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04 March 2018, 02:04 | Rodolfo Quinn
Researchers propose 5 distinct types of adult-onset diabetes
"This is the first step towards personalized treatment of diabetes", Dr. Leif Groop, a physician and professor of diabetes and endocrinology at Lund University in Sweden, said in a press release.
Cluster 5: Mild age related diabetes, affecting 39.6 per cent of patients. They may explain why diabetics respond differently to treatment.
For decades the disease has been considered to be two different forms - type one, an autoimmune disease in which people stop producing insulin, and type two, in which the body becomes resistant to insulin. People either don't produce enough insulin or their body's cells don't respond to it, with varying degrees of severity.
Cluster 2 (17.5 percent): Severe insulin-deficient diabetes (SIDD) and similar to Cluster 1.
Researchers in Sweden and Finland have classified five distinct types of diabetes that can occur in adulthood, instead of the two now recognized.
The researchers later repeated the analysis in three studies from Sweden and Finland.
The major difference from today's classification is that type 2 diabetes actually consists of several subgroups, the results indicate. Clusters 1 and 2 had a greater risk of diabetic ketoacidosis and had a higher HbA1c at diagnosis.
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It was conducted by Lund University Diabetes Centre in Sweden and Finland's Institute for MolecularMedicine, and looked at 14,775 patients.
The team, from Lund University and the Institute for Molecular Medicine in Helsinki, examined data from 14,625 patients in five cohorts between January 2008 and November 2016.
"Type 1 diabetes isn't now preventable, but three in five cases of Type 2 diabetes can be prevented or delayed with a healthy lifestyle and better understanding of the condition", said Annika Palmer. But cluster 3, which had the highest degrees of insulin resistance, showed a significantly higher risk for diabetic kidney disease than the other groups. New research confirms that in general it's most commonly diagnosed in the young. This group had the largest proportion of patients prescribed insulin (42%), as well as the shortest time to insulin use (HR 26.87 versus cluster 5, 95% CI 21.17-34.11).
They believe the more precise groupings - each genetically distinct - will aid diagnosis, help tailor treatments and lead to precision medicines.
Cluster 4: Mild obesity related-diabetes mainly occurs among overweight people, whose metabolism is however much closer to normal compared with those in cluster 3.
(Other, secondary types of diabetes can involve insulin or other mechanisms). Cluster 3 (n = 1,373) was characterized by severe insulin resistance and high BMI, whereas cluster 4 (n = 1,942) was characterized by obesity, but not insulin resistance.
In addition to a more refined classification, the researchers also discovered that the different groups are more or less at risk of developing various secondary diseases.
In the same way that a patient requiring a transfusion must receive the right blood type, diabetes sub-types need different treatments, the study suggested.
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