Immunometabolic endotypes define distinct clinical trajectories in type 2 diabetes.

Four distinct immune endotypes in newly diagnosed T2D predict clinical outcomes, with severe inflammatory and lymphocyte-deficient types linked to higher risks.

• Why it matters: Current T2D classifications fail to reflect its biological complexity or guide personalized treatment, highlighting the need for better stratification methods.
• What they did: Researchers analyzed blood immune cell counts from over 1,500 individuals with T2D across European cohorts, using unsupervised clustering to identify stable, reproducible endotypes.
• The result: The identified endotypes, especially SIND and LYDD, correlated with increased cardiovascular, renal, and mortality risks, and improved risk prediction beyond existing models, enabling more precise immunometabolic management.