Reclassifying Diabetes?
Posted:
2018-03-12
A recent study in The Lancet Diabetes & Endocrinology journal raises the question - are more classifications of diabetes needed? Using data from five cohorts, the researchers conducted a data-driven cluster analysis in individuals newly diagnosed with diabetes (aged 18-97 years; n=8980) focused on six variables. These variables included measurement of glutamate decarboxylase antibodies, age at diagnosis, BMI, A1C and homeostatic model assessments - two estimates of β-cell function and insulin resistance. Results were replicated in three of the cohorts (n=5795). Five clusters were identified, each demonstrating different characteristics and risk of diabetes complications. Cluster 1 (autoimmune), 2 (insulin-deficient) and 3 (insulin-resistant) were classified as severe. Cluster 4 (obesity-related) and 5 (age-related) were classified as mild. The authors concluded that a refined classification, particularly for type 2 diabetes, could help tailor treatment regimes and help identify at diagnosis those with increased risk of complications. Potential client health actions or inactions with diagnoses ranging from mild to severe were not addressed. The authors plan to conduct further research on the optimal classification of diabetes subtypes.