Diabetes 'consists of 5 distinct types'


After analyzing the measures in a cohort of 8980 adults at first, researchers identified 1 autoimmune type of diabetes and 4 distinct subtypes of type 2 diabetes, which were then tests across 3 more cohorts of 5795 people: the Scania Diabetes Registry (n=1466), All New Diabetics in Uppsala (n=844) and Diabetes Registry Vaasa (n=3485).

Researchers have said that this new classification system could help to identify patients at high risk of complications, and provide guidance on the choice of treatment.

"Five hundred people are diagnosed with type 2 diabetes across the United Kingdom every day; that's the equivalent of one person every three minutes".

They found cluster 3 was most resistant to insulin, and had significantly higher risk of diabetic kidney disease than those in clusters 4 and 5. Three forms were severe and two mild.

Group 1: Severe autoimmune diabetes (SAID), which affects otherwise healthy people from a young age. "These included the age of diagnosis, body mass index, long-term glycaemic control, successful functioning of the insulin-producing cells in the pancreas, insulin resistance and presence of auto-antibodies associated with autoimmune diabetes".

There are five distinct types of diabetes that can occur in adulthood, rather than the two now recognised, they reported in The Lancet Diabetes & Endocrinology, a leading medical journal. "This study moves us towards a more clinically useful diagnosis, and represents an important step towards precision medicine in diabetes". The clusters and associated complications will need to be verified in other populations, including other ethnicities that may have a different risk of diabetes, such as Asian populations.

Having diabetes means that a person's blood sugar (glucose) levels are too high.

GETTY Images Diabetes type 2 Condition affects about 4.6 million people in the UK
GETTY Images Diabetes type 2 Condition affects about 4.6 million people in the UK

Lead author of the study Professor Leif Groop from the Lund University Diabetes Centre in Sweden said early treatment is vital for diabetics.

Diabetes influences around one of every 11 grown-ups worldwide and expands the risk of heart assault, stroke, blindness, kidney failure and appendage removal. "Evidence suggests that early treatment for diabetes is crucial to prevent life-shortening complications", he said in a statement. The report comes from Emma Ahlqvist, PhD, of Lund University in Sweden, and her team and is published in the latest issue of the Lancet Diabetes & Endocrinology.

The researchers measured insulin resistance, insulin secretion, blood sugar levels and age at onset of illness in determining the five classes.

A single genetic defect can cause monogenic diabetes called Maturity Onset Diabetes of the Young (MODY) which has been identified in those who are young and lean. 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.

"This research takes a promising step toward breaking down type 2 diabetes in more detail", Dr. Emily Burns, from Diabetes U.K., told the BBC. Though manageable, it is one of the leading causes of death, directly responsible for killing 1.6 million (2.8 percent) people in 2015.

"This is not changing the diagnosis or the terminology for the diagnosis", Wyne said. Also, the patients were all of Scandinavian ancestry - meaning more genetic diversity could show more facets of the disease types. The researchers plan to launch similar studies in China and India.