Diabetes mellitus reclassified into 5 subtypes

Emma Ahlqvist PhD Associate Professor Lund University

Emma Ahlqvist PhD

Researchers identified genetically marked groupings of the disease that vary by severity, age at which they most often occur and probable complications.

Unlike type 1 diabetes, type 2 diabetes is incredibly common and accounts for 80-90 per cent of all cases of the disease.

The three severe forms could be treated more aggressively than the two milder ones, he said. People with this type were overweight, and while still making insulin, their bodies weren't responding to it.

The anti-inflammatory drug, lefluonamide, lowered blood glucose levels and reversed insulin resistance in mouse models of type-2 diabetes, which suggests that this therapy could be repurposed as an effective antidiabetic treatment, particularly suitable for patients with both diabetes and rheumatoid arthritis.

Researchers in Sweden and Finland have classified five distinct types of diabetes that can occur in adulthood, instead of the two now recognized.

The team analysed data on newly diagnosed patients from the Swedish All New Diabetics in Scania cohort, to arrive at their findings.

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According to the authors of the report, the results of their study show that there are distinct clusters of patients with diabetes - especially adult onset diabetes.

Diabetes is now classified into Type 1 and Type 2 diabetes.

Cluster 2 had the highest risk of retinopathy, which can cause blindness.

"Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment", said lead author Leif Groop, an endocrinologist at the Lund University Diabetes Center in Sweden as well as the Folkhalsan Research Centre in Finland, in a statement. This development was made by the experts from Lund University.

"Today, diagnoses are performed by measuring blood sugar", Groop said. These clusters can also understand the disease mechanism better they write adding that they used the key parameters that are used to monitor diabetes.

Most of the patients (nearly 40 percent) in the cohort belonged to the cluster 5.

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Each cluster has different risks associated with it, and patients could respond better to different treatments, researchers say. They were also among the lowest proportion of patients taking the drug metformin, usually prescribed to treat Type 2 diabetes, but the study says they would get the most benefit from it.

Initially looked very similar to cluster 1, but the immune system in these patients was not at fault.

The categories were discovered by considering six different metrics, including a measure of blood glucose control, age at diagnosis, BMI, the presence of certain antibodies linked to autoimmune diabetes, and a measure of insulin sensitivity. Further research is needed to see whether these 5 clusters hold true for non-Scandinavian populations.

Group 4, MOD (mild obesity-related diabetes): includes obese patients who fall ill at a relatively young age.

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

Dr. Victoria Salem, a consultant and clinical scientist at Imperial College London, told the BBC that the study was a step forward for diabetes treatment but that it wouldn't lead to a change in practice just yet.

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