Diabetes can be divided into five separate types, not two

Ebony Scott
March 4, 2018

Most people with diabetes - between 85% and 90% - have type 2 diabetes, in which the body does not produce enough insulin, or the insulin they have does not work properly.

Cluster 5: Mild age related diabetes, affecting 39.6 per cent of patients.

The results have been published in The Lancet: Diabetes and Endocrinology.

Diabetes is actually not one or two, but five separate diseases, scientists say.

The researchers also report that numerous people in the studies were not receiving appropriate treatment, suggesting that a more individual approach to the disease could be beneficial.

The researchers later repeated the analysis in three studies from Sweden and Finland. They were hierarchically classified.

Funding was provided by the Swedish Research Council, European Research Council, Vinnova, the Academy of Finland, Novo Nordisk Foundation, Scania University Hospital, Sigrid Jusélius Foundation, the European Union Innovative Medicines Initiative 2 Joint Undertaking, Vaasa Hospital, Jakobstadsnejden Heart Foundation, Folkhälsan Research Foundation, the Ollqvist Foundation and the Swedish Foundation for Strategic Research.

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Based on these parameters the participants were classified into 5 groups. "Anyone with Type 2 diabetes concerned about medication should speak to a health professional". As in cluster 1, strikes young and healthy people, but the immune system isn't at fault. Clinical characteristics included early-onset of the disease and being GADA positive, along with a lower BMI, poor metabolic control, and insulin deficiency. They had to be prescribed insulin injections for treatment (in 42 percent patients). The remaining severe group was insulin-deficient patients who had auto-antibodies associated with autoimmune diabetes (6-15%), the form called type-1, or latent autoimmune diabetes in adults. These patients had a high degree of insulin resistance and a high HOMA2-IR index.

Three in five women (59 per cent) and two in three men (68 per cent) are overweight or obese.

Other researchers caution that the team's results need to be replicated elsewhere, using even more diverse patient samples. Will also provide an opportunity to identify people at risk of serious complications of this disease. Clusters 3 and 4 can be thought of as falling between the two extremes. They were usually older adults and their metabolic profiles were not as bad as the others. For example, those in cluster 2 (insulin-deficient) had the highest risk of losing eyesight, while patients in cluster 3 (most resistant to insulin) showed a higher risk of developing diabetic kidney disease. TCF7L2 gene mutation further was seen in clusters 2, 4, and 5 and was not seen in cluster 3.

Severe insulin-resistant diabetes (SIRD): characterised by insulin resistance and high BMI.

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 researchers, led by experts at Lund University, last night said the findings should prompt a "paradigm shift" in the way people treat diabetes.

A medical assistant administers an insulin shot to a diabetes patient at a private clinic in New Delhi. He mentioned a caveat saying that this study cohort was a uniform Scandinavian population and thus all races and ethnicities were not adequately represented.

Other reports by GizPress

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