What are the different types of diabetes?

Researchers propose 5 distinct types of adult-onset diabetes

Cluster 5 are patients with mild, age-related diabetes who developed symptoms at a late age, hence diabetes was not as severe.

Dr Emily Burns, head of research communications at Diabetes UK told The Guardian that while the research was promising, there was still more digging to be done: "We still need to know more about these subtypes before we can understand what this means for people living with the condition", she said.

They found different disease profiles were also present in these patients, including three severe and two mild forms of the disease. Type 1 is an autoimmune condition where the body mistakenly attacks the pancreas, stopping it from producing insulin.

Cluster 1 is severe autoimmune diabetes, generally similar to type 1. People with type 1 diabetes have these antibodies-and therefore can not make insulin on their own-while people with type 2 do not.

The results were checked against three other studies from Sweden and Finland.

The researchers said type one should be renamed "severe autoimmune diabetes". The subgroup classifications were based upon clinical characteristics, including presence of glutamate decarboxylase antibodies (GADA), age at diabetes diagnosis, BMI, hemoglobin A1c, as well as homeostasis model assessment 2 (HOMA2) estimates or beta-cell function and insulin resistance.

But it is also campaigning for people at high risk of Type 2 diabetes to be identified and referred to the NHS Diabetes Prevention Programme, which supports people to make changes that could prevent the onset of the condition.

"Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment", said lead author Leif Groop, an endocrinologist at the Lund University Diabetes Center in Sweden as well as the Folkhalsan Research Centre in Finland, in a statement.

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Breaking out these subgroups and recognising them as distinct types of diabetes could hopefully lead to better tailored treatment, the researchers say. People with this type do not respond to insulin and have a high likelihood of developing liver and diabetic kidney disease. Another had relatively young, insulin-deficient individuals with poor metabolic control but no auto-antibodies (9-20%). This suggested more studies were needed to confirm exactly what was causing the drug's anti-diabetic effects.

By combining measurements of, for example, insulin resistance, insulin secretion, blood sugar levels and age at onset of illness, the researchers were able to distinguish five distinct clusters.

Mild obesity-related diabetes (MOD): characterised by obesity but not insulin resistance. They found that the risk of kidney complications was substantially increased in patients with SIRD, while the risk of diabetic retinopathy was highest in those with SIDD.

Cluster 4: Mild obesity related-diabetes mainly occurs among overweight people, whose metabolism is however much closer to normal compared with those in cluster 3.

They believe that the study might help tailor and target treatment and lay the foundation for precision medicine in the future.

While the study had limited non-Scandinavian involvement, similar studies are in the works in China and India with people of different ethnic backgrounds.

In the same way that a patient requiring a transfusion must receive the right blood type, diabetes sub-types need different treatments, the study suggested.

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