One in eleven of us has been diagnosed with diabetes, but new research suggests that there could be five categories of the disease- here’s why, and how it’s a positive for treatment prospects…
Diabetes : it’s a life-long health condition, and it’s on the rise. I only have to look at my mum’s workload to see that: as a diabetes specialist nurse, she’s busier than ever, supporting patients throughout day to day management of their condition and some of the more serious complications of the disease, from blindness to kidney failure and limb amputation. New research published in the Lancet Diabetes and Endocrinology indicates, however, that treatment could be even more personalised and precise, and scientists think that, in addition to the currently recognised diabetes type 1 and type 2 , diabetes can also be split into type 3, 4 and 5.
A study conducted by scientists at Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine in Finland analysed the blood sugar levels of 14,775 patients, and from their observations of the disease concluded that diabetes could in fact be split into five diagnoses’, rather than two:
Cluster 1: A severe autoimmune condition whereby the body attacks and destroys insulin producing cells, meaning that the body doesn’t produce any insulin and as a result blood sugar levels are not controlled. New research confirms that in general it’s most commonly diagnosed in the young. 6.4 per cent of patients in the study were thought to be affected by this type of diabetes.
Cluster 2: This category is labelled ‘severe insulin-deficient diabetes’, affecting 17.5 per cent of patients, As above, those in this bracket tend to be young and at a healthy weight, but it’s not thought that the immune system is implicated in the development of diabetes. These patients had a higher risk of blindness.
Cluster 3: Severe insulin resistant diabetes, affecting 15.3 per cent of patients studied. People with this type were overweight, and while still making insulin, their bodies weren’t responding to it. These patients were at a higher risk of developing kidney disease.
Cluster 4: Mild obesity related diabetes, seen in 21.6 per cent of patients. People in this category were generally very overweight.
Cluster 5: Mild age related diabetes, affecting 39.6 per cent of patients. As the name indicates, this type was recognised to affect older people, with milder symptoms.
At present, according to Diabetes UK , of those diagnosed with diabetes in the UK, 10 per cent have type 1 and 90 per cent type 2, but these new sub categories could explain why some patients respond well to certain treatments while others do not. Given the complex genetic and environmental factors that can affect the onset of diabetes and are still not well understood, some scientists predict that these ‘clusters’ could grow, eventually allowing diagnoses’ and treatment plans to become ever more accurate and effective. While no cure exists, and any changes to current treatment are likely a good way off, exploring the root causes and various manifestations of diabetes is a positive step forward for the development of new medicines that could in future reduce or prevent some of the most serious complications from arising. Professor Leif Groop, who led the study, told the BBC that the research advances the prospect of more tailored treatment in the future for those with all types of diabetes:
“This is the first step towards personalised treatment of diabetes. In the ideal scenario, this is applied at diagnosis and we target treatment better.”
With more aggressive possible treatment plans for severe forms of the disease, and potential new avenues of knowledge as to the best lifestyle, diet and medication pathways for all diabetes patients, perhaps the so-called diabetes epidemic can be slowed for future generations, or at least controlled.