Published: Sun, March 04, 2018
Health Care | By Oscar Goodwin

Five Distinct Subgroups of Patients With Diabetes Identified

Five Distinct Subgroups of Patients With Diabetes Identified

"This is the first step towards personalized treatment of diabetes", Dr. Leif Groop, a physician and professor of diabetes and endocrinology at Lund University in Sweden, said in a press release.

Diabetes that begins in adulthood falls into five distinct categories, new research has revealed, with scientists suggesting it is time to ditch the idea that diabetes is largely split into two types.

"Both type 1 and type 2 diabetes are serious conditions that can lead to devastating complications such as amputation, blindness, kidney disease, stroke and heart disease if people don't receive a timely diagnosis and begin receiving the right care".

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.

The most severe cluster of the five is defined similarly to classical type 1 diabetes, while the remaining four clusters represent subtler subtypes of type ii diabetes.

These findings are based on initial results of ANDIS - a study covering all newly diagnosed diabetics in southern Sweden.

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Given the complex genetic and environmental factors that can affect the onset of diabetes and are still not well understood, some scientists predict that these "clusters" could grow, eventually allowing diagnoses' and treatment plans to become ever more accurate and effective.

It has always been known that type-2 diabetes is highly variable, but classification has remained unchanged for decades.

Group 2, the severe insulin-deficient diabetes, includes individuals with impaired insulin secretion and moderate insulin resistance.

New research suggests that diabetes may actually be five different diseases rather than two separate types as previously thought. 11 to 17 per cent showed severe insulin resistance and a high risk of kidney disease.

"Today, diagnoses are performed by measuring blood sugar", Groop said.

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. Cluster 5 (n = 3,513) was described as mild, age-related diabetes with older patients but only modest metabolic derangements, according to researchers. The 5 types of the disease found are associated with different characteristics and complications, illustrating a variety of treatment methods needed. The fifth group was made of patients who developed diabetes later on in life; they also had the mildest symptoms.

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

Other researchers caution that the team's results need to be replicated elsewhere, using even more diverse patient samples.

The findings could help doctors provide diabetes patients with tailored treatment programs - also called "precision medicine" - and help explain why some patients respond to medications differently. Cluster 1 (n = 577) was characterized by early-onset disease, low BMI, poor metabolic control, insulin deficiency and presence of GADA.

The researchers are also planning to launch similar studies in China and India with people of different ethnic backgrounds.

Cluster 4 (21.6 percent): Obese by not insulin resistant, labeled as mild obesity-related diabetes.

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