Research Identifies Five Types of Diabetes, Not Two

So, you have been diagnosed with diabetes; but do you know exactly which type of diabetes you’re living with? As it turns out, diabetes is not as simple as type 1 and type 2.

According to a research article, titled “Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables,” there may actually be five categories of diabetes. These “types” now seem to be important to differentiate as treatment options are a bit different, depending on which sort of diabetes you are diagnosed with.

The investigators in a very recent study have proposed these five new diabetes classifications with the idea that treatment can now be better “tailored” to the appropriate subtype.^[1]  The proposed new categories are

1. Severe autoimmune diabetes (formerly type 1)
2. Severe insulin-deficient diabetes
3. Severe insulin resistant diabetes
4. Mild obesity-related diabetes
5. Mild age-related diabetes

Although the new categories are not yet formally adopted by medical boards, it is interesting to note that the researchers found complication risk to be quite different, depending on the sub-type of diabetes found in a given patient.

For example, those living with severe insulin resistant diabetes were found to have a higher risk of kidney disease than those with mild obesity-related diabetes or mild age-related diabetes. Similarly, those with severe insulin-deficient diabetes had the highest risk of retinopathy. As you can probably see, the main subtypes are really different forms of type 2 diabetes.

Currently, treatment strategies for patients with type 2 diabetes are clear-cut but do not allow for genetic variations of the disease, which are only now being looked at. This means that future treatment plans will most likely be more dependent on which subtype of diabetes a patient is found to have.  As an example, if a patient is found to have mild obesity-related diabetes, treatment strategies will most likely target weight reduction.

These classifications are still very new and more studies will need to take place to see what is the best criteria to subdivide and diagnosis these new forms of diabetes. It seems to be the future of medicine to individualize treatment paradigms based on the genetic makeup of a patient, along with all of the other patient characteristics such as family history, whether they are smokers and other factors.

The impact of this study and how diabetes will be treated in the future can be huge. The research may help avoid using treatment strategies that don’t work well for certain patients. This is specifically powerful since it can be frustrating for people with diabetes to see a medication working for a friend or relative that doesn’t seem to work for them. Genetic differences can account for this and will likely impact protocols in the years ahead.

For now, a balanced and healthy diet for everyone is a logical beginning coupled with consistent exercise and, of course, frequent monitoring of blood glucose.