Uncovering actionable cardiovascular risk subgroups in type 2 Diabetes: A latent class analysis

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AIMS: The study aimed to identify type 2 diabetes subgroups with varying, actionable cardiovascular disease (CVD) risk factor patterns and explored subgroup differences in characteristics and three-year CVD incidence. METHODS: A Latent Class Analyses was performed to determine classes with similar lifestyle and psychosocial CVD risk patterns, predictive value of demographic, socioeconomic and medical factors, and class differences in CVD outcomes. RESULTS: The 3-class model was superior. The 'low risk' class was largest (71.2 %). The 'mobility related risk' class (19.3 %) showed high probability of limitations in mobility (0.90) and not meeting the exercise norm (0.89). The 'psychosocial risk' class (9.5 %) had similar risks, with additional probabilities to be lonely (0.49) and have anxiety and depression (0.56). Strong predictors (OR ≥ 2.00) for membership of risk classes were: female gender, non-western immigrant status, lower education, financial difficulties, being unfit for work and/or prior heart failure. Three years CVD incidence was lower in members of the 'low risk' class had cardiology care and/or stroke diagnosis compared to the risk classes. CONCLUSIONS: Diverse lifestyle and psychosocial CVD risk factor patterns impact CVD outcomes in individuals with type 2 diabetes, emphasizing the necessity of a whole-person CVD prevention tailored to the person's needs.

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