New classification of Diabetes

Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body does not efficiently use the insulin it produces. The effect of uncontrolled diabetes is hyperglycemia (increased blood sugar).

According to studies carried out by the WHO, 1 in 10 individuals suffer from diabetes.

In 2014, 8.5% of adults aged 18 years or older already had diabetes. According to research conducted in 2015, 1.6 million people died as a direct result of diabetes and high blood glucose levels were the cause of another 2.2 million deaths in 2012.

New advances:

The first investigations classify diabetes in two types: 1 and 2, and this classification has not been updated in more than 50 years, but a new study by researchers from the University of Lund in Sweden, has indicated that the classification could be changed of this disease and take it to five (5) subgroups, which constitutes a great advance towards a more exact diagnosis, which would allow to provide an optimized attention of the disease.

The new grouping in adult patients with diabetes is superior to the standard classification, when identifying patients at high risk of diabetic complications at the time of diagnosis.

The researchers used four (4) studies, starting in 2008, which allowed them to monitor close to fifteen thousand (15,000) patients in Sweden and Finland, all over 18 years of age, who had recently been diagnosed with diabetes.

Six (6) measurements that are used to control people with diabetes were analyzed:

Age at the beginning of the disease.
Body mass index.
Long-term glycemic control.
Insulin resistance.
Insulin secretion.
Presence of antibodies associated with autoimmune diseases and also genetic analysis.

After analyzing a group of 8,980 adults, the researchers were able to identify one (1) type of autoimmune diabetes and four (4) different subtypes of type two diabetes (2), which were then analyzed by three (3) groups over 5,795 people .

From the results of these analyzes, the researchers distinguished five (5) different groups that differ from the current classification:

Three (3) serious forms.
Two (2) mild forms of the disease.

Group 1: Severe autoimmune diabetes

It is the form of diabetes commonly known as type 1 diabetes or LADA, it was observed in patients with insulin deficiency and these had antibodies associated with autoimmune diabetes; This type of diabetes was present between 6 and 15 percent of the group of people studied.

Group 2: Severe diabetes with insulin deficiency

This type of diabetes affects relatively young individuals with insulin deficiency, poor metabolic control, insulin secretion altered by HbA1C and the highest incidence of retinopathy, this type of diabetes was found between 9 and 20 percent of the group of people studied .

Group 3: Severe insulin-resistant diabetes

This group had the highest incidence of kidney damage and is characterized by obesity and severe insulin resistance, affecting between 11 and 17 percent of the patients studied.

Group 4: Mild diabetes related to obesity

It was observed in overweight patients who get sick at an early age; this group affected between 18 and 23 percent of the patients studied.

Group 5: Mild diabetes related to age

The largest group with the disease; It was one of the most moderate forms and was observed in elderly people, affecting between 39 and 47 percent of patients.

The researchers pointed out that the 5 subtypes are genetically distinct and do not present mutations; They also explain that the types are not different stages of the same disease.

This new classification could help to adjust and direct the treatment early, which would probably have a positive impact on people suffering from this disease.

Fuente

These data were provided by the WHO in 2017

Data and numbers:

The number of people with diabetes has increased from 108 million in 1980 to 422 million in 2014.
The global prevalence of diabetes in adults (over 18 years of age) has increased from 4.7% in 1980 to 8.5% in 2014.
The prevalence of diabetes has increased more rapidly in middle and lower income countries.
Diabetes is a major cause of blindness, kidney failure, myocardial infarction, stroke, and amputation of the lower limbs.
It is estimated that in 2015 diabetes was the direct cause of 1.6 million deaths. Another 2.2 million deaths were attributable to hyperglycemia in 2012.
Approximately half of the deaths attributable to hyperglycemia occur before 70 years of age. According to WHO projections, diabetes will be the seventh cause of death by 2030.
Healthy diet, regular physical activity, maintenance of a normal body weight and avoidance of tobacco use prevent type 2 diabetes or delay its onset.
Diabetes can be treated and prevent or delay its consequences with diet, physical activity, medication and periodic examinations to detect and treat its complications.

Diagnosis and treatment:

Diagnosis can be established early with relatively inexpensive blood tests.</div
The treatment of diabetes consists of a healthy diet and physical activity, along with the reduction of blood glucose and other known risk factors that damage blood vessels. To avoid complications it is also important to stop smoking.
Among the interventions that are feasible and economical in developing countries are:

Control of blood glucose, particularly in people with type 1 diabetes. Patients with type 1 diabetes need insulin and patients with type 2 diabetes can be treated with oral medications, although they may also need insulin;
Control of blood pressure; y
Podiatric care.