Type 5 Diabetes?

We often say that no two cases of Type 1 diabetes behave in the same way, and that each presents its own set of challenges. Diabetes presents itself differently depending on whether one was diagnosed in childhood or adulthood, and having both insulin resistance and Type 1 diabetes is more difficult to manage than just Type 1 diabetes alone. And then there are the diagnostic grey areas, including Latent Autoimmune Diabetes (LADA), Maturity Onset Diabetes of the Young (MODY), and what is sometimes characterized as brittle diabetes, all of which are difficult to diagnose properly.

Swedish researchers now suggest that there should be five distinct diagnostic subgroups of diabetes, instead of the binary division between Type 1 diabetes and Type 2 diabetes. According to a report in Endocrinology Advisor, researchers at the Lund University Diabetes Centre made this recommendation after analyzing genetic and non-genetic markers for more than 15,000 patients with diabetes in Finland and Sweden. They then used five diagnostic yardsticks (age of onset, body mass index, A1C score, level of insulin secretion and how the insulin interacts in the bloodstream) to accurately predict changes in A1C scores over time in both people with Type 1 diabetes and people with Type 2 diabetes.

From these experiments, the researchers now believe these should be the five different groups of people with diabetes:

  1. Those with what would be categorized as “typical” Type 1 diabetes from autoimmune reactions
  2. Those who have beta cell impairment caused by something other than autoimmune reaction
  3. Those who have the most insulin-resistance and highest risk of kidney disease
  4. Those who are the most obese
  5. Those with diabetes that seems to come as a product of aging

The researchers believe these distinctions will help tailor diabetes care more to the needs of individual patients. This isn’t the first call to change the diagnostic criteria for diabetes, but as diagnostic tools and treatments get more refined, there may be growing momentum to change the diagnostic status quo.

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Craig Idlebrook is a past editor for Insulin Nation, Type 2 Nation, and Información Sobre Diabetes. He is now the community engagement and content manager for T1D Exchange.

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