-cell function and the lowest βxS. Mean total Defined Daily Dose of GLT was