Results of a Swedish study (ANDIS) have indicated that there are more than two types of diabetes, meaning the need for new and better treatment options is greater than ever.
Since 2008, researchers have been monitoring 13,720 diagnosed patients between 18 and 97 years of age, combing measurements of insulin resistance, blood sugar levels, insulin secretion and age at onset of illness, in a bid to understand the various types of diabetes.
Around 425 million people in the world have diabetes, and according to the International Diabetes Federation the number is expected to have increased to 629 million by 2045.
What are the five types of diabetes?
The major difference from today’s classification is that Type 2 diabetes does, in fact, comprise several subgroups, the results indicate:
- Group 1: Severe autoimmune diabetes (SAID) – Corresponds to Type 1 diabetes and latent autoimmune diabetes in adults (LADA) and is characterised by onset at a young age, poor metabolic control, impaired insulin production and the presence of GADA antibodies;
- Group 2: Severe insulin-deficient diabetes (SIDD) – Includes individuals with high HbA1C, impaired insulin secretion and moderate insulin resistance. This group had the highest incidence of retinopathy;
- Group 3: Severe insulin-resistant diabetes (SIRD) – Characterised by obesity and severe insulin resistance. This group had the highest incidence of kidney damage;
- Group 4: Mild obesity-related diabetes (MOD) – Includes obese patients who fall ill at a relatively young age; and
- Group 5: Mild age-related diabetes (MARD) – This is the largest group and consists of the most elderly patients.
The researchers repeated the analysis in a further three studies from Sweden and Finland.
Leif Groop, physician and professor of diabetes and endocrinology at Lund University, Sweden, said: “Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment.
“This is the first step towards personalised treatment of diabetes.”
He added: “The outcome exceeded our expectations and highly corresponded with the analysis from ANDIS. The only difference was that Group 5 was larger in Finland than in Skåne. The disease progression was remarkably similar in both groups.”
Diagnosing secondary diseases
In addition to the number of refined classifications, the researchers also discovered that the different groups are more or less at risk of developing various secondary diseases, such as kidney failure, amputations, retinopathy and cardiovascular diseases.
Emma Ahlqvist, associate professor and lead author of the publication, said: “This will enable earlier treatment to prevent complications in patients who are most at risk of being affected.”
Ahlqvist said that the longer the study runs, the better the data will get. The researchers are also planning to launch similar studies in China and India with people of different ethnic backgrounds.
These results have been published in The Lancet Diabetes & Endocrinology.
I very much agree with the sub typing of diabetes to 5 categories. I am practising Diabetology since last 28 years and found this new classification helpful to decide individualise treatment. Of all five, the last three subtypes are potentially reversible as far as my experience counts. I want to learn more about this.