A completely new classification of diabetes which also predicts the risk of serious complications and provides treatment suggestions. We are now seeing the first results of ANDIS – a study covering all newly diagnosed diabetics in southern Sweden — published in The Lancet Diabetes & Endocrinology.
The major difference from today’s classification is that type 2 diabetes actually consists of several subgroups, the results indicate.
“This is the first step towards personalised treatment of diabetes”, says Leif Groop, physician and professor of diabetes and endocrinology at Lund University in Sweden.
Today, about 425 million people around the world have diabetes. By 2045, the number is expected to have increased to 629 million*. Secondary diseases in the form of kidney failure, retinopathy (eye damage), amputations and cardiovascular diseases result in huge costs to society and major individual suffering. Thus, the need for new and better treatment options is great.
“Current diagnostics and classification of diabetes are insufficient and unable to predict future complications or choice of treatment”, explains Professor Leif Groop, who initiated the study.
He believes that the results represent a paradigm shift in how to view the disease in the future.
“Today, diagnoses are performed by measuring blood sugar. A more accurate diagnosis can be made by also considering the factors accounted for in ANDIS (All New Diabetics In Skåne).”
Since 2008, the researchers have monitored 13 720 newly diagnosed patients between the ages 18 and 97. By combining measurements of, for example, insulin resistance, insulin secretion, blood sugar levels (BMI, HbA1c, GADA, HOMA-B and HOMA-IR) and age at onset of illness, the researchers were able to distinguish five distinct clusters that differ from today’s classification (see diagram).
In addition to a more refined classification, the researchers also discovered that the different groups are more or less at risk of developing various secondary diseases.
“This will enable earlier treatment to prevent complications in patients who are most at risk of being affected”, says Emma Ahlqvist, associate professor and lead author of the publication.
Diabetes is currently divided into: type 1 diabetes (approx. 10 per cent), type 2 diabetes (85–90 per cent) and a number of less common diseases such as LADA, MODY and secondary diabetes.
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