New diabetes classification could lead to better treatments

Researchers propose 5 distinct types of adult-onset diabetes

The researchers, led by experts at Lund University, last night said the findings should prompt a "paradigm shift" in the way people treat diabetes.

Researchers then distinguished 5 distinct clusters that differ from today's classification: 3 severe and 2 mild forms of the disease.

Severe autoimmune diabetes is largely the same as the classical type 1.

It has always been known that type-2 diabetes is highly variable, but classification has remained unchanged for decades. They explain that this method of classification could also be used in clinical trials for drugs used in diabetics for better results and deeper understanding of the mechanism of action of the drugs.

Emma Ahlqvist, Ph.D., from Lund University in Sweden, and colleagues used data from the Swedish All New Diabetics in Scania cohort to do data-driven, cluster analysis in 8,980 patients with newly diagnosed diabetes.

Some of the overlapping features include the fact that clusters 3, 4 and 5 were prescribed similar anti-diabetic treatment and they responded well.

Severe insulin-resistant diabetes patients, generally overweight and producing insulin, which their body was no longer responsive to.

The outcomes, distributed in The Lancet Diabetes and Endocrinology, demonstrated the patients could be separated into five particular groups. As in cluster 1, strikes young and healthy people, but the immune system isn't at fault. Those with type 2 diabetes, who make up around three-quarters of all cases, either stop producing as much insulin they once did, or they stop responding to the presence of insulin as easily.

Mild diabetes related to obesity mainly observed in people who were very overweight, but closer to the norm than those in cluster 3 in terms of their metabolic system. Now researchers have come up with a five subgroup classification for diabetes to differentiate between their risks and related complications.

The results were checked against three other studies from Sweden and Finland. I only have to look at my mum's workload to see that: as a diabetes specialist nurse, she's busier than ever, supporting patients throughout day to day management of their condition and some of the more serious complications of the disease, from blindness to kidney failure and limb amputation.

In addition to a more refined classification, the researchers also discovered that the different groups are more or less at risk of developing various secondary diseases. Mild form of diabetes developed by older people. New research confirms that in general it's most commonly diagnosed in the young.

Now just over six people in every hundred have diabetes in the county - a shade under the national average of 6.6 but enough, says Diabetes UK, to cause concern.

The researchers are also planning to launch similar studies in China and India with people of different ethnic backgrounds. Future research will be needed to test and refine the five types.

They believe that the study might help tailor and target treatment and lay the foundation for precision medicine in the future. The clusters and associated complications will need to be verified in other populations, including other ethnicities that may have a different risk of diabetes, such as Asian populations.

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