Prediabetes Classified Into Six Subtypes Based On Pathophysiology

Diabetes is a worldwide pandemic. Type 2 diabetes does not develop in one day. People often go through a longer preliminary stage of diabetes, in which blood glucose levels are already elevated but they are not ill. Researchers at the Institute for Diabetes Research and Metabolic Diseases (IDM) have classified prediabetes into six subtypes on basis of Pathophysiology. The results of the study have been published in Nature Medicine. According to researchers, all prediabetes is not the same: in people in the preliminary stages of type 2 diabetes, there are six clearly distinguishable subtypes, which differ in the development of the disease, diabetes risk, and the development of secondary diseases. The new classification can help in the future to prevent the manifestation of diabetes or the development of diabetes complications through targeted prevention. In the research, for the people with prediabetes it was possible to predict whether they would develop diabetes and be at risk for serious complications such as kidney failure, or whether they would only have a harmless form with slightly higher blood glucose levels but without significant risk. Such a distinction is important for the targeted prevention of the metabolic disease and thus for counteracting the diabetes pandemic. Using cluster analysis in people with prediabetes, researchers have discovered six distinct subtypes with different diabetes risk. The research group has conducted detailed studies of the metabolism of people with prediabetes who are still considered healthy. They have repeatedly undergone intensive clinical, laboratory chemical, magnetic resonance imaging and genetic examinations over the past 25 years. Based on key metabolic parameters such as blood glucose levels, liver fat, body fat distribution, blood lipid levels and genetic risk, the researchers were able to identify six subtypes of prediabetes. Three of these groups (clusters 1, 2 and 4) are characterized by a low diabetes risk. The study participants in clusters 1 and 2 were healthy. Slim people are the main members of cluster 2. They have a particularly low risk of developing complications. Cluster 4 consists of overweight people, whose metabolism is still relatively healthy. The three remaining subtypes (clusters 3, 5 and 6) are associated with an increased risk of diabetes and/or secondary diseases. People who belong to subtype 3 produce too little insulin and have a high risk of developing diabetes. People in cluster 5 have a pronounced fatty liver and a very high risk of diabetes because their bodies are resistant to the blood sugar lowering effect of insulin. In subtype 6, damage to the kidneys occurs even before diabetes is diagnosed. Here, mortality is also particularly high.

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