Scandinavian Study Proposes Splitting Diabetes into Five Types

Diabetes insulin-syringe

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.

The findings are consistent with the growing trend toward "precision medicine", which takes into account differences between individuals in managing disease.

"The most insulin resistant patients (Group 3) have the most to gain from the new diagnostics as they are the ones who are now most incorrectly treated", Groop said. If someone has Type 1 diabetes, their pancreas does not create insulin. They tested these across three more cohorts of patients, consisting of 5795 people.

The disease is now classified by doctors in two forms, either type one or type two.

Get the latest health and science news, plus: burning questions and expert tips. The first group basically fit the bill of type 1 cases: Young, otherwise healthy people whose insulin supply was demolished by their immune system.

The figures show that the number of people who have been diagnosed with type 1 and type 2 diabetes has increased by an estimated 10,533 in the past year - from 283,922 to 294,455.

In the new study lead author Prof Xuilong Xu and colleagues discovered that leflunomide not only normalised blood glucose levels, but caused cells to start responding to insulin again. In it, they created five categories of diabetes instead of two.

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.

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The study can not confirm that the five types of adult-onset diabetes have different causes, nor whether patients' disease type changes over time. People with this type do not respond to insulin and have a high likelihood of developing liver and diabetic kidney disease.

New Brunswick is giving more attention to diabetes prevention and care by increasing the age limit to avail funding for diabetes-related supplies like insulin pumps.

Cluster 1 (6.4 percent of patients): Early-onset, low BMI, poor metabolic control, insulin deficiency and severe autoimmune diabetes (SAID). And two other clusters, Mild Age-Related Diabetes (MARD) and Mild Obesity-Related Diabetes (MOD) seemed to be more benign forms of diabetes.

For this study, the team looked at All New Diabetics in Scania (ANDIS) cohort comprising of 8,980 newly diagnosed Swedish patients of diabetes.

The researchers noted that a web-based tool to assign patients to specific clusters, provided the appropriate variables have been measured, is under development.

Severe autoimmune diabetes, broadly similar to type 1 in that it affected patients at a younger age leaving them seemingly unable to produce insulin. "It would be reasonable to target individuals in these clusters with intensified treatment", they wrote.

Researchers say the groupings held both for those with newly diagnosed diabetes and those who had long had the disease, further suggesting the five categories are not simply down to different stages of the same form of diabetes - although further work is needed to explore whether patients can move between the types. Of this, a majority - 39 to 47 per cent - were elderly people with mild diabetes while 18-20 per cent were obese.

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