Diabetes is actually made up of FIVE different conditions - not two, discover researchers

• For decades, the condition has been considered to come in either type 1 or 2
• But type 2 diabetes should actually be categorised as four different diseases
• Researchers said the findings should prompt a ‘paradigm shift’ in diabetes
• They say the more precise groupings will aid diagnosis and tailor treatments
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Diabetes is actually made up of five conditions, researchers have discovered.

For decades it has been considered to be two different forms - type one, an autoimmune disease in which people stop producing insulin, and type two, in which the body becomes resistant to insulin.

But now a major project in Sweden and Finland has found type two diabetes should actually be categorised as four different diseases.

The researchers, led by experts at Lund University, said the findings should prompt a ‘paradigm shift’ in the way people treat diabetes.

They believe the more precise groupings - each of which are genetically distinct - will aid diagnosis, help tailor treatments and lead to proper precision medicines for the disease.

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A major project in Sweden and Finland has found type two diabetes should actually be categorised as four different diseases

The researchers said type one should be renamed ‘severe autoimmune diabetes’.

And type two should be split into four categories, two serious and two mild.

The first of these - severe insulin-deficient diabetes - was shown to include people with high blood sugar, low insulin production and moderate insulin resistance.

Another type - severe insulin-resistant diabetes - is predominantly linked to obesity and severe insulin resistance.

WHAT ARE THE FIVE NEW TYPES OF DIABETES?

For decades the disease has been considered to be two different forms - type one, an autoimmune disease in which people stop producing insulin, and type two, in which the body becomes resistant to insulin.

But now a major project in Sweden and Finland has found type two diabetes should actually be categorised as four different diseases.

The researchers, led by experts at Lund University, said the findings should prompt a ‘paradigm shift’ in the way people treat diabetes.

Cluster 1. Severe Autoimmune Diabetes- which until now has been known as ‘type one’ diabetes - is an autoimmune disease in which people stop producing insulin. Usually strikes in childhood but can emerge in adults. Requires insulin injections for life.

Cluster 2. Severe Insulin-Deficient Diabetes - young people often misdiagnosed as having type one, but whose immune systems are fine. Actually a variant of type two diabetes, but often of a healthy weight. High blood sugar, low insulin production and moderate insulin resistance.

Cluster 3. Severe Insulin-Resistant Diabetes - is predominantly linked to obesity and severe insulin resistance.

Cluster 4. Mild Obesity-Related Diabetes- includes obese patients, but is less serious and includes people who fall ill at a relatively young age.

Cluster 5. Mild Age-Related Diabetes is the largest group, with 40 per cent of all patients, and consists mostly of elderly patients.Mild obesity-related diabetes includes obese patients, but is less serious and includes people who fall ill at a relatively young age.

And the final group, mild age-related diabetes, is the largest group, with 40 per cent of all patients, and consists mostly of elderly patients.

Diabetes is rapidly becoming Britain’s fastest growing health crisis, with the number of affected patients having doubled in 20 years to 3.7million.

The researchers, whose work is published in the Lancet Diabetes & Endocrinology journal, based their findings on 14,775 newly diagnosed patients in Sweden and Finland.

Researcher Professor Leif Groop said: ‘This is the first step towards personalised treatment of diabetes.

‘Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment.

‘Existing treatment guidelines are limited by the fact they respond to poor metabolic control when it has developed, but do not have the means to predict which patients will need intensified treatment.

‘This study moves us towards a more clinically useful diagnosis, and represents an important step towards precision medicine in diabetes.’ Dr Emily Burns of Diabetes UK said: ‘Type one and type two diabetes are very different conditions, but we don’t yet know enough about the subtypes that could exist within them.

‘Finding those subtypes will help us personalise treatments and potentially reduce the risk of diabetes-related complications in the future.

‘This research takes a promising step toward breaking down type twp diabetes in more detail, but we still need to know more about these subtypes before we can understand what this means for people living with the condition.

‘For example, whether we’d find the same subtypes in people of different ethnicity or nationality.’