A 25-year study has identified 6 distinct types of prediabetes

People with prediabetes have higher than normal blood sugar levels and sometimes – but not always – develop type 2 diabetes. Doctors should now be able to better manage this risk, thanks to study identifying six different subtypes of prediabetes.

In an analysis spanning 25 years of data and 899 individuals, researchers were able to categorize these six subtypes across a series of common biomarkers, including glucose levels, liver fat, body fat distribution, levels of blood lipids and genetic risk.

The six subtypes (or “clusters”) carry different levels of risk when it comes to developing type 2 diabetes, which should help healthcare professionals adapt treatments, as well as manage the condition. prediabetes and related secondary problems.

“For people with prediabetes, it has so far not been 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 one form. harmless with slightly higher blood sugar levels but without significant risk, ”says medical researcher Hans-Ulrich Häring of the German Diabetes Research Center (or DZD).

Clusters 1, 2 and 4 represent a low risk of diabetes: they include participants who are not overweight or who are overweight but have a relatively healthy metabolism. Clusters 3, 5 and 6, on the other hand, are linked to an increased risk of diabetes and secondary diseases.

Those in group 3 produce too little insulin naturally, as well as other biomarkers such as increased intima-media thickness (IMT) in their arteries. Group 5 includes people who are more resistant to the effects of insulin and with higher amounts of liver fat.

Those in group 6 have higher levels of particular types of body fat (visceral and renal sinuses). Although these people have a lower risk of developing diabetes compared to groups 3 and 5, there is a higher risk of death and greater risk of kidney dysfunction in this group.

(DZD)

“As in overt diabetes, there are also different types of diseases in the early stage of diabetes, which differ in blood sugar, insulin action and insulin secretion, distribution of body fat, liver fat and genetic risk, ”said diabetologist Robert Wagner of DZD. .

To further verify their results, the researchers compared their data to an analysis of 6,810 records collected in the UK under a different project. The same subtypes or groups have been identified there, using similar markers and methods.

Knowing how people differ in terms of their likelihood of developing diseases, diabetes, and complications makes a big difference compared to putting everyone in the same prediabetes treatment group, specific treatments can be given to individuals. specific risk groups.

With the growing number of people developing diabetes – globally there could be as many as 700 million people with type 2 diabetes by 2045 – and the disease already causing millions of deaths per year, it is important to act as quickly as possible.

“Next, in prospective studies, we will first seek to determine to what extent the new findings are applicable for classifying individuals into risk groups,” says diabetologist Andreas Fritsche of DZD.

The research was published in Nature medicine.