Researchers announced on Friday that diabetes is five separate diseases and that treatment should be specifically tailored to each form, according to BBC News.
Diabetes is a disease where the body is incapable of responding or producing of the hormone insulin to regulate blood sugar levels and is normally split into type 1 and type 2, but scientists in Sweden and Finland say the picture is actually far more complicated.
The new research says that the future of diabetes treatment will likely be far more personalized, though changes to treatment would not be immediate.
Diabetes affects around one in 11 million adults worldwide and increases the risk of blindness, heart attack, stroke, kidney failure, and amputation.
Type 1 diabetes is a disease that affects the immune system as it attacks the body's insulin production factories known as beta-cells, making the body unable to have enough of the hormone to control blood sugar levels.
While type 2 diabetes is a chronic condition that can be reversible with diet and lifestyle changes to affect how insulin works in the body.
The new study from Lund University Diabetes Center in Sweden and the Institute for Molecular Medicine Finland examined 14,775 patients, including a detailed analysis of their blood.
The results were published in The Lancet Diabetes and Endocrinology and showed that the patients could be separated into five clusters.
The first cluster is severe autoimmune diabetes that is broadly similar to type 1, which affects people when they were young and healthy but developed into an immune disease that left them to produce insulin.
Cluster 2 contains severe insulin-deficient diabetes patients that appeared similar to cluster 1, since they developed the condition when they were young and had a healthy weight but the immune system was not at fault for the development of the disease.
The third cluster is severe insulin-resistant diabetes patients that were typically overweight and make insulin, but their bodies are no longer responding to insulin.
The fourth cluster contains patients with mild obesity-related diabetes seen in patients that were very overweight, but metabolically comparable to normal than those in the third cluster.
Cluster 5 was mild age-related diabetes patients that started having symptoms when they were older than the other groups and had milder symptoms than other patients.
Prof. Leif Groop, one of the researchers on the project, said, "This is extremely important, we're taking a real step towards precision medicine. In the ideal scenario, this is applied to diagnosis and we target treatment better."
Groop said that the three sever forms could be treated more aggressively than the two milder groups.
The second cluster of patients would be classified as type 2 since they do not have an autoimmune disease, but the study suggests that the disease is caused by a defect in their beta-cells rather than being overweight and their treatments should be closer to patients classified as type 1 diabetes.
Researchers found that cluster 2 had a higher risk for blindness, while cluster 3 had the highest risk for developing kidney disease, so Groom said that certain groups could benefit from enhanced screenings catered to their increased risks.
Dr. Victoria Salem, a consultant and clinical scientist at Imperial College London, said that many specialists were aware that type 1 and type 2 were "not a terrible accurate classification system."
Dr. Salem agreed that the study was "definitely the future of how we think about diabetes as a disease."
However, she also warned that the study was only conducted on Scandinavians and that the risk around the world for diabetes was variable, including an increased risk for South Asians.
"There is still a massively unknown quantity - it may well be that worldwide there are 500 subgroups depending on genetic and local environmental effects. Their analysis has five clusters, but that may grow," Dr. Salem said.
Prof. Sudhesh Kumar who works as a professor of medicine at Warwick Medical School said, "Clearly, this is only the first step. We also need to know if treating these groups differently would produce better outcomes."
Dr. Emily Burns with Diabetes U.K. said that a better understanding of diabetes could improve personalizing the treatments in the future and decrease risks associated with the disease in the future.
"This research takes a promising step toward breaking down type 2 diabetes in more detail, but we still need to know more about these subtypes before we can understand what this means for people living with the condition," Dr. Burns said.
Dpw2683 on March 2nd, 2018 at 06:28 UTC »
Just got diagnosed with type 1 January 4th, 19y/o male. It's crazy the amounts of articles I have come across over the past few months describing how some researcher or medical team has found a new treatment/cure. In a lot of these cases these treatments have still yet to be approved by the FDA, and can take years to get finalized. That said, I think it must be so tiring for people who have had diabetes their whole lives to see articles like this. I'm already tired of it.
binder673 on March 2nd, 2018 at 06:18 UTC »
I never know what to believe with this stuff. For years I have heard we are on the breakthrough for curing type 1 diabetes, but I have been on the same meds for the past 10 years now pretty much with not much change.
StridAst on March 2nd, 2018 at 06:08 UTC »
Reading this, it seems they forgot about gestational diabetes.