Diabetes that begins in adulthood falls into five distinct categories, rather than the two currently recognised, new research has revealed.
Findings shed light on variations in response to treatment between diabetics and could help identify those at high risk of complications.
The study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, looked at 14,775 patients including a detailed analysis of their blood.
Six different measurements were used across four separate studies: age at diagnosis, body mass index, long-term glycaemic control, the function of insulin-producing cells in the pancreas, insulin resistance and the presence of specific autoantibodies linked to autoimmune diabetes.
Researchers found adult-onset diabetes consists of five types of disease that have different physiological and genetic profiles, rather than the traditional type 1 and 2 classification.
Researchers have developed a novel diabetes classification system that calls for five distinct disease etiologies to better target early treatment to patients.
The five unique subgroups based on severity and underlying disease mechanism analysis reported by Emma Ahlqvist, PhD, of Lund University in Sweden, and colleagues were:
Cluster 1: Severe autoimmune diabetes (SAID)
Cluster 2: Severe insulin-deficient diabetes (SIDD)
Cluster 3: Severe insulin-resistant diabetes (SIRD)
Cluster 4: Mild obesity-related diabetes (MOD)
Cluster 5: Mild age-related diabetes (MARD)
All of the newly classified subgroups are genetically distinct and have numerous differences, including the age at which they tend to occur and different levels of risk for complications.
For the patient, I think it will mean a more individualised therapy [and] a better quality of life,” said Leif Groop, professor of diabetes and endocrinology at Lund University, who led the study.
This study moves us towards a more clinically useful diagnosis and represents an important step toward precision medicine in diabetes.
The researchers do note some limitations though: there’s no evidence yet that these five types of diabetes have different causes and the sample only included Scandinavian patients, so a wider study is going to be required to investigate this further.
The study is the first step towards personalized treatment of diabetes. The study was published in the journal The Lancet Diabetes & Endocrinology.