Should diabetes be divided into 5 categories to improve treatment?

04 March, 2018, 05:08 | Author: Jared Lewis
  • Researchers propose 5 distinct types of adult-onset diabetes

This lends credence to the idea that the five types of diabetes are not simply different stages of the same disease.

Prof Leif Groop, one of the analysts, told the BBC: "This is critical, we're making a genuine stride towards exactness drug". Most diagnoses are type 2 (75-85%), and while it's known that type 2 disease is highly variable, few attempts have been made to explore these distinctions.

And the final group, mild age-related diabetes, is the largest group, with 40 per cent of all patients, and consists mostly of elderly patients.

Diabetes has five categories not just types one and two, scientists said.

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Cluster 2 are severely insulin-deficient patients who were likewise young and healthy, and struggled with insulin, but the cause was not immune system failure.

The first of these - severe insulin-deficient diabetes - was shown to include people with high blood sugar, low insulin production and moderate insulin resistance. Their bodies make insulin but don't use it the right way.

At present the disease is classified by two forms.

"If you would like to find out more about the programme or believe you may be at risk of developing type 2 diabetes, please visit your GP or talk to your practice nurse for more information". It is usually diagnosed in childhood and is caused by the body's immune system wrongly destroying cells in the pancreas that make insulin.

In their analysis of nearly 9000 patients with adult-onset diabetes, they identified five replicable clusters of disease, each with significantly different characteristics and risk of complications.

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Cluster 3 (15.3 percent): Severe insulin resistant diabetes (SIRD) with insulin resistance and high BMI.

Cluster 1 - severe autoimmune diabetes, similar to the classical type 1, affected younger people who were otherwise healthy.

Clusters 3 and 4 describe diabetes in generally overweight individuals with insulin resistance, but those in Cluster 4 are metabolically closer to normal compared to those in Cluster 3.

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. Groop said the existing guidelines can not differentiate between patients who will need intensified treatment and those who will not. "It would be reasonable to target individuals in these clusters with intensified treatment", they wrote.

Published online March 1 in The Lancet: Diabetes & Endocrinology, one study-led by Emma Ahlqvist, PhD, with the Lund University Diabetes Center in Malmo, Sweden-suggests patients be divided into five subgroups by disease progression and complications. However, it's not yet clear whether patients can move between clusters over time, and the authors say they can't yet claim that their clustering method is the best classification system for diabetes subtypes. Further research is needed to see whether these 5 clusters hold true for non-Scandinavian populations.

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After analyzing the data of almost 15,000 diabetics using information taken from four registries in Sweden and Finland, the team found that Type 2 is actually made up of four categories, including two of the most severe types of the disease.



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