American Diabetes Association Professional Practice Committee, ElSayed NA, McCoy RG, Aleppo G, Balapattabi K, Beverly EA, Briggs Early K, Bruemmer D, Ebekozien O, Echouffo-Tcheugui JB, Ekhlaspour L, Gaglia JL, Garg R, Khunti K, Lal R, Lingvay I, Matfin G, Pandya N, Pekas EJ, Pilla SJ, Polsky S, Segal AR, Seley JJ, Selvin E, Stanton RC, Bannuru RR (2025) 2. Diagnosis and classification of diabetes: standards of care in diabetes—2025. Diabetes Care 48:S27–S49. https://doi.org/10.2337/dc25-S002
Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, Stein C, Basit A, Chan JCN, Mbanya JC, Pavkov ME, Ramachandaran A, Wild SH, James S, Herman WH, Zhang P, Bommer C, Kuo S, Boyko EJ, Magliano DJ (2022) IDF diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 183:109119. https://doi.org/10.1016/j.diabres.2021.109119
Ahlqvist E, Storm P, Käräjämäki A, Martinell M, Dorkhan M, Carlsson A, Vikman P, Prasad RB, Aly DM, Almgren P, Wessman Y, Shaat N, Spégel P, Mulder H, Lindholm E, Melander O, Hansson O, Malmqvist U, Lernmark Å, Lahti K, Forsén T, Tuomi T, Rosengren AH, Groop L (2018) Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. Lancet Diabetes Endocrinol 6:361–369. https://doi.org/10.1016/S2213-8587(18)30051-2
Schön M, Prystupa K, Mori T, Zaharia OP, Bódis K, Bombrich M, Möser C, Yurchenko I, Kupriyanova Y, Strassburger K, Bobrov P, Nair ATN, Bönhof GJ, Strom A, Delgado GE, Kaya S, Guthoff R, Stefan N, Birkenfeld AL, Hauner H, Seissler J, Pfeiffer A, Blüher M, Bornstein S, Szendroedi J, Meyhöfer S, Trenkamp S, Burkart V, Schrauwen-Hinderling VB, Kleber ME, Niessner A, Herder C, Kuss O, März W, Pearson ER, Roden M, Wagner R, Al-Hasani H, Belgardt B-F, Bönhof GJ, Geerling G, Herder C, Icks A, Jandeleit-Dahm K, Kotzka J, Kuss O, Lammert E, Rathmann W, Roden M, Schlesinger S, Schrauwen-Hinderling V, Szendroedi J, Trenkamp S, Wagner R (2024) Analysis of type 2 diabetes heterogeneity with a tree-like representation: insights from the prospective german diabetes study and the LURIC cohort. Lancet Diabetes Endocrinol 12:119–131. https://doi.org/10.1016/S2213-8587(23)00329-7
Ahlqvist E, Prasad RB, Groop L (2020) Subtypes of type 2 diabetes determined from clinical parameters. Diabetes 69:2086–2093. https://doi.org/10.2337/dbi20-0001
Article CAS PubMed Google Scholar
Zaharia OP, Strassburger K, Strom A, Bönhof GJ, Karusheva Y, Antoniou S, Bódis K, Markgraf DF, Burkart V, Müssig K, Hwang J-H, Asplund O, Groop L, Ahlqvist E, Seissler J, Nawroth P, Kopf S, Schmid SM, Stumvoll M, Pfeiffer AFH, Kabisch S, Tselmin S, Häring HU, Ziegler D, Kuss O, Szendroedi J, Roden M, Belgardt B-F, Buyken A, Eckel J, Geerling G, Al-Hasani H, Herder C, Hwang J-H, Icks A, Kotzka J, Kuss O, Lammert E, Markgraf D, Müssig K, Rathmann W, Roden M, Szendroedi J, Ziegler D (2019) Risk of diabetes-associated diseases in subgroups of patients with recent-onset diabetes: a 5-year follow-up study. Lancet Diabetes Endocrinol 7:684–694. https://doi.org/10.1016/S2213-8587(19)30187-1
Zheng Y, Ley SH, Hu FB (2018) Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 14:88–98. https://doi.org/10.1038/nrendo.2017.151
Xourafa G, Korbmacher M, Roden M (2023) Inter-organ crosstalk during development and progression of type 2 diabetes mellitus. Nat Rev Endocrinol. https://doi.org/10.1038/s41574-023-00898-1
Herder C, Roden M (2022) A novel diabetes typology: towards precision diabetology from pathogenesis to treatment. Diabetologia 65:1770–1781. https://doi.org/10.1007/s00125-021-05625-x
Article PubMed PubMed Central Google Scholar
Deutsch AJ, Ahlqvist E, Udler MS (2022) Phenotypic and genetic classification of diabetes. Diabetologia 65:1758–1769. https://doi.org/10.1007/s00125-022-05769-4
Article PubMed PubMed Central Google Scholar
Jiang Q, Hu Y, Ma J-H (2025) Various classification methods for diabetes mellitus in the management of blood glucose control. World J Diabetes 16:103316. https://doi.org/10.4239/wjd.v16.i5.103316
Article PubMed PubMed Central Google Scholar
Wesolowska-Andersen A, Brorsson CA, Bizzotto R, Mari A, Tura A, Koivula R, Mahajan A, Vinuela A, Tajes JF, Sharma S, Haid M, Prehn C, Artati A, Hong M-G, Musholt PB, Kurbasic A, De Masi F, Tsirigos K, Pedersen HK, Gudmundsdottir V, Thomas CE, Banasik K, Jennison C, Jones A, Kennedy G, Bell J, Thomas L, Frost G, Thomsen H, Allin K, Hansen TH, Vestergaard H, Hansen T, Rutters F, Elders P, t’Hart L, Bonnefond A, Canouil M, Brage S, Kokkola T, Heggie A, McEvoy D, Hattersley A, McDonald T, Teare H, Ridderstrale M, Walker M, Forgie I, Giordano GN, Froguel P, Pavo I, Ruetten H, Pedersen O, Dermitzakis E, Franks PW, Schwenk JM, Adamski J, Pearson E, McCarthy MI, Brunak S (2022) Four groups of type 2 diabetes contribute to the etiological and clinical heterogeneity in newly diagnosed individuals: An IMI DIRECT study. Cell Rep Med 3:100477. https://doi.org/10.1016/j.xcrm.2021.100477
Article PubMed PubMed Central Google Scholar
Kaya S, Khamees A, Geerling G, Strzalkowski P, Gontscharuk V, Szendroedi J, Müssig K, Ziegler D, Roden M, Guthoff R, for the GDS Cohort (2025) Macular perfusion alterations in people with recent-onset diabetes and novel diabetes subtypes. Diabetologia 68:1140–1156. https://doi.org/10.1007/s00125-025-06407-5
Xiong X, Yang Y, Wei L, Xiao Y, Li L, Sun L (2021) Identification of two novel subgroups in patients with diabetes mellitus and their association with clinical outcomes: a two-step cluster analysis. J Diabetes Investig 12:1346–1358. https://doi.org/10.1111/jdi.13494
Article CAS PubMed PubMed Central Google Scholar
Kahkoska AR, Geybels MS, Klein KR, Kreiner FF, Marx N, Nauck MA, Pratley RE, Wolthers BO, Buse JB (2020) Validation of distinct type 2 diabetes clusters and their association with diabetes complications in the DEVOTE, LEADER and SUSTAIN -6 cardiovascular outcomes trials. Diabetes Obes Metab 22:1537–1547. https://doi.org/10.1111/dom.14063
Article CAS PubMed PubMed Central Google Scholar
Zaharia OP, Strassburger K, Knebel B, Binsch C, Kupriyanova Y, Möser C, Bódis K, Prystupa K, Yurchenko I, Mendez Cardenas DM, Schön M, Herder C, Al-Hasani H, Schrauwen-Hinderling V, Jandeleit-Dahm K, Wagner R, Roden M (2024) Role of patatin-like phospholipase domain-containing 3 gene for decreasing kidney function in recently diagnosed diabetes mellitus. Diabetes Metab Syndr Clin Res Rev 18:103137. https://doi.org/10.1016/j.dsx.2024.103137
Christensen DH, Nicolaisen SK, Ahlqvist E, Stidsen JV, Nielsen JS, Hojlund K, Olsen MH, García-Calzón S, Ling C, Rungby J, Brandslund I, Vestergaard P, Jessen N, Hansen T, Brøns C, Beck-Nielsen H, Sørensen HT, Thomsen RW, Vaag A (2022) Type 2 diabetes classification: a data-driven cluster study of the danish centre for strategic research in type 2 diabetes (DD2) cohort. BMJ Open Diabetes Res Care 10:e002731. https://doi.org/10.1136/bmjdrc-2021-002731
Article PubMed PubMed Central Google Scholar
Spoto B, Pisano A, Zoccali C (2016) Insulin resistance in chronic kidney disease: a systematic review. Am J Physiol-Ren Physiol 311:F1087–F1108. https://doi.org/10.1152/ajprenal.00340.2016
Smeijer JD, Gomez MF, Rossing P, Heerspink HJL (2025) The effect of the endothelin receptor antagonist atrasentan on insulin resistance in phenotypic clusters of patients with type 2 diabetes and chronic kidney disease. Diabetes Obes Metab 27:511–518. https://doi.org/10.1111/dom.16041
Article CAS PubMed Google Scholar
Mazzieri A, Porcellati F, Timio F, Reboldi G (2024) Molecular targets of novel therapeutics for diabetic kidney disease: a new era of nephroprotection. Int J Mol Sci 25:3969. https://doi.org/10.3390/ijms25073969
Article CAS PubMed PubMed Central Google Scholar
Zaharia OP, Strassburger K, Knebel B, Kupriyanova Y, Karusheva Y, Wolkersdorfer M, Bódis K, Markgraf DF, Burkart V, Hwang J-H, Kotzka J, Al-Hasani H, Szendroedi J, Roden M, GDS Group, Roden M, Al-Hasani H, Burkart V, Buyken AE, Eckel J, Geerling G, Hwang JH, Herder C, Icks A, Jandeleit-Dahm K, Kahl S, Kotzka J, Kuss O, Lammert E, Trenkamp S, Rathmann W, Szendroedi J, Ziegler D (2020) Role of patatin-like phospholipase domain–containing 3 gene for hepatic lipid content and insulin resistance in diabetes. Diabetes Care 43:2161–2168. https://doi.org/10.2337/dc20-0329
Anjana RM, Baskar V, Nair ATN, Jebarani S, Siddiqui MK, Pradeepa R, Unnikrishnan R, Palmer C, Pearson E, Mohan V (2020) Novel subgroups of type 2 diabetes and their association with microvascular outcomes in an Asian Indian population: a data-driven cluster analysis: the INSPIRED study. BMJ Open Diabetes Res Care 8:e001506. https://doi.org/10.1136/bmjdrc-2020-001506
Article PubMed PubMed Central Google Scholar
Scott RA, Lu VI, Grove N, Patnaik JL, Manoharan N (2024) Rates of diabetic retinopathy among cluster analysis—identified type 2 diabetic mellitus subgroups. Graefes Arch Clin Exp Ophthalmol 262:411–419. https://doi.org/10.1007/s00417-023-06260-5
Article CAS PubMed Google Scholar
Tang H, Luo N, Zhang X, Huang J, Yang Q, Lin H, Zhang X (2024) Association between biological aging and diabetic retinopathy. Sci Rep 14:10123. https://doi.org/10.1038/s41598-024-60913-x
Article CAS PubMed PubMed Central Google Scholar
Fu S, Zhang L, Xu J, Liu X, Zhu X (2023) Association between abdominal obesity and diabetic retinopathy in patients with diabetes mellitus: a systematic review and meta-analysis. PLoS ONE 18:e0279734. https://doi.org/10.1371/journal.pone.0279734
Article CAS PubMed PubMed Central Google Scholar
Moura J, Rodrigues J, Gonçalves M, Amaral C, Lima M, Carvalho E (2017) Impaired T-cell differentiation in diabetic foot ulceration. Cell Mol Immunol 14:758–769. https://doi.org/10.1038/cmi.2015.116
Article CAS PubMed Google Scholar
Holt RIG, DeVries JH, Hess-Fischl A, Hirsch IB, Kirkman MS, Klupa T, Ludwig B, Nørgaard K, Pettus J, Renard E, Skyler JS, Snoek FJ, Weinstock RS, Peters AL (2021) The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 64:2609–2652.
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