Medicine

There are five types of diabetes not two, say scientists

There are five types of diabetes not two, say scientists

One in eleven of us has been diagnosed with diabetes, but new research suggests that there could be five categories of the disease- here's why, and how it's a positive for treatment prospects...

For their study, researchers assessed recently-diagnosed patients in Sweden and Finland and focused on six main measurements that reflect aspects of diabetes and ways to monitor patients. They also did genetic analyses, and compared disease progression, treatment, and development of complications for each type. Three forms were severe and two mild. People with this type were overweight, and while still making insulin, their bodies weren't responding to it. The more common form, type 2, in which little insulin is produced or does not trigger glucose uptake by the body's cells, generally develops later in life and is linked to obesity. The BBC reports diabetes is typically separated into type 1-an immune system disease-and type 2-mostly seen as the result of an unhealthy lifestyle.

She explained that while Type 1 diabetes isn't now preventable, three in five cases of Type 2 diabetes can be prevented or delayed with a healthy lifestyle and better understanding of the condition. Obesity accounts for 80 to 85 per cent of the overall risk of developing type 2 diabetes and underlies the current global spread of this condition.

"More accurately diagnosing diabetes could give us valuable insights into how it will develop over time, allowing us to predict and treat complications before they develop", Leif Groop, PhD, professor in the department of clinical sciences at Lund University Diabetes Centre, Sweden, and the Institute for Molecular Medicine Finland, said in a press release.

But the study authors, from the University of Gothenberg and Lund University in Sweden, say additional subgroups are needed. Among the severe forms, one group had severe insulin resistance and a significantly higher risk of kidney disease than the other types (affecting 11-17% of patients).

The researchers analysed certain characteristics - such as body weight, blood sugar control and presence of antibodies - against the likelihood of disease complications and need for insulin. If someone has Type 1 diabetes, their pancreas does not create insulin.

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The first cluster - defined as severe autoimmune diabetes - was the least common, with only 6.4% of the cohort fitting this type.

Millions more are thought to have prediabetes, or blood sugar levels that are above the normal range but not yet high enough to be classified as diabetic. The fifth group was made of patients who developed diabetes later on in life; they also had the mildest symptoms.

Other researchers caution that the team's results need to be replicated elsewhere, using even more diverse patient samples. This group was at greatest risk of diabetic eye damage or retinopathy.

The researchers also want similar studies in China and India with people of different ethnic backgrounds.

They believe that the study might help tailor and target treatment and lay the foundation for precision medicine in the future.

According to researchers, the more specific categorization could lead to a more targeted and personalized treatment for diabetes. "Importantly, patients in the insulin-resistant diabetes cluster would likely benefit from an early more intensified treatment".


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