Population stratification in type 2 diabetes mellitus: A systematic review

Area of Science:

• Endocrinology and Metabolism
• Public Health and Epidemiology
• Biostatistics

Background:

• Type 2 diabetes management increasingly uses population stratification to personalize care and improve patient outcomes.
• Systematic reviews are crucial for understanding current stratification methodologies in type 2 diabetes research.

Purpose of the Study:

• To systematically review and collate literature on population stratification methods in adults with type 2 diabetes.
• To describe and compare stratification methodologies, population characteristics, variables, and outcomes used in existing studies.

Main Methods:

• Searched MEDLINE, EMBASE, CINAHL, and Cochrane databases up to July 2020.
• Included studies on adults with type 2 diabetes using population stratification.
• Followed PRISMA guidance and registered the protocol on PROSPERO (ID: CRD42020206604).

Main Results:

• Analyzed 348 studies involving over 10.7 million participants (mean age 61.0 years).
• 6.7% of studies employed data-driven stratification; the remainder used expert-driven approaches.
• HbA1c was the most common stratification variable; few studies used non-traditional variables like health behaviors.

Conclusions:

• Most type 2 diabetes stratification studies are expert-driven, focusing on predicting glycemic control, mortality, and cardiovascular outcomes.
• Data-driven approaches are underutilized but offer potential for hypothesis generation beyond current knowledge.
• Research gaps exist, particularly in stratification related to type 2 diabetes remission.