Five subtypes of type 1 and 2 diabetes, study finds

Posted on 02 March 2018

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It was reported today in various outlets that researchers have identified five categories of diabetes within type 1 and type 2 diabetes.

Here we explain the research behind this article, and what it means for type 1 diabetes.

What was the research?

A team of researchers from Sweden and Finland analysed a number of characteristics in nearly 15,000 people living with diabetes, including age at diagnosis, HbA1c and body mass index (BMI).

They used this data to see if different subtypes of diabetes could be identified.

The analysis looked at people thought to have type 1 diabetes, type 2 diabetes, latent autoimmune diabetes of adulthood (LADA) and secondary diabetes, and does not specify whether people with gestational diabetes or maturity-onset diabetes in the young (MODY) were included.

What did they find?

The team identified five distinct groups of people living with diabetes with shared characteristics. These groups were:

  • SAID – Severe Autoimmune Diabetes, where people were unable to produce insulin due to an autoimmune condition
  • SIDD – Severe Insulin-Deficient Diabetes, where people made little insulin but there was no sign of an autoimmune condition
  • SIRD – Severe Insulin-Resistant Diabetes, where people were overweight and making insulin, but their body had developed resistance to it
  • MOD – Mild Obesity-related Diabetes, where people were obese but their body had not developed insulin resistance like the SIRD group
  • MARD – Mild Age-Related Diabetes, where people developed a less aggressive form of diabetes at an older age

The risk of developing certain complications also differed between the groups.

What does this mean for type 1?

Overall, the results indicate that there are different subtypes of diabetes, which the researchers suggest may need different treatment approaches.

In their paper however, the researchers write that the SAID group ‘overlapped with type 1 diabetes and LADA’. This suggests that people living with type 1 diabetes have more characteristics in common with each other than with people living with other forms of diabetes, and so the current gold standard treatment for type 1 diabetes remains the most appropriate option for people with type 1 at present.

What’s next?

At this stage we cannot say whether these new groupings are the most appropriate, and more research is needed before any re-categorisation of diabetes types can occur.

The researchers have indicated that looking at more characteristics, such as genes and blood pressure, would help to understand the different subtypes of diabetes further.

In addition, more work will also be needed to understand if these subtypes of diabetes are suitable categories for people from other parts of the world, as this analysis only looked at data from Swedish and Finnish people.

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