Researchers Propose Five Clusters Of Diabetes Instead Of Two Types

There is often confusion between MODY and Type 1 Diabetes as both are found to affect young people or children. Type 1 Diabetes is diagnosed in those suffering from MODY leading to misdiagnosis

Researchers propose 5 distinct types of adult-onset diabetes

Researcher professor Leif Groop said: 'This is the first step towards personalised treatment of diabetes. Groop's team studied 14,775 diabetics and determined diabetes should actually be broken into five "genetically distinct" clusters. They also did genetic analyses, and compared disease progression, treatment, and development of complications for each type.

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.

There were patients whose cells also stopped producing insulin, but not due to their immune system; they were often young and in otherwise good shape.

In studies it lowered blood glucose levels and reversed insulin resistance in mice with Type 2 diabetes. Type 1 was a result of autoimmune conditions wherein insulin hormones would be necessary to correct its deficiency while type 2 diabetes was associated with an imbalance of insulin need and supply and utilization within the body.

The results were confirmed using data from 5,795 other adult patients across another three further databases from Sweden and Finland.

The fifth and most common cluster, which comprised almost 40% of patients with adult-onset diabetes, was marked by an older age of diabetes onset, without as poor a metabolic profile as other clusters.

"Implementing this clustering in the clinic could both guide the choice of therapy and help identify patients with a high risk of diabetic complications", lead author, Emma Ahlqvist, PhD, Lund University, told MD Magazine.

Thus, the need for new and better treatment options is great, Lund University said in a statement.

Breaking popular perceptions about there being only two types of Diabetes - Type I which onsets in childhood and Type II which is more of a lifestyle disorder - a study by medical journal The Lancet has gone on to say that there are at least five types of adult diabetes.

"Meanwhile, there are many drugs available for controlling blood sugar levels. A more accurate diagnosis can be made by also considering the factors accounted for in ANDIS - All New Diabetics In Skane (in Sweden)", Groop said. This group had a low proportion of patients taking metformin, although the authors say they would be expected to benefit the most from the drug.

The six metrics used in the study include age at diagnosis, BMI, the presence of certain antibodies linked to autoimmune diabetes, insulin sensitivity measures and blood glucose control measures.

The largest group of the disease was one of the more moderate forms and was seen in elderly people, affecting 39-47% of patients (cluster 5/ mild age-related diabetes (MARD)).

Severe insulin-deficient diabetes (SIDD): GADA-negative but otherwise similar to SAID.

The researchers plan to launch similar studies in China and India.

Improved understanding may allow necessarily treatment to be tailored and help us recognise which patients are more likely to develop complications.

According to researchers, the more specific categorization could lead to a more targeted and personalized treatment for diabetes.

Cluster 4 - mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically were closer to normal than those in cluster 3.

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