Phenotypic stratification of microvascular complication risk in people with type 2 diabetes

The primary objective of the project is to develop a microvascular complication risk prediction tool with potential for point-of-care use for patients with type 2 diabetes. Traditional demographic, lifestyle and clinical characteristics will be combined with subclinical markers and potential biomarkers to develop a multivariable prognostic model for microvascular disease complications.

The study will use data from the Edinburgh Type 2 Diabetes Study (ET2DS): a 10-year prospective cohort study of elderly people with type 2 diabetes living in the central Lothian region of Scotland. Microvascular endpoints of interest will include diabetic retinopathy (DR), diabetic chronic kidney disease (DCKD) and diabetes-related neuropathy (exploratory). A prognostic model will be build for each endpoint and for a composite microvascular endpoint (DR, DCKD and neuropathy combined). Model building will evaluate the prognostic benefit of adding (i) biomarkers and (ii) genetic variables (subject to availability) to a base model comprising routinely-collected data variables.

Prior to model building, initial study phases will focus on finalising the 10-year endpoint data collection and conducting a formal literature review. The aim of the review will be to identify evidence-based candidate variables for subsequent model building as well as existing published prognostic models to ensure the work addresses an unmet need and or validates and further develops existing work in this area.