Diabetes has largely been classified as either Type 1 or Type 2. But researchers in Sweden and Finland now say there may be five different types of the disease, some of which are more dangerous than others.
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Their new research, published Thursday in the journal The Lancet: Diabetes & Endocrinology, included a data-driven cluster analysis of approximately 9,000 patients newly diagnosed with diabetes.
In their analysis based on age at diagnosis, hemoglobin A1C, beta cell functioning and more, the researchers realized the heterogeneity of the disease among the patients called for a “refined classification” of diabetes.
In Type 1 diabetes, the insulin-producing beta cells of the pancreas are "mistakingly attacked and destroyed by the immune system," according to Medical News Today.
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And in Type 2, the most common category of diabetes accounting for 90-95 percent of all cases, the body’s cells either stop responding to insulin or the beta cells can’t produce enough of the hormone.
People suffering from either type of the disease have blood sugar levels that can become too high. This condition is called hyperglycemia and can lead to kidney disease, heart disease and more if it’s not properly controlled or treated.
But the characteristics of those suffering with Type 2 diabetes varied significantly, especially when it came to risk of diabetic kidney disease.
The researchers proposed five “clusters” of the disease instead.
- Cluster 1 (6-15 percent of patients involved): Broadly the same as the Type 1 diabetes, Cluster 1 diabetes typically hits people when they are young and seemingly healthy. It's characterized by insulin deficiency and the presence of autoantibodies.
- Cluster 2 (9-20 percent): While these patients look similar to those in Cluster 1 in the beginning (healthy and young), this type of diabetes is not characterized by autoantibodies.
- Cluster 3 (11-17 percent): Those with Cluster 3 diabetes have are severely insulin-resistant, are generally overweight and and have a higher risk of kidney disease.
- Cluster 4 (18-23 percent): Most common in obese patients, Cluster 4 diabetes is associated with mild obesity-related factors.
- Cluster 5 (39-47 percent): Patients in this mild age-related diabetes cluster developed symptoms at significantly older ages than in other groups. This is the most common form of diabetes.
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In addition to reclassifying the disease, researchers pointed out that the patients in the five clusters were receiving inappropriate treatments. This further indicated that the current classification needs to be revised.
By refining the disease to five categories, the scientists believe that tailored treatments for specific clusters may represent “a first step towards precision medicine in diabetes.”
They call for larger studies with more diverse populations and variables to further study the proposed five-cluster reclassification.
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