Heterogeneity in type 2 diabetes mellitus (T2DM) continues to influence clinical presentation and treatment response across populations. A cross-sectional study published in Journal of Diabetology evaluated the clinical utility of a cluster-based classification approach in individuals with T2DM in Ghana.

This study consecutively recruited 353 adults aged ≥18 years with T2DM from diabetes clinics across four hospitals in the Greater Accra Region between March and June 2023. K-means clustering was performed using five parameters, including age at diagnosis, body mass index (BMI), glycosylated hemoglobin (HbA1c), homeostatic model assessment 2 for beta-cell function (HOMA2-β), and insulin resistance (HOMA2-IR). Additional clinical variables, including blood pressure (BP), waist circumference (WC), and lipid profile, were incorporated to enhance clinical characterization following clustering.

Four distinct clusters were identified: severe insulin-resistant diabetes (SIRD), mild age-related diabetes (MARD), severe insulin-deficient diabetes (SIDD), and mild obesity-related diabetes (MOD). The MARD cluster was most prevalent, comprising 37% of the cohort. Significant differences were observed across clusters in medication use, total cholesterol, systolic blood pressure, and waist circumference (all P<0.001). Comparison of severe subtypes showed greater insulin deficiency relative to insulin resistance.

These findings indicate that cluster-based classification identified distinct subgroups with varying clinical characteristics and treatment patterns in this population.