What are the different types of diabetes?

Researchers propose 5 distinct types of adult-onset diabetes

Diabetes falls into five categories rather than two, according to a study that promises new personalised treatments.

The researchers studied 14,775 patients across Sweden and Finland, analysing their genes and comparing disease progression, treatment and development of complications for each type.

Severe autoimmune diabetes, broadly similar to type 1 in that it affected patients at a younger age leaving them seemingly unable to produce insulin. Bodies of largely overweight people no longer respond to insulin being produced.

Diabetes is now divided into two major groups - Type-1 diabetes which accounts for around 10 per cent of the cases and Type-2 diabetes which accounts for 85-90 per cent of the cases.

These types of diabetes were distinct, and included three severe and two mild forms of the disease.

The fifth and most common cluster, which comprised almost 40% of patients with adult-onset diabetes, was marked by an older age of diabetes onset, without as poor a metabolic profile as other clusters.

It has always been known that type-2 diabetes is highly variable, but classification has remained unchanged for decades.

"More accurately diagnosing diabetes could give us valuable insights into how it will develop over time, allowing us to predict and treat complications before they develop", Leif Groop, PhD, professor in the department of clinical sciences at Lund University Diabetes Centre, Sweden, and the Institute for Molecular Medicine Finland, said in a press release.

The team, from Lund University and the Institute for Molecular Medicine in Helsinki, examined data from 14,625 patients in five cohorts between January 2008 and November 2016.

Most people are aware there are two main forms of diabetes, yet new research has suggested that splitting type 2 diabetes into five separate sub-diseases could benefit people living with the condition.

"To support people to maintain a healthy weight and be more active, Bradford City and Bradford District Clinical Commissioning Groups (CCGs) are offering people at significant risk of diabetes across Bradford a place on the new NHS diabetes prevention programme".

"Meanwhile, there are many drugs available for controlling blood sugar levels".

Severe insulin-deficient diabetes (SIDD): GADA-negative but otherwise similar to SAID.

Patients within each cluster demonstrated different kinds of health risks. Diabetic ketoacidosis was more frequent in clusters 1 and 2, whereas cluster 3 had the highest prevalence of nonalcoholic fatty liver disease.

The two other categories are mild forms of the disease with one of them, known as mild obesity-related diabetes, linked to high BMI and the other, mild age-related diabetes, generally seen in older patients.

Severe autoimmune diabetes (SAID): this tended to start at a younger age, in people with a relatively low BMI, poor blood sugar control, insulin deficiency and GADA. Further research is needed to see whether these 5 clusters hold true for non-Scandinavian populations.

They believe the more precise groupings - each genetically distinct - will aid diagnosis, help tailor treatments and lead to precision medicines.

He said that this would lead to more precise diagnosis and treatment of diabetes tailored to individual needs.

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