Are there actually five types of diabetes rather than two?
04/03/18Diabetes affects about one in 11 adults worldwide and increases the risk of heart attack, stroke, blindness, kidney failure and limb amputation.
My stepfather has been battling type-1 diabetes for over 40 years, but struggles to control his condition. Type 1 diabetes affects around only 10% of people with the condition in the UK. It attacks the body's insulin preventing the natural control of blood sugar levels.
However, it is our children who are at risk. According to estimates from Public Health England, two thirds of adults and a quarter of children between two and 10 years old are overweight or obese. We will see a significant increase in Type 2 diabetes, which is largely seen as a disease of poor lifestyle and linked to obesity.
The recent study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, looked at 14,775 patients. The results, published in The Lancet Diabetes and Endocrinology, showed that these patients could be separated into five distinct clusters.
- 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
- 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
- Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and making insulin but their body was no longer responding to it
- 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
- Cluster 5 - mild age-related diabetes patients developed symptoms when they were significantly older than in other groups and their disease tended to be milder.
Dr Emily Burns, from Diabetes UK, said: "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."
Getting treatment for diabetes right is so important, particularly, if according to Simon Stevens, Chief Executive of NHS England: “Obesity is the new smoking”.
Diabetes is five separate diseases, and treatment could be tailored to each form.