Most of us know about the two main types of diabetes: type one and type two. But a new study has revealed that this information is incomplete. As it turns out, there are actually 5 types of diabetes.
A study published in The Lancet has uncovered three more subgroups. This recent research to uncover the 5 types of diabetes was led by Prof. Leif Groop from Lund University Diabetes Centre, Sweden, and the Institute for Molecular Medicine Finland in Helsinki.
His study suggests that apart from gestational diabetes and type one and two diabetes mellitus, the additional three subgroups can help create tailor-made treatments for patients. Knowing details about these 5 types of diabetes can prove to be quite beneficial to both healthcare providers and those who have the condition.
“This new substratification might eventually help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes,” the study says.
This discovery of the 5 types of diabetes will reportedly be the first step “towards precision medicine” for the chronic illness.
Study uncovers 5 types of diabetes
Prof. Groop and his team of researchers studied almost 14,775 diabetic patients. They analysed specific data like blood-glucose control in these patients.
Based on their analysis, they were able to identify 5 types of diabetes subgroups that were genetically distinct.
Out of the five, they classified three as “severe” and two subgroups as “mild.” They also described each of the 5 types of diabetes or clusters based on specific severity levels.
1. Cluster 1: Severe Auto-Immune Diabetes
The researchers included severe autoimmune forms of diabetes — similar to type 1 — in this cluster. Patients who suffer from this type of diabetes are usually young. They might even be healthy but are unable to make enough insulin due to an “errant immune system.”
2. Cluster 2: Severe Insulin-Deficient Diabetes (SIDD)
Among the 5 types of diabetes, the researchers labelled patients in this cluster as having “severe insulin-deficient diabetes.” Similar to the first cluster, this group also included young people with healthy body weight and an inability to produce insulin.
These patients also had a higher risk of a diabetic eye disease. The difference to type 1 diabetes lies in that here, it is not due to an errant immune system.
3. Cluster 3: Severe Insulin-Resistant Diabetes (SIRD)
In this cluster, researchers analysed patients who have severe insulin-resistant diabetes. These patients were overweight and their bodies were not responding to insulin effectively. In addition, patients in this cluster also ran a high risk of kidney and liver diseases.
4. Cluster 4: Mild Obesity-Related Diabetes (MOD)
This cluster is classified into the “mild” category. In this cluster, also called the Mild Obesity-related diabetes (MOD) the patient develops diabetes that is “characterised by obesity but not by insulin resistance.”
5. Cluster5: Mild Age-Related Diabetes (MARD)
Again, this cluster is listed as “mild.” The patients listed in this group also have normal metabolic functions. The only difference between these clusters is that patients in the fifth cluster can develop a milder form of diabetes at an older age.
At the moment, type two diabetes covers the last four types of diabetes. And in addition to all of these is gestational diabetes, which is temporary.
Commenting on this discovery, Prof Groop shared in a statement, “More accurately diagnosing diabetes could give us valuable insights into how it will develop over time.” He added that this research is “allowing us to predict and treat complications before they develop.”
Going forward, researchers are hoping that identifying these 5 types of diabetes will help in understanding the root cause of diabetes. This will lead to more effective prevention methods.
But before we move on to understand the treatments of diabetes in general, let’s take an in-depth look at this dangerous lifestyle disease.
What is diabetes?
Diabetes is a chronic illness of elevated blood sugar levels in the body. It occurs when the pancreas is unable to produce enough insulin or when it is unable to utilise the insulin produced. It can also be due to a combination of the two.
Insulin, as you may know, is a hormone that regulates blood sugar in our body. When it rises, it is medically termed Hyperglycaemia. This is a common effect of diabetes and it can lead to serious damage to the body, especially the blood vessels and the nerves.
1. Type 1 diabetes
Researchers believe this type of diabetes is due to an autoimmunity condition. As per the University of California, about 10 percent individuals suffer from type 1 diabetes.
In this condition, the body is unable to make enough insulin or only makes a small amount. But because of the autoimmunity factor, your body destroys the insulin-producing cells. And this damage is permanent.
Unfortunately, it is not clear as to what prompts this type of attack. It may be either due to genetics or environmental factors because lifestyle is not believed to play a role. Type 1 diabetes is also known as “childhood diabetes” because it emerges during childhood.
2. Type 2 diabetes
In this type of diabetes, the body is unable to use the insulin properly. It begins to show resistance to insulin. That stimulates the pancreas to produce more insulin. However, most times it is unable to keep up with the need. This results in a sudden decrease in insulin production and that leads to high blood sugar.
The exact cause of why the body suddenly stops producing enough insulin is again, unknown. However, lifestyle factors such as excess weight and genetics are often attributed to it.
3. Gestational diabetes
This is a specific type of diabetes that only occurs in pregnant women. Almost eight out of 100 pregnancies in Singapore are complicated by gestational diabetes.
Gestational Diabetes Mellitus (GDM) is characterised by high blood sugar levels. This condition usually develops between the 24th and the 26th week of pregnancy.
GDM is a disorder of high blood glucose (sugar) levels that is first diagnosed during pregnancy. The hormones produced by the placenta interfere with the mother’s insulin efficiency. Usually, the pancreas remedies the situation by producing more insulin. When this doesn’t happen, blood glucose levels rise, resulting in GDM.
Although this condition will not cause your baby to be born with diabetes, it will affect your child’s health if GDM is not under control.
These three types of diabetes as described above are not that difficult to identity because of their distinct symptoms.
You can keep your eyes peeled for the following general symptoms of diabetes. These hold true of any of the 5 types of diabetes (as uncovered by the researchers).
- Excessive hunger and thirst
- Frequent urination
- Fatigue or drowsiness
- Dry and/or itchy skin
- Blurry vision, and
- Slow healing wounds
1. Symptoms of type 1 diabetes
Generally, type 1 diabetes develops quickly. You may notice some of the following specific symptoms:
- Weight loss
- Diabetic Ketoacidosis. This is a condition in which the body produces excess blood acids (ketones). According to WebMD, “Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy because there is not enough insulin.”
Symptoms of this type of diabetes can occur in children and young adults.
2. Symptoms of type 2 diabetes
Those who suffer from type 2 diabetes may notice the following:
- Dark patches in the folds of skin, especially in the armpits and neck
- Numbness or pain in your feet at that time
Typically, symptoms of type 2 diabetes take longer to show. Symptoms of type 2 diabetes generally occur in people over the age of 45. However, the chances of youngsters displaying the symptoms is increasing. That’s because the incidences of type 2 diabetes in youngsters is also on the rise.
For both types (1 and 2), the fact is the number of patients is on the rise.
As per statistics by the World Health Organisation (WHO), ” In 2014, 8.5 percent of adults aged 18 years and older had diabetes. In 2015, diabetes was the direct cause of 1.6 million deaths and in 2012 high blood glucose was the cause of another 2.2 million deaths.”
But, according to the latest statistics by The Statista, “The Western Pacific is the region with the highest number of diabetics worldwide, with some estimated 159 million persons aged between 20 and 79 years suffering from diabetes.”
3. Symptoms of gestational diabetes
The symptoms of gestational diabetes are rare and not easily detectable. This condition is usually diagnosed from screening tests before any symptoms develop. That’s why doctors recommend an antenatal test during the 24th through the 28th week.
However, you may develop the following symptoms during pregnancy:
- Feeling thirsty more often than usual
- Urinating more often that usual
- Likelihood of developing infections that affect the urinary tract
Although diabetes complications develop over time, their high numbers have increased the chances of severe complications.
People who suffer from any from any of the main types of diabetes can also have the following complications:
- Small vessel disease, in which walls of the small arteries in the heart are damaged and therefore can lead to a heart attack or cardiac arrest
- Retinopathy, which as per the National Eye Institute (NEI), “affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults.”
- Skin conditions or infections
- Neuropathy, which is a condition characterised by a damage of the nerves
- Nephropathy, which is characterised by damage to the kidney and can lead to kidney failure.
- Alzheimer’s disease, which can be caused by type 2 diabetes. This can happen because the blood sugar goes out of control.
Complications of gestational diabetes
While most women who develop gestational diabetes often deliver healthy babies, they are still susceptible to certain health complications. As mentioned in our previous article, the following complications might affect you and the baby.
As for gestational diabetes, even though it is not a permanent condition, there are certain precautions that you can take to make sure that you do not end with type 2 diabetes in the future.
Adopt a healthy lifestyle, monitor your blood sugar levels, decrease your intake of sugar-based foods, exercise and take prescribed medications, as advised.
In general, the best way to keep diabetes under control (any type) include the following:
Monitoring blood sugar
You must monitor your blood sugar levels at least four to five times a day, especially if you are pregnant. You can use the various diabetes testers available in the market. These draw a drop of blood from your finger and analyse it for sugar level in the blood.
Certain basic lifestyle changes may help prevent diabetes. These include making healthy food choices. Eat a variety of foods including fresh fruits and vegetables, and limit fat intake to 30 percent or less of daily calories. Remember that healthy eating habits can go a long way in preventing diabetes and other health problems.
Regular exercise allows your body to use glucose without extra insulin. This helps combat insulin resistance. Of course, never start an exercise program without checking with your doctor first.
If you have been prescribed medications to keep the blood sugar under control, then you must stick to the schedule. Some people are also prescribed insulin injections (even expecting mums), so make sure that you do not miss them.
Monitoring the baby
If you have gestational diabetes, you also need to monitor the development of the baby through ultrasounds. It will generally reduce the possibility of analysing a preterm delivery situation.