Diabetes 'consists of 5 distinct types'

There is often confusion between MODY and Type 1 Diabetes as both are found to affect young people or children. Type 1 Diabetes is diagnosed in those suffering from MODY leading to misdiagnosis

It's also possible that researchers will find that diabetes, specifically the subtypes that would fall into type 2 diabetes, can be classified into many more clusters than just five.

Findings from a study of 13,270 subjects at Lund University in Sweden have helped explain why not all diabetes patients respond in the same way to treatment. Obesity and lack of physical activity are two of the most common causes of this form of diabetes.

Group 1, SAID (severe autoimmune diabetes): essentially corresponds to type 1 diabetes and LADA (latent autoimmune diabetes in adults), and is characterised by onset at young age, poor metabolic control, impaired insulin production and the presence of GADA antibodies.

She explained that while Type 1 diabetes isn't now preventable, three in five cases of Type 2 diabetes can be prevented or delayed with a healthy lifestyle and better understanding of the condition.

The 5 subtypes are genetically distinct with no mutations, concluding that the types are not different stages of the same disease.

From that analysis, they identified five "clusters" of disease with significantly different characteristics. People with this type do not respond to insulin and have a high likelihood of developing liver and diabetic kidney disease.

The outcomes, distributed in The Lancet Diabetes and Endocrinology, demonstrated the patients could be separated into five particular groups. It is an autoimmune disease, which means that the immune system mistakenly attacks the beta cells in the pancreas, which produce insulin. Cluster 3 (n = 1,373) was characterized by severe insulin resistance and high BMI, whereas cluster 4 (n = 1,942) was characterized by obesity, but not insulin resistance.

The researchers later repeated the analysis in three studies from Sweden and Finland.

With type-1 - generally diagnosed in childhood and accounting for about 10 percent of cases - the body simply doesn't make insulin, a hormone that helps regulate blood sugar levels. The study found that people with this type most commonly developed eye disease. "A more accurate diagnosis can be made by also considering the factors accounted for in ANDIS (All New Diabetics In Skåne)". I only have to look at my mum's workload to see that: as a diabetes specialist nurse, she's busier than ever, supporting patients throughout day to day management of their condition and some of the more serious complications of the disease, from blindness to kidney failure and limb amputation.

The team say the findings show that type 1 diabetes and a late-onset autoimmune form of diabetes can be grouped together as one form, dubbed severe autoimmune diabetes.

In the ANDIS study, blood samples were taken from people at registration, allowing the researchers to analyse their DNA and blood chemistry.

Experts warn Britain is sitting on a diabetes time bomb with the number of prescriptions for Type 2 sufferers rising by a third in five years to 35 million. A new classification system could help doctors identify the people most at risk for complications, the study authors say, and could pave the way for more personalized and effective treatments. 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.

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