Diabetes Patients May Fall Into Five Categories (BBC News / NHS Choices / Lancet Diabetes and Endocrinology)

Summary

Scandinavian research indicates there may not be simply two diabetic conditions (Type 1 and Type 2).  Patients can be separated into five distinct clusters or sub-types, each with distinct symptoms, complications and possible treatments.

1. Cluster 1: Severe Autoimmune Diabetes, broadly the same as the Type 1.
2. Cluster 2: Severe Insulin-Deficient Diabetes, similar to above but where the immune system is not at fault.)
3. Cluster 3: Severe Insulin-Resistant Diabetes, where patients are overweight and making insulin but their bodies no longer respond to it.
4. Cluster 4: Mild Obesity-Related Diabetes, where people are overweight but metabolically more similar to normal.
5. Cluster 5: Mild Age-Related Diabetes, where patients develop symptoms when older and the disease is typically milder.

Treating people in distinct groups differently might yield better outcomes, along the lines of personalised medicine.

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Reference

Gallagher, J. (2018). Diabetes is actually five separate diseases, research suggests. London: BBC Health News, March 2^nd 2018.

Further clarification from Bazian:

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Reference

Are there actually 5 types of diabetes? London: NHS Choices; Behind the Headlines, March 2^nd  2018.

This relates to:

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Reference

Ahlqvist, E. Storm, P. [and] Käräjämäki, A. [et al] (2018). Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. Lancet Diabetes and Endocrinology. March 1^st 2018. [Epub ahead of print].

Possibly of interest, regarding earlier diagnosis and intervention:

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Reference

Therrien, A. (2018). Type-2 diabetes signs ‘detectable years before diagnosis’. London: BBC Health News, October 5^th 2018.

Prevalence and Cost Trends

NHS Digital data on the increasing prevalence and costs of diabetes in England:

“…diabetes prescribing costs £1 billion per year, but it is estimated that the total cost to the NHS is over £10 billion per year… ”. Robin Hewings: Diabetes UK.

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Reference

Ives, L. (2018). Diabetes prescriptions now cost NHS £1bn, figures show. London: BBC Health News, November 8^th 2018.

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