Type 1 diabetes affects the immune system, wherein the body's insulin making cells are attacked, leading to less control of blood sugar levels. LADA is often mistaken for type 2 diabetes because of its similar symptoms, but it needs to be treated in the same way as type 1 diabetes.
However, this study alone is not sufficient to lead to changes in diabetes treatment guidelines, as it was only based on groups of diabetes patients in Scandinavia.
But what are these different types, and why did the researchers make this decision?
They were able to analyse key measurements of the disease, as well as blood composition and genetic features. The subgroup classifications were based upon clinical characteristics, including presence of glutamate decarboxylase antibodies (GADA), age at diabetes diagnosis, BMI, hemoglobin A1c, as well as homeostasis model assessment 2 (HOMA2) estimates or beta-cell function and insulin resistance.
Now there are two types of diabetes - both of which cause a person's blood sugar levels to become too high. They also stated that an alarming 37 per cent of severe diabetes population is young and not obese.
The study was carried out by researchers from Lund University, Uppsala University and the University of Gothenburg in Sweden; and Vaasa Health Centre and the University of Helsinki in Finland. "These included a cluster of very insulin-resistant individuals with significantly higher risk of diabetic kidney disease than the other clusters, a cluster of relatively young insulin-deficient individuals with poor metabolic control (high HbA1c), and a large group of elderly patients with the most benign disease course".
People in cluster 3 had the highest risk of kidney disease, a complication of diabetes, while people in cluster 2 had the highest risk of retinopathy, another complication of diabetes that can cause vision loss. Now diabetes will distinguish: autoimmune diabetes, severe insulinzavisimy, heavy insulinorezistentne, lightweight form that is associated with excess weight, and also age-related diabetes easy form.
Cluster 4 are the patients with mild, obesity-related diabetes who are closer to those in cluster 3 in terms of insulin production.
The first study - All New Diabetics in Scania (ANDIS) - recruited 14,625 people newly diagnosed with diabetes from across 177 general practices in Scania County, Sweden, between 2008 and 2016.
Ahlqvist's group noted that a web-based classification tool is now under development.
Researchers have said that this new classification system could help to identify patients at high risk of complications, and provide guidance on the choice of treatment. "It would be reasonable to target individuals in these clusters with intensified treatment", they wrote.
The disease is normally classified into just two: type 1 and type 2 diabetes.
The study could not confirm if the five types have different causes, nor if patients' type changes over time.
"The form of treatment is affordable sulphonylurea tablet which is the cheapest form of treatment", stated the group of researchers in their submission in the paper. Type 1 was a result of autoimmune conditions wherein insulin hormones would be necessary to correct its deficiency while type 2 diabetes was associated with an imbalance of insulin need and supply and utilization within the body. "This study moves us towards a more clinically useful diagnosis, and represents an important step towards precision medicine in diabetes".