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Scientists say diabetes is five separate diseases, and treatment could be tailored to each form.<\/p>\nScientists say diabetes is five separate diseases, and treatment could be tailored to each form.<\/p>\n
Diabetes – or uncontrolled blood sugar levels – is normally split into type 1 and type 2.<\/p>\n
But researchers in Sweden and Finland think the more complicated picture they have uncovered will usher in an era of personalised medicine for diabetes.<\/p>\n
Experts said the study was a herald of the future of diabetes care but changes to treatment would not be immediate.<\/p>\n
Diabetes affects about one in 11 adults worldwide and increases the risk of heart attack, stroke, blindness, kidney failure and limb amputation.<\/p>\n
Type 1 diabetes is a disease of the immune system, which affects around 10% of people with the condition in the UK. It errantly attacks the body's insulin factories (beta-cells) so there is not enough of the hormone to control blood sugar levels.<\/p>\n
Type 2 diabetes is largely seen as a disease of poor lifestyle as body fat can affect the way the insulin works.<\/p>\n
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.<\/p>\n
The results, published in The Lancet Diabetes and Endocrinology, showed the patients could be separated into five distinct clusters.<\/p>\n
Cluster 1 – severe autoimmune diabetes is broadly the same as the classical type 1 – it hit people when they were young, seemingly healthy and an immune disease left them unable to produce insulin<\/p>\n
Cluster 2 – severe insulin-deficient diabetes patients initially looked very similar to those in cluster 1 – they were young, had a healthy weight and struggled to make insulin, but the immune system was not at fault<\/p>\n
Cluster 3 – severe insulin-resistant diabetes patients were generally overweight and making insulin but their body was no longer responding to it<\/p>\n
Cluster 4 – mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically much closer to normal than those in cluster 3<\/p>\n
Cluster 5 – mild age-related diabetes patients developed symptoms when they were significantly older than in other groups and their disease tended to be milderProf Leif Groop, one of the researchers, told the BBC: “This is extremely important, we're taking a real step towards precision medicine.<\/p>\n
“In the ideal scenario, this is applied at diagnosis and we target treatment better.”<\/p>\n
The three severe forms could be treated more aggressively than the two milder ones, he said.<\/p>\n
Cluster 2 patients would currently be classified as type 2 as they do not have an autoimmune disease.<\/p>\n
However, the study suggests their disease is probably caused by a defect in their beta-cells rather than being too fat.<\/p>\n
And perhaps their treatment should more closely mirror patients who are currently classed as type 1.<\/p>\n
Cluster 2 had a higher risk of blindness while cluster 3 had the greatest risk of kidney disease, so some clusters may benefit from enhanced screening.<\/p>\n
Better classification<\/strong><\/p>\n Dr Victoria Salem, a consultant and clinical scientist at Imperial College London, said most specialists knew that type 1 and type 2 was “not a terribly accurate classification system”.<\/p>\n She told the BBC: “This is definitely the future of how we think about diabetes as a disease.”<\/p>\n But she cautioned the study would not change practice today.<\/p>\n The study was only on Scandinavians and the risk of diabetes varies considerably around the world, such as the increased risk in South Asians.<\/p>\n Dr Salem said: “There is still a massively unknown quantity – it may well be that worldwide there are 500 subgroups depending on genetic and local environment effects.<\/p>\n “Their analysis has five clusters, but that may grow.”<\/p>\n Sudhesh Kumar, a professor of medicine at Warwick Medical School, said: “Clearly this is only the first step.<\/p>\n “We also need to know if treating these groups differently would produce better outcomes.”<\/p>\n Dr Emily Burns, from Diabetes UK, said understanding the diseases could help “personalise treatments and potentially reduce the risk of diabetes-related complications in the future”.<\/p>\n She added: “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.”BBC.<\/p>\n","protected":false},"excerpt":{"rendered":" Scientists say diabetes is five separate diseases, and treatment could be tailored to each form. Diabetes – or uncontrolled blood sugar levels – is normally split into type 1 and type 2. But researchers in Sweden and Finland think the more complicated picture they have uncovered will usher in an era of personalised medicine for […]<\/p>\n","protected":false},"author":7,"featured_media":41932,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[19],"tags":[],"yoast_head":"\n\n\n\n\n\n\n\n\n\n\n\n\t\n\t\n\n\n\t\n