The 5 (Yes, 5) Groups of Diabetes

DIABETES CARE|Nov.10, 2018


How many types of diabetes are there? Many would say there are two. And that is correct.

However, recent diabetes research suggests this chronic condition is not as simple as type 1 and type 2. A large groundbreaking study finds there are actually five subgroups of diabetes — and that info may make your diabetes management plan more successful down the line.

The current classifications of type 1 and type 2 diabetes haven't changed for more than 20 years. For the more than 420 million people worldwide living with diabetes, these new findings indicate a step toward improved treatment.

The Study

A recent study in The Lancet: Diabetes & Endocrinology looked at six measurable factors in nearly 15,000 people recently diagnosed with diabetes: age, body mass index, the presence of beta-cell antibodies, level of metabolic control, measures of beta-cell function and insulin resistance. By looking at these diagnostic factors, researchers were able to define not just two, but five, subgroups of diabetes. In particular, type 2 diabetes appears to have highly variable characteristics.

The findings offer a better understanding of the underlying factors of diabetes, as well as hope for earlier and more personalized treatments that may prevent complications.

Here's what to know.

Group 1: Severe Autoimmune Diabetes (SAID)

This type is what is currently classified as type 1 diabetes. In people with this type of diabetes, the immune system produces antibodies that destroy beta cells (the cells that produce insulin). This production is known as an autoimmune response.

The diabetes management plan for people with type 1 diabetes includes close monitoring of blood glucose levels and insulin replacement with daily injections or use of an insulin pump.

Group 2: Severe Insulin-Deficient Diabetes (SIDD)

People with this type of diabetes looked very similar to those with type 1: They were younger, not overweight and their bodies didn't produce adequate insulin. The difference was there weren't antibodies present, which means their immune system wasn't the underlying cause of their condition.

In people with SIDD, damage to insulin-producing cells caused their bodies to produce too little insulin. This group had the highest risk of vision loss.

The diabetes management plan for people with this type of diabetes is similar to those with type 1, but they may also take oral medications.

Group 3: Severe Insulin-Resistant Diabetes (SIRD)

This type of diabetes was characterized by insulin resistance, which means their body doesn't respond to its own insulin properly. People with SIRD are generally overweight, which further contributes to insulin resistance. The study found those with type 3 diabetes had a higher risk of kidney disease.

Researchers also found that of the five subgroups, the diabetes management plans for people with SIRD were the least effective. That means these people stand to benefit the most from new diagnostics and more intensive treatment that may come from this research.

Group 4: Mild Obesity-Related Diabetes (MOD)

People with this milder form of diabetes are very overweight and have some insulin resistance. Because the insulin resistance isn't as severe as with SIRD, this milder form of diabetes is believed to be caused by obesity.

Group 5: Mild Age-Related Diabetes (MARD)

People with MARD were elderly and had a milder form of diabetes than those who developed it in middle age. The study found this was the most common form of diabetes.

The Takeaway

Researchers aren't suggesting it's time to reexamine the current type 1 or type 2 diabetes diagnoses. This is, however, a great jumping off point to refine our understanding of diabetes and the specific diabetes management plans for each type.

Staying on top of the latest research and treatment advances is an important part of your diabetes management plan. Be sure to discuss what you learn with your doctor and ask if there are ways you can improve your treatment.