Leif GroopLunds Universitets DiabetescentrumFinnish Institute for Molecular Medicine

Diabetesjukdomens maringnga ansikten-steg mot individualiserad behandling

Sveriges Endokrinologfoumlrening Umearing 30 januari 2019

SDR (7512)Skaringne Diabetes Register

ANDISANDIUAll New Diabetics In SkaringneUppsala

19086 880

httpandisludcmedluse

DIREVA (6139)Diabetes Register Vasa

ANDIS- All New Diabetics in ScaniaA Traditional classificationB Cluster-based classification

Age at diagnosisBMIHbA1cGADAC-peptide (HOMA-B)HOMA-IS)

ANDIS Hierarchical clustering and silhouette analysis

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden Det garingr inte att visa bilden

Men n=5334 Women n=3646

Replication Diabetes Registry VAasaDIREVA Finland

Det garingr inte att visa bilden

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden

Diabetes duration lt 2 years N=878 Diabetes duration 10plusmn10 years N=2607

Replikerad i Peking KinaDet garingr inte att visa bilden

Xou X et al Lancet DampE 2019

SAIDSevere autoimmune diabetes

bull 64 of patientsbull All GADA positive = T1D+LADAbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SAID Mean (SD)

HBA1C at diagnosis mmoll 80 (31)

BMI kgm2 27 (6)Age at diagnosis years 50 (18)

HOMA2B 57 (45)HOMA2IR 22 (16)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

SDR (7512)Skaringne Diabetes Register

ANDISANDIUAll New Diabetics In SkaringneUppsala

19086 880

httpandisludcmedluse

DIREVA (6139)Diabetes Register Vasa

ANDIS- All New Diabetics in ScaniaA Traditional classificationB Cluster-based classification

Age at diagnosisBMIHbA1cGADAC-peptide (HOMA-B)HOMA-IS)

ANDIS Hierarchical clustering and silhouette analysis

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden Det garingr inte att visa bilden

Men n=5334 Women n=3646

Replication Diabetes Registry VAasaDIREVA Finland

Det garingr inte att visa bilden

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden

Diabetes duration lt 2 years N=878 Diabetes duration 10plusmn10 years N=2607

Replikerad i Peking KinaDet garingr inte att visa bilden

Xou X et al Lancet DampE 2019

SAIDSevere autoimmune diabetes

bull 64 of patientsbull All GADA positive = T1D+LADAbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SAID Mean (SD)

HBA1C at diagnosis mmoll 80 (31)

BMI kgm2 27 (6)Age at diagnosis years 50 (18)

HOMA2B 57 (45)HOMA2IR 22 (16)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

ANDIS- All New Diabetics in ScaniaA Traditional classificationB Cluster-based classification

Age at diagnosisBMIHbA1cGADAC-peptide (HOMA-B)HOMA-IS)

ANDIS Hierarchical clustering and silhouette analysis

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden Det garingr inte att visa bilden

Men n=5334 Women n=3646

Replication Diabetes Registry VAasaDIREVA Finland

Det garingr inte att visa bilden

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden

Diabetes duration lt 2 years N=878 Diabetes duration 10plusmn10 years N=2607

Replikerad i Peking KinaDet garingr inte att visa bilden

Xou X et al Lancet DampE 2019

SAIDSevere autoimmune diabetes

bull 64 of patientsbull All GADA positive = T1D+LADAbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SAID Mean (SD)

HBA1C at diagnosis mmoll 80 (31)

BMI kgm2 27 (6)Age at diagnosis years 50 (18)

HOMA2B 57 (45)HOMA2IR 22 (16)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

ANDIS Hierarchical clustering and silhouette analysis

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden Det garingr inte att visa bilden

Men n=5334 Women n=3646

Replication Diabetes Registry VAasaDIREVA Finland

Det garingr inte att visa bilden

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden

Diabetes duration lt 2 years N=878 Diabetes duration 10plusmn10 years N=2607

Replikerad i Peking KinaDet garingr inte att visa bilden

Xou X et al Lancet DampE 2019

SAIDSevere autoimmune diabetes

bull 64 of patientsbull All GADA positive = T1D+LADAbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SAID Mean (SD)

HBA1C at diagnosis mmoll 80 (31)

BMI kgm2 27 (6)Age at diagnosis years 50 (18)

HOMA2B 57 (45)HOMA2IR 22 (16)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

Replication Diabetes Registry VAasaDIREVA Finland

Det garingr inte att visa bilden

Det garingr inte att visa bildenDet garingr inte att visa bilden

Det garingr inte att visa bilden

Diabetes duration lt 2 years N=878 Diabetes duration 10plusmn10 years N=2607

Replikerad i Peking KinaDet garingr inte att visa bilden

Xou X et al Lancet DampE 2019

SAIDSevere autoimmune diabetes

bull 64 of patientsbull All GADA positive = T1D+LADAbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SAID Mean (SD)

HBA1C at diagnosis mmoll 80 (31)

BMI kgm2 27 (6)Age at diagnosis years 50 (18)

HOMA2B 57 (45)HOMA2IR 22 (16)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

Replikerad i Peking KinaDet garingr inte att visa bilden

Xou X et al Lancet DampE 2019

SAIDSevere autoimmune diabetes

bull 64 of patientsbull All GADA positive = T1D+LADAbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SAID Mean (SD)

HBA1C at diagnosis mmoll 80 (31)

BMI kgm2 27 (6)Age at diagnosis years 50 (18)

HOMA2B 57 (45)HOMA2IR 22 (16)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

SAIDSevere autoimmune diabetes

bull 64 of patientsbull All GADA positive = T1D+LADAbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SAID Mean (SD)

HBA1C at diagnosis mmoll 80 (31)

BMI kgm2 27 (6)Age at diagnosis years 50 (18)

HOMA2B 57 (45)HOMA2IR 22 (16)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

SIDDSevere insulin-deficient diabetes

bull 175 of patientsbull High HbA1cbull Low insulin secretionbull Relatively leanbull Relatively young

SIDD Mean (SD)

HBA1C at diagnosis mmoll 102 (19)

BMI kgm2 29 (5)Age at diagnosis years 57 (11)HOMA2B 48 (29)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

0

002

004

006

008

01

012

014

016

1SAID 2SIDD 3SIRD 4MOD 5MARD

Proliferative

Non proliferative

Severe

Moderate

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS ANDIU

SIDD vs MARD OR 16 p=97x10-7 OR 46 p=41x10-13

SIDDSevere insulin-deficient diabetes

Diabetic retinopathy

Neuropathy is also increased in this group

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

Hba1

c m

mol

LHbA1c over time

Ketoacidosis at diagnosis

SIDDSevere insulin-deficient diabetes

ZnT8A auto-antibodiesGene - SNP SAID (N=313) SIDD (N=676)

OR P OR P

HLA DQB1 - rs2854275 205 57x10-10 082 008

HLA DQB1 - rs9273363 033 20x10-32 108 037

TCF7L2 - rs7903146 117 008 15

1 28x10-10

Genetics ndash cluster vs non-diabetic controls (N=2754)

0

005

01

015

02

025

03

035

1SAID 2SIDD 3SIRD 4MOD 5MARD

0

005

01

015

02

025

03

1SAID 2SIDD 3SIRD 4MOD 5MARD

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

1-cu

mul

ativ

e su

rviv

al

SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

ANDIS eGFRlt45 mLmin173m2

SDR Macroalbuminuria

SDR ESRD

eGFRlt15 mLmin173m2

HR(CI95) p

1SAID 10 (06-19) 098

2SIDD 17(12-25) 0003

3SIRD 33(26-43) 8x10-21

4MOD 17(10-30) 0045

HR(CI95) p

04(01-10) 0056

13(07-22) 039

22(13-36) 0003

13(07-24) 0371 -

HR(CI95) p19(07-53) 02323(11-46) 0024

49(27-89) 24x10-7

17(07-44) 0251 -

1-cu

mul

ativ

e su

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SIRDSevere insulin-resistant diabetes

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

bull 216 of patientsbull Low HbA1cbull Very obesebull Relatively youngbull Low risk of complicationsMOD Mean (SD)

HBA1C at diagnosis mmoll 58 (16)

BMI kgm2 36 (5)Age at diagnosis years 49 (10)

HOMA2B 95 (32)HOMA2IR 34 (12)

MODModerate obesity-related diabetes

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

MODModerate obesity-related diabetes

Gene - SNP 3SIRD (N=603) 4MOD (N=727)

OR P OR P

TM6SF2 - rs10401969 062 31x10-6 089 026

TCF7L2 - rs7903146 100 086 138 57x10-7

JAZF1 ndash rs864745 093 014 081 18x10-4

KCNJ11 ndash rs5219 103 067 128 12x10-4

Genetics ndash cluster vs non-diabetic controls (N=2754)

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

MARDModerate age-related diabetes

bull 391 of patientsbull Low HbA1cbull Relatively oldbull Relatively leanbull Low risk of complicationsMARD Mean (SD)

HBA1C at diagnosis mmoll 50 (10)

BMI kgm2 28 (3)Age at diagnosis years 67 (9)

HOMA2B 87 (26)HOMA2IR 26 (08)

HBA1C BMI AGE

HOMA2-B HOMA2-IRDet garingr inte att visa bilden

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

Emma Ahlqvist

296 kommentarer i internationell press de foumlljande 5 dagarna

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

En app foumlr diabetesmottagningenbaserad paring maskinlaumlrning

Olof Asplund

Naumlsta steg

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17

TACK foumlr uppmaumlrksamheten

Naumlr foumlraumlndringens vindar blaringser aumlr det baumlttre med vaumlderkvarnar aumln vindskydd

• Bildnummer 1
• Bildnummer 2
• Bildnummer 3
• ANDIS Hierarchical clustering and silhouette analysis
• Replication Diabetes Registry VAasaDIREVA Finland
• Bildnummer 6
• SAID Severe autoimmune diabetes
• SIDDSevere insulin-deficient diabetes
• Bildnummer 9
• Bildnummer 10
• Bildnummer 11
• Bildnummer 12
• Bildnummer 13
• MARDModerate age-related diabetes
• Bildnummer 15
• Bildnummer 16
• Bildnummer 17