Diabetes is actually five separate diseases, research suggests

From BBC - March 1, 2018

Scientists say diabetes is five separate diseases, and treatment could be tailored to each form.

Diabetes - or uncontrolled blood sugar levels - is normally split into type 1 and type 2.

But researchers in Sweden and Finland think the more complicated picture they have uncovered will usher in an era of personalised medicine for diabetes.

Experts said the study was a herald of the future of diabetes care but changes to treatment would not be immediate.

Diabetes affects about one in 11 adults worldwide and increases the risk of heart attack, stroke, blindness, kidney failure and limb amputation.

Type 1 diabetes is a disease of the immune system. It errantly attacks the body's insulin factories (beta-cells) so there is not enough of the hormone to control blood sugar levels.

Type 2 diabetes is largely seen as a disease of poor lifestyle as body fat can affect the way the insulin works.

The study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, looked at 14,775 patients including a detailed analysis of their blood.

The results, published in The Lancet Diabetes and Endocrinology, showed the patients could be separated into five distinct clusters.

Prof Leif Groop, one of the researchers, told the BBC: "This is extremely important, we are taking a real step towards precision medicine.

"In the ideal scenario, this is applied at diagnosis and we target treatment better."

The three severe forms could be treated more aggressively than the two milder ones, he said.

Cluster 2 patients would currently be classified as type 2 as they do not have an autoimmune disease.

However, the study suggests their disease is probably caused by a defect in their beta-cells rather than being too fat.

Better classification


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