Are there more forms of diabetes than type 1 and type 2?
More and more people in Germany suffer from diabetes. So far, a distinction has always been made between type 1 diabetes and type 2 diabetes. But researchers have now found that adult diabetes can be divided into five different categories.
In their research, Lund University scientists found that adult diabetes has to be divided into five different categories. The scientists published the results of their study in the English-language journal "The Lancet Diabetes and Endocrinology".
All subgroups differ genetically from one another
The experts explained that all newly classified subgroups are genetically different and have numerous differences, including the age at which they occur and the different risk of complications such as kidney disease. The results provide information about why some diabetics react very differently to the treatment. The new findings could identify diabetics who have a high risk of complications. This would contribute to tailor-made treatment of the disease. Such an individualized therapy could lead to an improved quality of life for patients, explains study author Professor Leif Groop from Lund University.
So far, diabetes has been divided into only two main forms
Diabetes is currently divided into two main forms, both of which have links to genetics. Type 1 diabetes is an autoimmune disease in which the hormone insulin is not produced. This type of diabetes usually develops in childhood. The more common form, type 2 diabetes, produces very little insulin or there is no glucose uptake by the body's cells. This form of the disease generally develops later in life and is often associated with obesity. The latest study suggests that this classification of diabetes is too easy.
Doctors examined 8,980 diabetics
In their investigation, the researchers have now discovered five subgroups by analyzing the data from a total of 8,980 diabetics from Sweden. The results were confirmed using data from 5,795 other adult patients in three other databases from Sweden and Finland.
Type 2 diabetes actually includes four categories of the disease
The team says the results show that type 1 diabetes and a late autoimmune form of diabetes can be combined into what is known as severe autoimmune diabetes. However, the researchers say that what is commonly referred to as type 2 diabetes actually includes four categories of the disease, two of which are particularly severe forms of the disease.
What is severe insulin deficient diabetes?
A form called severe insulin-deficient diabetes shows features similar to those of the autoimmune group - e.g., a relatively low body mass index (BMI), insulin deficiency, and an early onset in life - but has no telltale antibodies, which indicate an autoimmune disease. So-called diabetic retinopathy occurs most frequently in this group, say the doctors. This group also has the highest proportion of patients using the drug metformin, which is not the optimal treatment for this disease, the scientists explain. Those affected will soon need insulin, almost as much as patients with type 1 diabetes, adds Professor Groop.
What is severe insulin resistant diabetes?
The other severe category, known as severe insulin-resistant diabetes, is associated with obesity and shows a strong tendency for the body's cells to not respond to insulin, and these patients are most likely to have liver disease, chronic kidney disease and diabetic damage To develop kidney. This group had a small proportion of patients taking metformin, although the authors say they would benefit most from the drug.
What other forms are there?
The other two categories are mild forms of the disease. One of them is called mild obesity diabetes, this form is associated with a high BMI. The other form is the so-called mild age-related diabetes, which generally occurs in older patients. The doctors explain that both categories can be treated with metformin and lifestyle advice.
How were the categories determined in the study?
The categories were determined by considering six different measures, including a measure of blood sugar control, age at diagnosis, BMI, the presence of certain antibodies related to autoimmune diabetes and a measure of insulin sensitivity.
More research is needed
The results of the study are a promising step to differentiate type 2 diabetes in more detail, but more research needs to be done on the subtypes before it can be understood what the sub-forms of the disease mean for people who have diabetes experts say. (as)