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Diabetes undergoing a ‘paradigm shift’ as 5 types of the disease identified

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New research has suggested that diabetes can be separated into 5 distinct types

A group of Scandinavian scientists have said diabetes can be separated into five different diseases, with specific treatments for each one possible.

The researchers from Sweden and Finland claim they have unearthed a far more complex picture of the disease and that we should give up the idea diabetes can be divided into just two types.

Leif Groop, professor of diabetes at Lund University and author of the study, claimed the results could herald a ‘paradigm shift’ in our understanding of the disease and said it could be the ‘first step towards personalised treatment’.

In the UK there are almost 3.7 million people living with diabetes, with a further 1 million estimated to be undiagnosed. Under current classifications, 90% of these have Type 2 diabetes.

The research, published in the Lancet, and which conducted a detailed analysis of 14,775 patients, argued the disease could be stratified into five distinct categories:

  • Severe autoimmune diabetes (SAID) – This is basically the same as Type 1 diabetes, where one’s immune system is unable to produce insulin and which effects people when they are young.
  • Severe insulin-deficient diabetes (SIDD) – Very similar to SAID, except their immune system was not to blame.
  • Severe insulin-resistant diabetes (SIRD) – For this class of patient, their pancreas was still producing insulin but their bodies were not responding to it. They were generally overweight.
  • Mild obesity-related diabetes (MOD) – This was mainly observed in people who were very overweight, although metabolically more health than those with SIRD.
  • And, mild age-related diabetes (MARD) – This form was linked to older age and tended to be milder and less harmful for patients.

Surprisingly, most specialists already acknowledged the shortcomings of type 1/type 2 split, said Dr Victoria Salem of Imperial College London.

She told the BBC that the incumbent method was ‘not a terribly accurate classification system’ and that ‘this is definitely the future of how we think about diabetes as a disease’.

Prof Groop said diabetes was not ‘the grey mass’ we had previously thought and that ‘there are really subsets of the disease that require different treatments’.

Dr Emily Burns, Head of Research Communications, said: ‘Type 1 and Type 2 diabetes are very different conditions, but we don’t yet know enough about the subtypes that could exist within them.

‘Finding those subtypes will help us personalise treatments and potentially reduce the risk of diabetes-related complications in the future.’

Emma Ahlqvist, another authors of the study, said the results could ‘enable earlier treatment to prevent complications in patients who are most at risk of being affected’.

‘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,’ said Diabetes UK.

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