What is Diabetes and How is it Classified?

Diabetes Matters

This is one of the Diabetes Matters posts that I am putting together and if you want to see the full series you can go to main page and find the full Table of Contents of all the topics I have covered to date at Diabetes Matters

Diabetes is typically classified as a chronic metabolic condition in which the body either doesn't respond to, or lacks Insulin in the body. The body requires Insulin to help ensure that the blood sugars which are produced from the consumption predominantly from carbohydrates does not go high within the blood resulting in a whole array of issues.

When people think of Diabetes, or Diabetes Mellitus "Sweet urine" they mainly think of two types of Diabetes; Type 1, or Insulin dependant (IDDM), and type 2, or Non Insulin dependant (NIDDM). These are just a few of the ways that the two predominant types are known by. Type 1 typically affects children and often before they are 10 years old, and Type 2 is more commonly associated with adulthood, however there are cases where it is reversed and adults who have Type 1 diabetes are further sub classified as bein Latent Autimmune Diabetes in Adults (LADA) and Type 2 when seen in children is known as Maturity Onset Diabetes in Youth (MODY).

What are the other types of diabetes?

Other common variations of diabetes include Gestational diabetes, drug induced diabetes (more commonly seen in adults) and a mulititude on genetic variations predominantly in children. There are also certian hormonal disease which are associated with diabetes.

Although often diabetes is associated with high blood sugars, this is not the actual cause of the problem the real underlying root cause of the problem is either the body is not producing insulin in sufficient quantities or the body is resistant to the effects of it. The actual mechanisms of this I shall cover in a later post.

In 2018 a team of Swedish doctors identified that the classification of diabetes is not as clear cut as we had once thought, although the evidence was satrting to gather for this with the increasing numbers of patients with either LADA or MODY which moved the number of types of Diabetes from 2 to 4 and even now some actually talk about Type 3 which is thought to be alzheimers. This would take the count to 5 "types". However Ahlqvist and her team [1] actually startified those with diabetes into 5 distinct subgroups as follows:

• Severe Autoimmune Diabetes (SAD)
• Severe Insulin Deficient Diabetes (SIDD)
• Severe Insulin Resistant Diabetes (SIRD)
• Mild Obesity Related Diabetes (MORD)
• Mild Age Related Diabetes (MARD)

Please do not be fooled into thinking depsite the term "mild" being mentioned in these titles it is by and no means mild, any form of diabetes can have a chtastrophic effect on the body and is well associated with the development of chronic complications if not properly managed.

So whilst many of you may have woke up this morning thinking diabetes only had two types Hopefully I have lit a lightbulb and informed you a little bit more into what diabetes is as far as the classification is concerned I might just leave you with another little bombshell and say although there may be five main clusters of diabetes when you look at Type 2 in the old money there are actually 65 genetic variants for this [2]

If there is anything specific you would like to know about diabetes drop me a message and I shall try to cover it in a subsequent post.

References (just in case the links do not work)

• https://www.thelancet.com/action/consumeSharedSessionAction?JSESSIONID=aaaSYuKX7nuRp6yaw4J5w&MAID=2q%2FJ0cDiE2S%2BaqWZoEnbtg%3D%3D&SERVER=WZ6myaEXBLF8FFqDK0WJyw%3D%3D&ORIGIN=361680256&RD=RD&rtc=0
• https://diabetes.diabetesjournals.org/content/64/5/1830