A new analysis published today in The Lancet Diabetes and Endocrinology indicates researchers were able to distinguish 5 new subgroups of patients with adult-onset diabetes, representing a first step toward precision medicine.
Researchers identified genetically marked groupings of the disease that vary by severity, age at which they most often occur and probable complications.
Cluster 1 is severe autoimmune diabetes, generally similar to type 1.
Cluster 1: A severe autoimmune condition whereby the body attacks and destroys insulin producing cells, meaning that the body doesn't produce any insulin and as a result blood sugar levels are not controlled.
Initial analysis of the six measures in a cohort of 8980 patient identified one autoimmune type of diabetes and four distinct subtypes of type 2 diabetes, which they then tested across three more cohorts of patients (5795 people).
Still, the findings seem to be a positive step toward improved treatment of diabetes, which affects more than 420 million people worldwide. Clustering was replicated across the remaining three cohorts.
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A patient in New Delhi is being administered with an insulin shot, a common diabetes treatment.
Diabetes can best be classified into five clusters instead of two, suggests new research.
The third cluster, accounting for 15.3% of the cohort, was marked by both a high degrees of insulin resistance - specifically a high HOMA2-IR index - paired with a high BMI. This group had a low proportion of patients taking metformin, although the authors say they would be expected to benefit the most from the drug.
"More accurately diagnosing diabetes could give us valuable insights into how it will develop over time, allowing us to predict and treat complications before they develop", Leif Groop, PhD, professor in the department of clinical sciences at Lund University Diabetes Centre, Sweden, and the Institute for Molecular Medicine Finland, said in a press release.
Additionally, the findings concluded that the different subgroups are more or less at risk of developing various secondary disease.
The study was supported by grants from the Swedish Research Council, a European Research Council Advanced Research grant, a Vinnova Swelife grant, and grants from the Academy of Finland, Sigrid Juselius Foundation, Novo Nordisk Foundation, and Scania University Hospital. He said that this would lead to more precise diagnosis and treatment of diabetes tailored to individual needs. "By contrast with previous attempts to dissect the heterogeneity of diabetes, we used variables reflective of key aspects of diabetes that are monitored in patients". Last night, research bodies welcomed the new study, but stressed more examination of the drug's effects was still needed. The clusters and associated complications will need to be verified in other populations, including other ethnicities that may have a different risk of diabetes, such as Asian populations.