The main types of diabetes could actually be classified as five separate diseases, according to researchers from Sweden and Finland.
Diabetes is often categorised as two main diabetes types; type 1 and type 2. This new report suggests that these two main types may benefit from a better classification system that could help to tailor treatment to each type.
Scientists from Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland say diabetes can be separated into five clusters. The classification was derived from a review of 14,475 Scandinavians.
Cluster 1, which is broadly similar to type 1 diabetes, is severe autoimmune diabetes. Cluster 2 is severe insulin deficiency when the immune system is not at fault. Cluster 3 is severe insulin resistance related to being overweight. Cluster 4 is mild-obesity related diabetes. And cluster 5 is mild age-related diabetes.
The researchers say the three severe forms would require a more intense approach to treatment than the milder clusters, but this new classification could help personalise treatment. For example, insulin is needed in autoimmune diabetes and a strong focus on lifestyle change is required in people with severe insulin resistance.
Study author Professor Leif Groop said: “This is extremely important, we’re taking a real step towards precision medicine. In the ideal scenario, this is applied at diagnosis and we target treatment better.”
Dr Victoria Salem, a consultant and clinical scientist at Imperial College London, who was not involved in the study, said: “This is definitely the future of how we think about diabetes as a disease”, adding that type 1 diabetes and type 2 diabetes is “not a terribly accurate classification system”.
Whilst the proposed classification presents some advantages, more research would be needed to test whether it would be robust enough to use in clinical practice.
The findings have been published online in The Lancet Diabetes and Endocrinology.

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