A paradigm shift in the diagnosis of diabetes

Diabetes insulin-syringe

She included: "This examination steps toward separating type 2 diabetes in more detail, yet regardless we have to find out about these subtypes before we can comprehend what this implies for individuals living with the condition".

Cluster 5: Mild diabetes among mostly older patients, accounting for 34 to 47% of cases.

Writing in a linked comment, Dr Rob Sladek, McGill University and Génome Québec Innovation Centre, Canada, says: "Diabetes is a group of chronic metabolic disorders that share the common feature of hyperglycaemia, meaning that, in principle, diabetes can be diagnosed via measurement of a single blood component".

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The scientists found one autoimmune type of diabetes - a condition in which the body produces chemicals that destroy insulin.

The three serious structures could be dealt with more forcefully than the two milder ones, he said. People with this type were overweight, and while still making insulin, their bodies weren't responding to it.

Based on these criteria, between 75% and 85% of people with diabetes are classified with type 2, the authors wrote in their paper.

Nearly 10 percent of the US population-30.3 million people-has a form of diabetes, according to the Centers for Disease Control and Prevention. 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.

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Writing in the journal The Lancet Diabetes and Endocrinology, researchers describe how they discovered the five sub-groups by analysing information from 8,980 diabetics diagnosed as adults in a Swedish registry. For example, those in cluster 2 (insulin-deficient) had the highest risk of losing eyesight, while patients in cluster 3 (most resistant to insulin) showed a higher risk of developing diabetic kidney disease.

Severe autoimmune diabetes or SAID or Cluster one was least common with only 6.4 percent affected.

The anti-inflammatory drug, lefluonamide, lowered blood glucose levels and reversed insulin resistance in mouse models of type-2 diabetes, which suggests that this therapy could be repurposed as an effective antidiabetic treatment, particularly suitable for patients with both diabetes and rheumatoid arthritis.

Dr. Kathleen Wyne, an endocrinologist at The Ohio State University Wexner Medical Center, who was not involved with the study, said that the new classification could be very useful, but stressed that the researchers aren't suggesting getting rid of type 1 and type 2 diagnoses.

Ahlqvist's group noted that a web-based classification tool is now under development.

The three severe forms could be treated more aggressively than the two milder ones, he said. They may explain why diabetics respond differently to treatment.

The study could not confirm if the five types have different causes, nor if patients' type changes over time. The new substratification might help to tailor and target early treatment to those who would benefit most.

The most severe cluster of the five is defined similarly to classical type 1 diabetes, while the remaining four clusters represent subtler subtypes of type ii diabetes.

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