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Research Suggest Five Types of Diabetes

By Michelle Partridge, BSN, CDE

Lately you may have heard about the five types of diabetes. But, aren’t there just two types of diabetes? Not according to new evidence suggesting that diabetes actually has five subgroups.

The classification of diabetes into Type 1 and Type 2 relies mainly on the presence or absence of certain autoantibodies known as GAD, which stands for glutamic acid decarboxylase. On this basis, approximately 80 percent of patients are identified as having Type 2 diabetes.

The ability to more accurately diagnose diabetes into these additional subgroups could give us valuable insights into how the disease will develop over time. This will allow us to predict and treat complications before they develop and direct more specific treatment toward Type 2 diabetes due to it being highly varied and diverse.

Here are the characteristics of the five types:

  • Diabetes Group 1: Early disease onset at a young age, essentially corresponds with Type 1 diabetes, Severe Autoimmune Diabetes (SAID), and Latent Autoimmune Diabetes in Adults (LADA), with relatively low body mass index, lack of insulin (deficiency) due to impaired insulin production, and always GAD-antibody positive. Insulin is prescribed most in this group.
  • Diabetes Group 2: Similar to group 1 but GAD-antibody negative, high hemoglobin A1C, highest incidence of diabetes-related eye disease resulting in blindness (retinopathy), Severe Insulin-Deficient Diabetes (SIDD). Metformin use is highest in this group. Insulin is prescribed 30 percent of the time. Patients in groups 1 and 2 were also more likely to have diabetic ketoacidosis (DKA) at diagnosis.
  • Diabetes Group 3: Insulin resistance, high body mass index and obesity. Severe-Insulin Resistant Diabetes (SIRD), and Maturity-Onset Diabetes in the Young (MODY). Group 3 was at the highest risk of developing chronic disease within the first three to four years. This group also had a higher risk of diabetes-related kidney disease (nephropathy) and protein in urine (microalbuminuria) with substantially higher risk of end-stage kidney disease leading to dialysis.
  • Diabetes Group 4: Obesity, younger age, not insulin resistant, Mild Obesity-Related Diabetes (MOD).
  • Diabetes Group 5:  Older age, Mild Age-Related Diabetes (MARD).

This new way of grouping diabetes types could change the way we think about Type 2 diabetes and help target early treatment more accurately, thereby representing a first step towards precision medicine in diabetes.

Struggling with diabetes? Get some great tips on lifestyle changes that will help you get on top of your condition.

Michelle Partridge is a diabetes nurse and educator at Samaritan Pacific Communities Hospital in Newport.