Context:

• Scientists unveiled a revised classification for diabetes, one they said could lead to better treatments and help doctors more accurately predict life-threatening complications from the disease.
• There are five distinct types of diabetes that can occur in adulthood, rather than the two currently recognised, they reported in The Lancet Diabetes & Endocrinology, a leading medical journal.

The study suggested:

• The findings are consistent with the growing trend toward “precision medicine”, which takes into account differences between individuals in managing disease. In the same way that a patient requiring a transfusion must receive the right blood type, diabetes sub-types need different treatments, the study suggested.

Distinct kinds of microbiome:

• Similarly, scientists have also identified distinct kinds of microbiome — the bacterial ecosystem in our digestive tract — that can react differently to the same medication, rendering it more or less effective.

Facts:

• People with diabetes have excessively high blood glucose, or blood sugar, which comes from food.
• Some 420 million people around the world today suffer from diabetes, with the number expected to rise to 629 million by 2045, according to the International Diabetes Federation.

Two sub-types:

• Currently, the disease is divided into two sub-types.
• With type-1 — generally diagnosed in childhood and accounting for about 10% of cases — the body simply doesn’t make insulin, a hormone that helps regulate blood sugar levels.
• For type-2, the body makes some insulin but not enough, which means glucose stays in the blood.
• This form of the disease correlates highly with obesity and can, over time, lead to blindness, kidney damage, and heart disease or stroke.
• It has long been known that type-2 diabetes is highly variable, but classification has remained unchanged for decades.
• Among the severe types, a group of patients with insulin resistance — in which cells are unable to use insulin effectively — was at far higher risk of kidney disease.
• This group has the most to gain from the new diagnostics as they are the ones who are currently most incorrectly treated.
• Another group facing serious complications was composed of relatively young, insulin-deficient patients.
• The third “severe” group were people with auto-immune diabetes corresponding to the original “type-1” diagnosis.
• The two other groups have milder types of the disease including one, which includes about 40% of the patients, beset with a form of diabetes related to advanced age.

Source:TH