Lancet Research suggests five types of diabetes, treatment needs differ

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Diabetes falls into five categories rather than two, according to a study that promises new personalised treatments.

The study could not confirm if the five types have different causes, nor if patients' type changes over time. "There are really subsets of the disease that require different treatment".

Diabetes is now divided into two major groups - Type-1 diabetes which accounts for around 10 per cent of the cases and Type-2 diabetes which accounts for 85-90 per cent of the cases.

There are five distinct types of diabetes that can occur in adulthood, rather than the two now recognised, they reported in The Lancet Diabetes & Endocrinology, a leading medical journal.

The first results of ANDIS - a study covering all newly diagnosed diabetics in southern Sweden-can be seen now.

Dr Waqas Tahir, GP and clinical lead for diabetes at Bradford Care Alliance, said: "Diabetes is one of the biggest health challenges people face in Bradford district". Researchers replicated the findings in three further independent cohorts: the Scania Diabetes Registry (n = 1,466), All New Diabetics in Uppsala (n = 844) and Diabetes Registry Vaasa (n = 3,485).

"Implementing this clustering in the clinic could both guide the choice of therapy and help identify patients with a high risk of diabetic complications", lead author, Emma Ahlqvist, PhD, Lund University, told MD Magazine.

Researcher at the Institute for Molecular Medicine in Finland, also involved in the study, said the results marked a 'paradigm shift, in the way diabetes could be treated in the future.


The team, from Lund University and the Institute for Molecular Medicine in Helsinki, examined data from 14,625 patients in five cohorts between January 2008 and November 2016.

Recent research from Sweden suggests that the two-pronged classification of diabetes-as type 1 or 2-may not be the best method for diagnosing and treating the disease.

Clusters 3 and 4 describe diabetes in generally overweight individuals with insulin resistance, but those in Cluster 4 are metabolically closer to normal compared to those in Cluster 3.

"Today, diagnoses are performed by measuring blood sugar", Groop said.

And the final group, mild age-related diabetes, is the largest group, with 40 per cent of all patients, and consists mostly of elderly patients.

There were 6 measurements analyzed that are used to monitor those with diabetes: age at onset of illness, body mass index, long-term glycemic control, insulin resistance, insulin secretion and presence of auto-antibodies associated with autoimmune diseases.

The authors noted that more research is needed on the issue.

The researchers are also planning to launch similar studies in China and India with people of different ethnic backgrounds. The most common cluster. Cluster 3 (n = 1,373) was characterized by severe insulin resistance and high BMI, whereas cluster 4 (n = 1,942) was characterized by obesity, but not insulin resistance. 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.

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