Scientists have come up with a new classification of diabetes

Phillip Cunningham
March 4, 2018

Diabetes falls into five categories rather than two, according to a study that promises new personalised treatments.

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. Bodies of largely overweight people no longer respond to insulin being produced. Type 1 is a disease of the immune system, where the body cannot manufacture the hormone insulin and although it is most commonly diagnosed in child patients, it can develop at any age.

The results were checked against three other studies from Sweden and Finland.

"O$3 ur data suggest that the combined information from a few variables central to the development of diabetes is superior to measurement of only one metabolite, glucose", Ahlqvist said. Subgroup classification was validated in three independent cohorts.

But it is also campaigning for people at high risk of Type 2 diabetes to be identified and referred to the NHS Diabetes Prevention Programme, which supports people to make changes that could prevent the onset of the condition.

Researchers from Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine in Finland gathered data on nearly 15,000 patients from across five cohorts in both countries.

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.

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.

Severe insulin-deficient diabetes (SIDD): GADA-negative but otherwise similar to SAID. South Asian people are also more likely to develop the disease at a younger age.

Another type of severe insulin-resistant diabetes is predominantly linked to obesity.

Cluster 4 are the patients with mild, obesity-related diabetes who are closer to those in cluster 3 in terms of insulin production. I only have to look at my mum's workload to see that: as a diabetes specialist nurse, she's busier than ever, supporting patients throughout day to day management of their condition and some of the more serious complications of the disease, from blindness to kidney failure and limb amputation.

The most common form found was a moderate type found in mostly older people, while the other was a mild form found mostly in obese patients.

Other researchers caution that the team's results need to be replicated elsewhere, using even more diverse patient samples. "For example, whether we'd find the same subtypes in people of different ethnicity or nationality". A new classification system could help doctors identify the people most at risk for complications, the study authors say, and could pave the way for more personalized and effective treatments.

"Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment", explains Professor Leif Groop, who initiated the study.

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.

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