Study shows there are five types of diabetes, not two
Diabetics may receive more tailored treatment after researchers in Sweden found the condition has five categories, rather than two.
The study at Lund University has helped to explain why not all diabetes patients respond in the same way to treatment.
The disease is classified as type 1, an autoimmune condition where the pancreas does not make insulin, and type 2, known as lifestyle-related and commonly triggered by obesity.
The scientists found that type 2 diabetes should be classified with four sub categories.
They said a refined classification could improve treatment and identify patients with higher risk of complications, such as nerve damage, cardiovascular disease or skin conditions.
The study identified five clusters of patients with diabetes who have significantly different characteristics and risk of associated complications.
Those in cluster 3, most resistant to insulin, were more at risk of diabetic kidney disease than those in clusters 4 and 5, despite the same treatment.
Insulin-deficient patients in cluster 2 had highest risk of retinopathy, leading to sight loss.
Researchers at the Institute for Molecular Medicine in Finland, also involved in the study, said the results marked a paradigm shift in the way diabetes could be treated.
The new classification shows that cluster 1, severe autoimmune diabetes similar to type 1, affected younger people who were otherwise healthy.
Cluster 2, severe insulin deficiency, was similar to cluster 1 but the immune system was not at fault.
Cluster 3 describes patients with severe resistance to insulin who are generally overweight but producing insulin, although their body does not responding to it.
In Cluster 4, mild obesity-related diabetes was diagnosed in people who are overweight but metabolically closer to normal than those in cluster 3.
Cluster 5 patients develop symptoms when they are significantly older than other groups.
The results have been published in The Lancet Diabetes and Endocrinology.