In people with prediabetes, preclinical medicine has categorized six clearly distinguishable subtypes. The so-called clusters differ in the development of the diseasesRisk of diabetesand the development of complications. This is shown by a study by the German Center for Diabetes Research (DZD). In the future, the new classification may help prevent the manifestation of diabetes or the development of diabetes complications through targeted prevention.
How does preclinical medicine identify prediabetes?
Diabetes is a global pandemic. Since 1980, the number of diabetics worldwide has quadrupled. In Germany alone, 7 million people suffer from it and the trend continues to rise. By 2040, the number of people with type 2 diabetes could rise to up to 12 million. However, type 2 diabetes does not develop overnight. People often go through a lengthy pre-diabetes stage in which blood sugar levels are already elevated but people are not yet sick. Tübingen researchers have now achieved an important breakthrough. Using cluster analysis in people with prediabetes, they discovered six different subtypes with different risk of diabetes. A differentiated classification of prediabetes and diabetes enables individual and early prevention and treatment of diabetes and its complications in a way that is adapted to the development of the disease.
Based on key metabolic parameters such as blood sugar levels, liver fat, body fat distribution, blood lipid levels and genetic risk, researchers were able to identify six subtypes of prediabetes. As with overt diabetes, there are also different types of disease in the pre-diabetes stage, which differ in blood sugar levels, insulin action and insulin secretion, body fat distribution, liver fat and genetic risk, according to the study authors.
Study results
Three of these groups (clusters 1, 2 and 4) are characterized by a low risk of diabetes. 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 body is resistant to the blood sugar-lowering effect of insulin. In subtype 6, damage to the kidneys occurs even before diabetes is diagnosed. Mortality is particularly high here too.
These resultsare based on research conducted over the last 25 years to characterize people at increased risk of diabetes. One of the goals of the DZD is to develop precise preventative and therapeutic measures. This enables appropriate prevention or treatment for the right group of people at the right time. The combination of in-depth clinical and molecular research and bioinformatics has made this internationally important result possible. The identification of subtypes in the preliminary stages of type 2 diabetes is an important step towards precision medicine in the prevention of diabetes and its complications.
