5 different types of diabetes identified now

[lucylocket61]

https://www.theguardian.com/society...abetes-not-just-type-1-and-type-2-study-shows

 

[Art Of Flowers]

See http://www.bbc.co.uk/news/health-43246261

 

[Art Of Flowers]

The five types are ...

• MARD - Mild Age Related Diabetes
• MOD - Mild Obesity Related Diabetes
• SIDD - Severe Insulin Deficient Diabetes
• SAID - Severe AutoImmune Diabetes = Type 1 + LADA
• SIRD - Severe Insulin Resistant Diabetes

Both mild types can be treated with metformin and lifestyle changes. I am not sure which category I would fit best as I was obese (BMI 33) and 63 years old when diagnosed.

 

[Fairygodmother]

Yes I saw the BBC article this morning too. The hopeful thing is that it’ll lead to better devised treatments to achieve the best outcomes - feeling optimistic.

 

[DJC3]

I’m sure my family will take great delight in calling me MARDy next time I yell at them for leaving towels on the floor/ mess in the kitchen etc!

 

[Cloherty123]

http://www.bbc.co.uk/news/health-43246261

 

[Alexandra100]

http://www.bbc.co.uk/news/health-43246261

See also:
https://www.theguardian.com/society...abetes-not-just-type-1-and-type-2-study-shows

http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30051-2/fulltext?elsca1=tlpr

 

[Brunneria]

It is good that they also recognise that if these 5 types are easily distinguishable in Scandinavian population, then other types may well exist elswhere.

Do you think that maybe, just maybe, people will begin to accept that different things work for different people with diabetes?
Let us hope, anyway.

 

[TIANDB]

Diabetes is actually five separate diseases, research suggests

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, which affects around 10% of people with the condition in the UK. 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.

• Cluster 1 - severe autoimmune diabetes is broadly the same as the classical type 1 - it hit people when they were young, seemingly healthy and an immune disease left them unable to produce insulin
• Cluster 2 - severe insulin-deficient diabetes patients initially looked very similar to those in cluster 1 - they were young, had a healthy weight and struggled to make insulin, but the immune system was not at fault
• Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and making insulin but their body was no longer responding to it
• Cluster 4 - mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically much closer to normal than those in cluster 3
• Cluster 5 - mild age-related diabetes patients developed symptoms when they were significantly older than in other groups and their disease tended to be milder

Links above..

 

[Alexandra100]

See also:
https://www.theguardian.com/society...abetes-not-just-type-1-and-type-2-study-shows

http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30051-2/fulltext?elsca1=tlpr

Sadly but not unexpectedly the researchers predict that drugs will be able to be targeted more effectively to suit the different needs of these various groups, but diet is never mentioned except by implication when they say that the 5th group (age-related mild diabetes) could be addressed by life-style measures. It seems to me that in fact diet is the one treatment appropriate to all groups.

 

[Fleegle]

Sadly but not unexpectedly the researchers predict that drugs will be able to be targeted more effectively to suit the different needs of these various groups, but diet is never mentioned except by implication when they say that the 5th group (age-related mild diabetes) could be addressed by life-style measures. It seems to me that in fact diet is the one treatment appropriate to all groups.

If you mean that regardless diet is important I think that is true.
But diet alone might not be enough. I thought that was the point and that is certainly true for T1s at least as I understand it.

I thought it was an excellent article - some generalisations of course - and some will just read the bits they want but I hope it leads to great treatments that can help people live the life they want to live. Though I have made great progress - I hate it. I hate carb free meals. I hate going out on social do's and not being able to drink a cocktail, not being able to have in an occasional treat because even if I smell a biscuit or cake my BG is off to the moon. I am in awe of the people on this site that have managed for 20years on LC.

Doesn't mean I would trade that for drugs I know will make me worse - but do hope that at some point there will be drugs for me to live a slightly modified life to the one I am living and this article seemed like acknowledgement of that.

 

[Sue192]

Type 2 diabetes is largely seen as a disease of poor lifestyle as body fat can affect the way the insulin works. This from the BBC article. An interesting view on the causes of diabetes but that sentence stood out for me (the Guardian article doesn't say this) as it does nothing to refute the public's perception of T2. Or am I being over-sensitive. However, it's good news that there are studies to show that that view is simplistic at the very least. There's a long way to go, but there are signs of hope.

 

[Fleegle]

Type 2 diabetes is largely seen as a disease of poor lifestyle as body fat can affect the way the insulin works. This from the BBC article. An interesting view on the causes of diabetes but that sentence stood out for me (the Guardian article doesn't say this) as it does nothing to refute the public's perception of T2. Or am I being over-sensitive. However, it's good news that there are studies to show that that view is simplistic at the very least. There's a long way to go, but there are signs of hope.

I don't think you are being over sensitive at all. It isn't helpful to the article.
However - as a question for posters:-
I think it is being proven is it not that T2 is largely but by no means completely attributed to poor lifestyle. I haven't seen any evidence that say's it not. In fact quite the opposite - quite a lot of the testimonials I read when I first got here were about poor eating and or loosing a heck of a lot of weight.

I ask the above as a question - I am genuinely interested if in fact T2 isn't related to poor lifestyle and weight. I think I am certainly guilty as charged personally.

 

[lindisfel]

IMHO that excluding T1 which is an auto immune disease and should not be lumped with the T2D types, the other diabetes types are usually of excess insulin not shortage of insulin.
Of course there are thin diabetics with high hba1c who perhaps have low insulin and may benefit from some insulin?
But what the Kraft studies showed were there were a number of types of hyperinsulinemia and it is manifest years before high blood glucose damages the body as well as the damage from high insulin.
It seems to me that we need to know our insulin status on carbs years before hba1c's are done!

Meds are a poor fix for most of us.

The new model of insulin resistance indicates our cells are crammed with blood glucose, we don't need more insulin in poisonous quantities.
I reckon faulty insulin is a theory that doesn't work for most of us.

I have another form of diabetes in that I have very low first phase insulin on carbs and then when my blood glucose peaks, my insulin floods my system after two hours and I hypo.
Like most T2D refined carb is a No No to counteract this problem.
Sounds like this study was funded by the drug companies but I could be wrong? .D.

 

[Alexandra100]

But diet alone might not be enough

Yes, I totally agree. But since diet is the ONLY treatment that can benefit all types, it seems a shame it was not mentioned.

 

[bulkbiker]

It is good that they also recognise that if these 5 types are easily distinguishable in Scandinavian population, then other types may well exist elswhere.

Do you think that maybe, just maybe, people will begin to accept that different things work for different people with diabetes?
Let us hope, anyway.

We can but hope although just look at all the opportunities for new drugs that 5 types will give them..
cynical moi?

 

[snowmonkey]

Not sure that i agree with the MOD and MARD distinction. If you are getting a bit older and less able to handle carbs (MARD) then having excess fat - even if not obese (MOD) - cannot help matters.

If I had to self-diagnose, I suspect that I am MARD but previously not helped by being overweight. Basically with an impaired tolerance to carbs, there is a need to both reduce the load (lowish carbs) and also keep the fat off.

Still it is good that the medical thinking is finally progressing....

 

[Guzzler]

Still no mention of those people who are TOFI.

 

[DJC3]

We can but hope although just look at all the opportunities for new drugs that 5 types will give them..
cynical moi?

Exactly the same thought crossed my mind!
Even when they were talking about it on this morning’s news it was all about ‘tayloring medication’. There’s some big bucks to be made here!

 

[first14808]

I ask the above as a question - I am genuinely interested if in fact T2 isn't related to poor lifestyle and weight. I think I am certainly guilty as charged personally.

I think it's where more research should provide answers, ie does diabetes cause weight gain, or the 'traditional' view. The way I understand it, hyperinsulemia would cause fat deposition, so weight gain would be a symptom. Managing diet and weight does seem a big part of the 'cure' though. Looking at beta cell/pancreatic function in the different cohorts should give pointers.