Study could help diabetics receive tailored treatment

Scientists identify five sub-categories of diabetes helping explain why not all patients respond the same way

Diabetics could benefit from a more tailored approach to their treatment after researchers in Sweden found the condition has five categories, rather than two.

Findings from a study of 13,270 subjects at Lund University in Sweden have helped explain why not all diabetes patients respond in the same way to treatment.

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

Type one diabetes is an autoimmune condition that prevents the pancreas from producing insulin, whilst type two is often referred to as a lifestyle related condition, commonly triggered by obesity.

Scientists have found type two diabetes should be classified with four sub categories, dependent on age and severity of the condition.

They said a refined classification could provide a powerful tool to individualise treatment and identify individuals with increased risk of complications at diagnosis, such as nerve damage, cardio vascular disease or skin conditions.


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The study identified five replicable clusters of patients with diabetes, which had significantly different patient characteristics and risk of associated complications.

Those in cluster 3 who were most resistant to insulin were found to be significantly more at risk of diabetic kidney disease than those in clusters 4 and 5, despite being prescribed the same treatment.

Insulin deficient patients in cluster 2 had the highest risk of retinopathy, leading to sight loss.

Researcher at the Institute for Molecular Medicine in Finland, also involved in the study, said the results marked a ‘paradigm shift, in the way diabetes could be treated in the future.

The results have been published in The Lancet: Diabetes and Endocrinology.

         Cluster 1 - severe autoimmune diabetes, similar to the classical type 1, affected younger people who were otherwise healthy.

         Cluster 2 - severe insulin-deficient diabetes patients were similar to those in cluster 1, but the immune system was not at fault.

         Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and producing insulin, but their body was no longer responding to it.

         Cluster 4 - mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically were closer to normal than those in cluster 3.

         Cluster 5 – age related diabetes with patients developing symptoms when they were significantly older than other groups.