Scientists identify diabetes as five separate diseases

03 March 2018

Scientists have identified diabetes as five separate diseases, and treatment could be tailored to each form.

Diabetes - or uncontrolled blood sugar levels has been thought of as type 1 and type 2.

However, researchers in Sweden and Finland think the more complicated picture they have uncovered would lead to personalised medicine for diabetes.

According to experts, the study would herald the future of diabetes care but changes to treatment would not be immediate.

About one in 11 adults worldwide suffers from diabetes which also increases the risk of heart attack, stroke, blindness, kidney failure and limb amputation.

Type 1 diabetes, an immune system disease affects around 10 per cent of people with the condition in the UK. It errantly attacks the body's insulin factories (beta-cells) leaving insufficient amounts of the hormone to control blood sugar levels.

Type 2 diabetes is largely seen to be a disease of poor lifestyle as body fat can affect the way the insulin works.

The study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, studied 14,775 patients including a detailed analysis of their blood.

According to the results published in The Lancet: Diabetes and Endocrinology, the patients could be separated into five distinct clusters.

  • Cluster 1: severe autoimmune diabetes is much like the classical type 1 - it hits people at a young age, seemingly healthy and as an immune disease leaves them unable to produce insulin
  • Cluster 2: severe insulin-deficient diabetes patients were much like those in cluster 1 - they were young, had a healthy weight and struggled to make insulin, but the immune system was not at fault
  • Cluster 3: severe insulin-resistant diabetes patients were generally overweight, making insulin but their bodies were no longer responding to it
  • Cluster 4: mild obesity-related diabetes mainly affects people who are very overweight but metabolically much closer to normal than those in cluster 3
  • Cluster 5: mild age-related diabetes patients develop symptoms when they are significantly older than in other groups and their disease tends to be milder

The research article, published in The Lancet: Diabetes & Endocrinology, calls for an updated diabetes classification system. The current system ''has not been much updated during the past 20 years,'' the authors wrote in their paper, ''and very few attempts have been made to explore heterogeneity of type 2 diabetes''-despite calls from expert groups over the years to do so.

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