"The most insulin resistant patients (Group 3) have the most to gain from the new diagnostics as they are the ones who are now most incorrectly treated", says Professor Leif Groop. This study - conducted on 14,775 patients across Finland and Sweden over age of 18 years - assumes significance as the medical classification of diabetes has not been updated for 20 years and mainly relies on measuring blood glucose levels.
DIABETES is five different diseases, not two, experts have discovered.
Patients in the fourth group were also often overweight, but their bodies weren't resistant to insulin, and they had milder symptoms and a healthier metabolism. It is usually diagnosed in childhood and is caused by the body's immune system wrongly destroying cells in the pancreas that make insulin.
In 2016 39,334 Dorset people were recorded as living with Type 1 and Type 2 diabetes.
Researchers believe that type 2 encompasses four kinds of diabetes, each affecting different age groups and carrying distinct threats.
The team analysed data on newly diagnosed patients from the Swedish All New Diabetics in Scania cohort, to arrive at their findings.
Dr Waqas Tahir, GP and clinical lead for diabetes at Bradford Care Alliance, said: "Diabetes is one of the biggest health challenges people face in Bradford district". Cluster 2 runs similar to Cluster 1 except that while it affects similar patients, their immune systems are not to blame for the insulin deficiency.
The team, from Lund University and the Institute for Molecular Medicine in Helsinki, examined data from 14,625 patients in five cohorts between January 2008 and November 2016.
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"The results of our study suggest that this new clustering of patients with adult-onset diabetes is superior to the classic diabetes classification because it identifies patients at high risk for diabetic complications at diagnosis and provides information about underlying disease mechanisms, thereby guiding choice of therapy", the researchers wrote.
Cluster 3: Severe insulin-resistant diabetes is mostly linked to obesity. It errantly assaults the body's insulin manufacturing plants (beta-cells) so there isn't sufficient of the hormone to control blood sugar levels.
The third "severe" group were people with auto-immune diabetes corresponding to the original "type-1" diagnosis.
Group 5, MARD (mild age-related diabetes): is the largest group (about 40%) and consists of the most elderly patients. Further research is needed to see whether these 5 clusters hold true for non-Scandinavian populations.
The researchers plan to launch similar studies in China and India.
Dr. Victoria Salem, a consultant and clinical scientist at Imperial College London, told the BBC that the study was a step forward for diabetes treatment but that it wouldn't lead to a change in practice just yet. Diabetic ketoacidosis was more frequent in clusters 1 and 2, whereas cluster 3 had the highest prevalence of nonalcoholic fatty liver disease.
Cluster 4 are the patients with mild, obesity-related diabetes who are closer to those in cluster 3 in terms of insulin production. The new substratification might help to tailor and target early treatment to those who would benefit most.
Another group facing serious complications was composed of relatively young, insulin-deficient patients.