Nearly 10% of adults worldwide are diabetic, and the rate is increasing. Now, some remarkable findings could have the medical community offering five or more custom treatments for it. New research shows diabetes, traditionally known as Type 1 or 2, is at least five separate disorders.
We've long known Type 1 diabetes as an immune system disorder. It depletes insulin, the hormone that controls our blood sugar levels.
And we might understand Type 2 diabetes as lifestyle-related, involving body fat that impacts the way the insulin works. But...
Is It Really That Simple?
Research at the Diabetes Centre at Lund Unive
rsity of Sweden, and Finland's Institute for Molecular Medicine, followed nearly 15,000 people with diabetes.
Their findings, now available in The Lancet: Diabetes & Endocrinology,
found classification more complex than conventional wisdom would have it. The researchers describe five distinct "clusters" of sufferers:
- The classic "Type 1" severe autoimmune
- Severely insulin-deficient people with diabetes initially resembling the Type 1 group, but without the immune system disorder;
- Severely insulin-resistant people, usually overweight, whose bodies produce insulin;
- Very overweight (mildly obese) people, yet metabolically closer to normal than people in the 3rd cluster;
- Mild diabetes sufferers in older populations.
A Real Step Forward
One of the researchers, Leif Groop, told the BBC the findings can enable a real step forward in precision medicine, with higher or lower treatment intensities.
While Cluster 2 would today be diagnosed as Type 2 (no immune system disorder), the sufferers beta-cells, rather than body fat, are most likely the culprit. This suggests changes in their treatments, which could look a lot more like today's Type 1 treatments. And given that people in Cluster 2 face a higher blindness risk, whereas Cluster 3 comes with a high risk of renal disease, specialized treatment could mean very helpful enhanced screenings for further issues.
The risk of diabetes, we well know, is not the same in all countries and among all cultures. And the subjects of the work published in March 2018 in TheLancet were northern Europeans. So there is much more to explore, including the possibility that many more diabetes clusters will be identified.
Meaning better understanding, and ultimately better treatment, around the world for people suffering from diabetes.
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