Researchers ID Five Distinct Adult-Onset Diabetes Subgroups

There is often confusion between MODY and Type 1 Diabetes as both are found to affect young people or children. Type 1 Diabetes is diagnosed in those suffering from MODY leading to misdiagnosis

There is often confusion between MODY and Type 1 Diabetes as both are found to affect young people or children. Type 1 Diabetes is diagnosed in those suffering from MODY leading to misdiagnosis

Cluster 1: This is a severe autoimmune form of diabetes - close to type 1 diabetes - affecting around 6% to 15% of participants.

Type 1 is an auto-immune disease which can not now be cured.

Around a fifth of all participants were classified in cluster 4. As the name indicates, this type was recognised to affect older people, with milder symptoms.

"Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment", explained Groop, who initiated the study.

"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". One corresponded to type 1 diabetes and the other 4 were subtypes of type 2 diabetes.

The study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, looked at 14,775 patients including a detailed analysis of their blood. Retinopathy risk was highest in cluster 2, which was insulin deficient. To demonstrate their argument, they analyzed health data from almost 15,000 Swedish people with type 2 diabetes, focusing on six variables that had been measured and recorded at the time of their diagnosis: age, body mass index, the presence of beta-cell antibodies, level of metabolic control and measures of beta-cell function and insulin resistance.

Future research is also needed to test and refine the 5 types to include biomarkers, genotypes, genetic risk scores, blood pressure and blood lipids.

"Type 1 diabetes isn't now preventable, but three in five cases of Type 2 diabetes can be prevented or delayed with a healthy lifestyle and better understanding of the condition".

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Millions more are thought to have prediabetes, or blood sugar levels that are above the normal range but not yet high enough to be classified as diabetic.

The study involved four cohort studies of 14775 adults who had been recently diagnosed with diabetes across Sweden and Finland. A recent analysis found that the number of people with diabetes in the United Kingdom had doubled in the past 20 years.

The rest were fairly young and not obese, but had severe forms of diabetes. Identified in 39% of the people in ANDIS.

Additionally, the findings concluded that the different subgroups are more or less at risk of developing various secondary disease.

How did the researchers interpret the results?

"This new substratification might eventually help to tailor and target early treatments to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes", the researchers said. "By contrast with previous attempts to dissect the heterogeneity of diabetes, we used variables reflective of key aspects of diabetes that are monitored in patients".

The young people suffering from Type 1 diabetes now have easy access to medical care.

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. And it only involved Scandinavian patients, so will need to be confirmed in other populations.

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