Five types of diabetes – a new classification system

Who developed this new classification?

A group of researchers in Sweden and Finland recently published the results of a study regarding the classification of diabetes. They have suggested that there are five types of diabetes instead of only two (type 1 and type 2). The study group was led by Dr. Leif Groop, of the Lund University Diabetes Centre in Malmö, Sweden.

Why was this classification developed?

Dr. Groop and his team analyzed data from a number of diabetes patient registries to do their research. The number of patients involved in the analysis was more than 13,000. For all of the patients, the researchers isolated measurements of a number of variables, including insulin resistance, insulin secretion, blood sugar levels, age and onset of illness.

The results of their data analysis suggested that there should be five classifications of diabetes – two mild types and three severe types.

What are the five types of diabetes under this new classification?

The five types of diabetes suggested by the researchers are as follows:

1. Severe autoimmune diabetes. This form is similar to type 1 diabetes. People in this category were relatively young when they were diagnosed, and they were not overweight. They had an autoimmune disease that prevented them from producing insulin.
2. Severe insulin-deficient diabetes. This is similar to “severe autoimmune diabetes,” as described above. People were relatively young when they were diagnosed, they were not overweight, and their bodies were not producing much – if any – insulin. However, importantly, it was determined by the researchers that their immune system was not the cause of these people’s disease; this is because they did not have “autoantibodies,” which indicate a person has type 1 diabetes. The researchers aren't sure why this happens, but they suspect that people in this group may have a deficiency in the cells that produce insulin.
3. Severe insulin-resistant diabetes. This type of diabetes occurred in people who were overweight and had high insulin resistance; this means their bodies were making insulin, but their cells were not responding to it.
4. Mild obesity-related diabetes. This form of diabetes occurred in people who had a milder form of the disease, i.e. they did not have as much insulin resistance as those with “severe insulin-resistant diabetes.” They also tended to be overweight or obese.
5. Mild age-related diabetes. This form of diabetes was found to be similar to “mild obesity-related diabetes.” The people in this classification were older when they were diagnosed. This was the most common form of diabetes, affecting about 40% of people in the study.

What does this mean for the future management of diabetes?

While one study – regardless of its large size – isn’t about to change how healthcare professionals treat diabetes, it may provide some insights into how diabetes should be managed. Depending on the type and cause of diabetes a person has, the management of their disease may differ accordingly. This might mean a much more “individualized” approach to future diabetes management by tailoring and targeting early treatment to patients who would benefit most.

Further studies in other populations and countries are definitely needed to confirm and validate the results of this study.