{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:38:19Z","timestamp":1793324299913,"version":"4.5.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Aims\/hypothesis<\/jats:title>\n                <jats:p>Our study aims to uncover glycaemic phenotype heterogeneity in type 1 diabetes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In the Study of the French-speaking Society of Type 1 Diabetes (SFDT1), we characterised glycaemic heterogeneity thanks to a set of complementary metrics: HbA<jats:sub>1c<\/jats:sub>, time in range (TIR), time below range (TBR), CV, Gold score and glycaemia risk index (GRI). Applying the Discriminative Dimensionality Reduction with Trees (DDRTree) algorithm, we created a phenotypic tree, i.e. a 2D visual mapping. We also carried out a clustering analysis for comparison.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 618 participants with type 1 diabetes (52.9% men, mean age 40.6 years [SD 14.1]). Our phenotypic tree identified seven glycaemic phenotypes. The 2D phenotypic tree comprised a main branch in the proximal region and glycaemic phenotypes in the distal areas. Dimension 1, the horizontal dimension, was positively associated with GRI (coefficient [95% CI]) (0.54 [0.52, 0.57]), HbA<jats:sub>1c<\/jats:sub> (0.39 [0.35, 0.42]), CV (0.24 [0.19, 0.28]) and TBR (0.11 [0.06, 0.15]), and negatively with TIR (\u22120.52 [\u22120.54, \u22120.49]). The vertical dimension was positively associated with TBR (0.41 [0.38, 0.44]), CV (0.40 [0.37, 0.43]), TIR (0.16 [0.12, 0.20]), Gold score (0.10 [0.06, 0.15]) and GRI (0.06 [0.02, 0.11]), and negatively with HbA<jats:sub>1c<\/jats:sub> (\u22120.21 [\u22120.25, \u22120.17]). Notably, socioeconomic factors, cardiovascular risk indicators, retinopathy and treatment strategy were significant determinants of glycaemic phenotype diversity. The phenotypic tree enabled more granularity than traditional clustering in revealing clinically relevant subgroups of people with type 1 diabetes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions\/interpretation<\/jats:title>\n                <jats:p>Our study advances the current understanding of the complex glycaemic profile in people with type 1 diabetes and suggests that strategies based on isolated glycaemic metrics might not capture the complexity of the glycaemic phenotypes in real life. Relying on these phenotypes could improve patient stratification in type 1 diabetes care and personalise disease management.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00125-024-06179-4","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T14:02:55Z","timestamp":1716472975000},"page":"1567-1581","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Heterogeneity of glycaemic phenotypes in type 1 diabetes"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5033-5966","authenticated-orcid":false,"given":"Guy","family":"Fagherazzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5625-1664","authenticated-orcid":false,"given":"Gloria 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Their participation is instrumental in the progress of type 1 diabetes-related research. We thank the French Juvenile Diabetes Research Foundation for supporting the SFDT1 study (grant 3-SRA-2023-1347-S-B). Additionally, we thank the SFDT1 study group for their diligent efforts and dedication to the study. Their collective expertise and commitment have played a critical role in ensuring a high-quality standard for the SFDT1 data. We also want to acknowledge the substantial work of Sano\u00efa CRO in supporting the management and execution of the study. Their professional conduct and expertise have ensured the rigorous implementation of our study protocol. Special thanks go to M. Huet and M. Brul\u00e9 for their exceptional contribution to the clinical operations of the SFDT1 study conduct. Their unwavering dedication has enriched our research and helped drive the study forward. We are sincerely grateful for the collaboration and dedication of all those involved, and we believe their invaluable contributions will continue to benefit future research in this field. The full list of active participants of the SFDT1 study group can be found here below:Jean-Pierre Riveline, Jean-Baptiste Julla, Tiphaine Vidal-Tr\u00e9can, Vanessa Juddoo, Bruno Verg\u00e8s, Sylvaine Clavel, Hermione Agopian, Emmanuel Cosson, Sopio Tatulashvili, Sylvie Picard, Fritz-Line Velayoudom, Alexana Prevot, Claude Gruel, Ingrid Cirederf, Charles Thivolet, M\u00e9lanie Gaudilliere, Sylvie Villar-Fimbel, B\u00e9atrice Mestre Filippini, Elise Bismuth, Hassina Benlarbi, Jacques Beltrand, Alix Besan\u00e7on, Pierre-Yves Benhamou, Sanine Lablanche, Manon Jalbert, Louis Potier, Aur\u00e9lie Carlier, Agn\u00e8s Sola, Nathalie Jeandidier, Laurence Kessler, Marion Munch, H\u00e9l\u00e8ne Hanaire, Pierre Gourdy, Raquel Tirado, Vincent Melki, Sarah Pinto, Yves Reznik, Bleuenn Dreves, Michael Joubert, Anne Rod, Sophie Borot, Annie Clergeot, Nathalie Bendelac, Vincent Rigalleau, Amandine Ferriere, Alice Larroumet, Isabelle Guilhem, Christele Derrien, Agathe Guenego, Patricia Vaduva, Elsa Bleichner, Emeric Rageul, Margot De La Vergne De Cerval, Annabelle Esvant, Mathilde Fichet, Auey Durous, Laurent Meyer, Lyse Bordier, Cyril Garcia, Sika Nassouri, Mathilde Sollier, Bruno Guerci, St\u00e9phanie Jellimann, Philip B\u00f6hme, Nicolas Scheyer, Mazen Soliman, Meliha Mahmutovic, Laura Mayer, Sylvia Franc, Alfred Penfornis, Coralie Amadou, Nicolas Chevalier, Anne-Ga\u00eblle Decoux-Poullot, St\u00e9phanie Palle Defille, Gaetan Prevost, Lucile Moreau Grange, Karine Durand, Florence Eas, Eric Renard, Anne Farret, Florence Galtier, Brigitte Delemer, Claire Carette, Alina Radu, Amel Ait Boudaoud Hansal, Samy Hadjadj, Pierre Morcel, Nadine Lucidarme, Igor Tauveron, Thomas Benichou, Sylvain Roumeau, Sarah Dallel, Mathilde Picard, Pierre-Fran\u00e7ois Souchon, Anne Sophie Salmon-Musial, Aurelie Berot, Lucien Marchand, C\u00e9dric Luyton, Isabela Banu, Blandine Delenne, Anne Vambergue, Didier Gouet, Emmanuel Sonnet, Nathalie Roudaut, Anne Spiteri, Pierre Henri Ducluzeau, Kalliopi Bilariki, Rachel Reynaud, Emmanuelle Sokol, Camille Vatier, B\u00e9n\u00e9dicte Fremy, Pascal Barat, Marc De Kerdanet, Brigitte Mignot, Laurence Salle, Caroline Sanz, Marie Mansilla, Paul Valenci, Pascale Massin.Some of the data were presented as an abstract at the European Diabetes Epidemiology Group Annual Meeting and at the Advanced Technologies & Treatments for Diabetes conference in 2023.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"Data used for this analysis are available for academic researchers on request submitted to the scientific committee of SFDT1: cohorte.sfdt1@gmail.com. Codes created for this analysis are available on request to the corresponding author: guy.fagherazzi@lih.lu.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"This work was made possible thanks to the institutional support from the Fondation Francophone pour la Recherche sur le Diab\u00e8te (FFRD), the Soci\u00e9t\u00e9 Francophone du Diab\u00e8te (SFD) and the Luxembourg Institute of Health, as well as from the following partners: Aide aux Jeunes Diab\u00e9tiques (AJD), F\u00e9d\u00e9ration Fran\u00e7aise des Diab\u00e9tiques, Lilly, Abbott, Air Liquide Healthcare, Novo Nordisk, Sanofi, Insulet, Medtronic, Dexcom, Ypsomed, Lifescan and Sur les Pas de So. The study sponsors\/funders were not involved in the design of the study; the collection, analysis and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"LB has performed consultancies and received honorarium from Eli Lilly, Boehringer Ingelheim, Novo Nordisk, Sanofi, AstraZeneca, Bayer, Servier, Pfizer, Abbott and MSD. MJ has performed clinical trials for and\/or has provided advisory\/speaking services for and\/or has received research grants from Abbott, Air Liquide Healthcare, Amgen, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Dexcom, Glooko, Lifescan, Eli Lilly, LVL, Medtronic, MSD, Nestle Home Care, Novo Nordisk, Orkyn, Roche Diabetes, Sanofi, Vitalaire and Voluntis. HH has performed clinical trials for and\/or has provided advisory\/speaking services for and\/or has received research grants from Abbott, Air Liquide Healthcare, AstraZeneca, Insulet Isis, Lifescan, Lilly, Medtronic, MSD, Novo Nordisk, Sanofi and Vitalaire. P-YB has received speaker honoraria from Abbott, Eli Lilly, Novo Nordisk and Sanofi; is the chief medical officer for Diabeloop; and served on advisory board panels for Abbott, Dexcom, Insulet, LifeScan, Eli Lilly, Novo Nordisk and Sanofi. LP has provided advisory\/speaking services for and\/or has received research grants from Eli Lilly, Novo Nordisk, AstraZeneca, Bayer, Boehringer Ingelheim and Sanofi. EB has received speaker honoraria from Abbott, Eli Lilly, Novo Nordisk, Dexcom, Vitalaire, Orkyn and Dinnosant\u00e9; served on advisory board panels for Insulet, Eli Lilly, Medtronic and Novo Nordisk; and performed clinical trials for Eli Lilly, Vitalaire and ProventionBio. GF has provided advisory\/speaking services for and\/or has received research grants and\/or speaker honoraria from MSD, MSDAvenir, Eli Lilly, Roche Diabetes Care, AstraZeneca, Danone Research, Diabeloop, Bristol Myers Squibb, L\u2019Or\u00e9al R&D, Abbvie Pharmaceutical, Pfizer, Vitalaire and Akuity Care. J-PR is an advisory panel member for Sanofi, MSD, Eli Lilly, Novo Nordisk, AstraZeneca, Abbott, Dexcom, Alphadiab, Air Liquide Healthcare and Medtronic; and has received research funding from and provided research support to Abbott, Air Liquide Healthcare, Sanofi and Novo Nordisk. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"GF conceived the study. GAA and GF wrote the first draft. J-PR and EC are the co-principal investigators. GAA, GF, LZ, J-PR and EC had full access to the data in the study, verified the data and had full responsibility for the decision to submit and publish. GF, HH, SP, LS, BV, NH, B. Detournay, MJ, B. Delemer, IG, AV, PG, SH, F-LV, BG, EL, NJ, J-FG, ER, LP, P-YB, AS, LB, EB, GP, LK, EC and J-PR contributed to protocol development and study design. NH collected the data. GAA and LZ performed the statistical analyses. GAA, GF, J-PR and EC wrote the statistical analysis plan (SAP). All authors read the SAP, critically revised it for important intellectual content and approved the final version. All authors read the manuscript, critically revised it for academic content and approved the final version. GF is the guarantor of this work and, as such, has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}