Wednesday, 25 April, 2018

Diabetes can be divided into five groups, finds study

Researchers propose 5 distinct types of adult-onset diabetes A Study Proposes Five New Distinct Types of Adult-Onset Diabetes
Jerome Frank | 04 March, 2018, 02:04

"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", says Professor Leif Groop.

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

"Diabetes is not the grey mass we have been calling type 2 - there are really subsets of the disease that require different treatment", said Groop.

After analyzing the data of almost 15,000 diabetics using information taken from four registries in Sweden and Finland, the team found that Type 2 is actually made up of four categories, including two of the most severe types of the disease.

Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and producing insulin, but their body was no longer responding to it. Type 1, an autoimmune condition where insulin is not produced and usually develops in childhood, and Type 2, a condition that develops in later life and is usually linked to obesity.

"Five hundred people are diagnosed with type 2 diabetes across the United Kingdom every day; that's the equivalent of one person every three minutes".

The number of people diagnosed with diabetes in Yorkshire has reached an estimated 294,455, according to new analysis released by Diabetes UK.

"O$3 ur data suggest that the combined information from a few variables central to the development of diabetes is superior to measurement of only one metabolite, glucose", Ahlqvist said.

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

Cluster 2 are severely insulin-deficient patients who were likewise young and healthy, and struggled with insulin, but the cause was not immune system failure.

Scientists at Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland found these two types to be too simplistic.

The researchers describe this as a paradigm shift in how to view the disease and say tailoring treatment to the different types could be more beneficial for patients than current treatment methods. Among the severe forms, one group had severe insulin resistance and a significantly higher risk of kidney disease than the other types (affecting 11-17% of patients).

"Today, diagnoses are performed by measuring blood sugar. A more accurate diagnosis can be made by also considering the factors accounted for in ANDIS - All New Diabetics In Skane (in Sweden)", Groop said.

Another type of severe insulin-resistant diabetes is predominantly linked to obesity.

The findings could help doctors provide diabetes patients with tailored treatment programs - also called "precision medicine" - and help explain why some patients respond to medications differently.

The authors noted that more research is needed on the issue.

However, this study alone is not sufficient to lead to changes in diabetes treatment guidelines, as it was only based on groups of diabetes patients in Scandinavia.

Furthermore, maybe their treatment should all the more intently reflect patients who are right now classed as type 1.

Another group facing serious complications was composed of relatively young, insulin-deficient patients.

In the ANDIS study, blood samples were taken from people at registration, allowing the researchers to analyse their DNA and blood chemistry.

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