We used a Japanese diabetes cohort study (J-DREAMS) to examine whether the Ahlqvist et al diabetes clustering is useful for stratifying DKD or ESKD outcomes independent of known risk factors in real-world settings.<h4>Methods</h4>Data-driven cluster analysis using k-means was performed based on GAD antibody levels, age at diagnosis, BMI, HbA<sub>1c</sub> and HOMA2 estimates of beta cell function and insulin resistance in 12,093 individuals with type 1 or type 2 diabetes. Here, GAD1 is linked to Insulin resistance.