About 420 million people suffer from diabetes worldwide, of whom 2.5 million are Poles. As in all diseases, the basis for effective treatment of diabetes is the correct diagnosis. Therefore, scientists are beginning to distinguish more types of this disease than those two well-rooted in patients' minds.
Typically, diabetes was divided into two types. Type 1 diabetes is diagnosed in young people, children or adolescents, in whom pancreatic β cells fall victim to a malfunctioning immune system. Destruction of this type of cells means impairment of the body's ability to produce insulin, and the treatment involves the need to administer this hormone so as to prevent hyperglycaemia. Type 1 diabetes is often genetic and leads to death if left untreated. Patients with type 1 diabetes are a minority among diabetics.
The second type of diabetes is mainly due to unhygienic lifestyle, poor diet, lack of physical activity, overweight or obesity. In type 2 diabetes, β-cells of the pancreas do not lose their ability to produce insulin, but the body ceases to be sensitive to this hormone. Insulin resistance causes an increase in blood glucose, and prolonged hyperglycemia promotes the development of diabetic complications from the circulatory system, nervous system, kidneys or eyes.
In addition to these two types, most patients associate with gestational diabetes, which affects 3-6 percent of pregnant women. Its development is related to hormonal changes in the body of the future mother, which lead to the development of insulin resistance. Physicians also distinguish LADA type diabetes.latent autoimmune diabetes in adults), i.e. late type 1 diabetes, developing in adulthood, not in childhood or adolescence. Another, classically distinguished type is MODA diabetes (ang.maturity onset diabetes of the young), a rare condition genetically determined, giving symptoms of type 2 diabetes in young people (15-35 years).
Is the third?
Analysis of data from 2 million diabetic citizens of the United Kingdom indicates that there is another type of diabetes, referred to as type 3c, often confused by doctors with type 2 diabetes. In type 3c, symptoms of diabetes result from pancreatic destruction for a reason other than autoimmune , for example as a result of pancreatitis, its cancer, tumors or surgery. Such destruction not only wreaks havoc on β cells responsible for the production of insulin, but also in other types of pancreatic cells responsible for the production of digestive enzymes such as trypsinogen, chymotrypsinogen, lipase, estrase, pancreatic amylase or nuclease. Symptoms of diabetes sometimes appear even a decade after damage to the pancreas. The most effective way to treat type 3c diabetes is not only the administration of insulin, but the combination of insulin therapy and the use of digestive enzymes.
Or maybe there are 5 of them?
Swedish and Finnish scientists propose a completely new division of diabetes into 5 types, of which 3 are heavy and 2 medium heavy.
Type 1 according to Scandinavian scholars is identical to traditional type 1 diabetes, a severe autoimmune disease resulting from insulin deficiency associated with the presence of antibodies against pancreatic β cells and affects 6-15 percent of all diabetics. Type 2 is also severe diabetes mellitus with insulin deficiency, which occurs in relatively young patients who, in addition to insulin deficiencies, have other metabolic impairments. In addition, patients with type 2 do not have antibodies against pancreatic cells. This type is expected to affect 9-20 percent of people with diabetes. A severe form of diabetes is also type 3, characterized by serious cellular resistance to insulin and a high risk of developing diabetic complications in the kidneys. It is supposed to touch 11-17 percent of diabetics.
Medium-heavy type 4 diabetes is most common in people with weight problems and affects 18-23 percent of patients. Type 5, in turn, is associated with older age and constitutes 39-47 percent of the total number of cases of diabetes.
Regardless of the number of diabetes types distinguished, the researchers point out that correct diagnosis means the implementation of an appropriate treatment scheme that can protect the patient from diabetic complications, extend his life and improve its quality.
Based:
E. Ahlqvist, et al.,Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. Lancet Diabetes Endocrinol (2018) DOI: 10.1016 / S2213-8587 (18) 30051-2
C. Woodmansey, et al.,Incidence, Demographics, and Clinical Characteristics of Diabetes of the Exocrine Pancreas (Type 3c): A Retrospective Cohort Study. Diabetes Care (2017) dc170542.
