8 ms·

Diabetes is actually five separate diseases, research suggests

133 points by sjcsjc 9y ago

liragg 9y ago
I was diagnosed with diabetes seven years ago, and I started getting complications such as renal failure. Someone suggested that I purchase diabetes herbal formula from BEST HEALTH HERBAL CENTRE which i did. I only used the diabetes herbal formula for 5 weeks only. Is three months now, no more renal failure and I have been free of diabetes ..please visit their website for more details...ww w .besthealthherbalcentre. com
liragg 9y ago
I was diagnosed with diabetes seven years ago, and I started getting complications such as renal failure. Someone suggested that I purchase diabetes herbal formula from BEST HEALTH HERBAL CENTRE which i did. I only used the diabetes herbal formula for 5 weeks only. Is three months now, no more renal failure and I have been free of diabetes .
DoreenMichele 9y ago
You can add a sixth class. I have been told that Cystic Fibrosis Related Diabetes (CFRD) is neither Type 1 nor Type 2.
Bitcoin_McPonzi 9y ago
There is certainly a need for a new category beyond "Type I" and "Type II". Estimates are that of Type II Diabetics who are overweight or obese, 85% of them would be asymptomatic if they simply reduced their weight to a healthy one, and didn't consume more calories than they burned each day. Obese people with "Type II" should be reclassified as "Type F Diabetes". This will help our healthcare system allocate funds and resources better. Why spend money on a population who has a free, safe, and natural remedy (eating less) available to them?
- deleted 9y ago
  [deleted]
- Girlang 9y ago
  Absolutely right. Here's a major disease that had a medically recognized free, safe, treatment which anyone can do.
- glenra 9y ago
  It would be lovely to live in a world in which telling obese people they should "just eat less" reliably allowed more than a tiny percentage of them to drop to a "normal" weight range and stay there for >5 years, but alas, that is not the world we do live in.
  - jack9 9y ago
    > It would be lovely to live in a world in which telling obese people they should "just eat less" Why would it matter? Telling cigarette smokers to just smoke less didn't work either, but it's just as prescriptive. People rather fail than change, so there's really no reason to lump the funding (type I vs type II) together. I welcome the discerning scrutiny in research, described which should properly aim the funding.
    - glenra 9y ago
      > Telling cigarette smokers to just smoke less didn't work either, but it's just as prescriptive. Hang on - by what measurement are you claiming telling people to smoke less didn't work? People are smoking less, both as individuals and collectively. People who want to smoke less or to stop smoking entirely do manage to successfully do that with a decent success rate. Suggesting a smoker become a nonsmoker by smoking less isn't anywhere near so useless as telling an obese person to stop being obese by eating less. (This even shows up in population level stats: the percentage of Americans who smoke has dropped in half since the 1970s whereas the percentage of Americans who are obese has more than doubled since the 1970s. Stopping smoking actually works - there is advice that works and there are treatments that work and people can just do it on their own. Whereas regarding obesity we just don't know what the hell is going on; most of the advice given is useless at best and counterproductive at worst.)
      - jack9 9y ago
        > It would be lovely to live in a world in which telling obese people they should "just eat less" vs > Telling cigarette smokers to just smoke less didn't work either, but it's just as prescriptive. "Work" is a weasel word being used here to describe the initial axiomatic assumption about "fat people". The assumption is there is a measure of conversion not being met by medical advice. The warning about the dangers of cigarettes are the template for such advice, so it's reasonable to equate the two. If you don't think telling people to eat less "works", then telling people to smoke less didn't "work" either. No other lever was applied and people continued to suffer the consequences. I thought it was obvious, how I was making a correlation to highlight the absurdity of the initial axiomatic statement. I was not trying to revise history.
- fludlight 9y ago
  Obesity should be taxed, but indirectly. Taxing people with an eating disorder seems mean. Let's nudge them in the right direction by adding a massive federal healthcare tax to sugars at the wholesale level. Let's see how many Oreos you eat when they go from $2 to $20 per box. This is politically challenging because people hate taxes and farmers & processed food companies like money and they're organized. That said, we managed to tax cigarettes despite tens of millions of smokers and plenty of tobacco farmers and even RJR Nabisco.
  - bufferoverflow 9y ago
    That will just create a black market. Prohibition doesn't work.
    - carlmr 9y ago
      Taxes aren't prohibition. Alcohol taxes work in most market, despite having a similar effect on price.
      - bufferoverflow 9y ago
        Insane taxes that increase the cost of the product 10 times is a form of prohibition. It doesn't even matter what you call it, you just created a black market with 900% margins. Alcohol taxes are quite low in most states: https://files.taxfoundation.org/legacy/docs/Spirits-Excise-Tax-Rates-2014%20%282%29.png https://files.taxfoundation.org/legacy/docs/Spirits-Excise-T... The comment above suggests a $18 tax on a tiny $2 pack, 14 Oz. That's very different from a few cents per bottle tax.
        GordonS 9y ago
        > Alcohol taxes are quite low in most states The world is bigger than the USA! Look at Norway, for example, which has high alcohol taxes and even runs a state monopoly for alcohol over a certain strength (ftom memory, ~4%
- tathougies 9y ago
  You know,.. I actually agree with you. For whatever reason, my below average weight wife has persistently elevated insulin, but normal blood sugar. Still, it was high enough for her doctor to wonder whether she had pancreatic cancer (she doesn’t, thankfully). Shes athletic and active and doctors can’t say she her body simply produces more insulin. It’s really awful to be doing research and read over and over that those with high insulin should lose weight. If my wife loses 10 pounds she would actually be underweight. When she was pregnant last, she lost ten pounds and the doctors were starting to get worried. The shittiest part is that my fat diabetic family try to give her diet advice while simultaneously having no discipline. We’ve tried diets to lose what weight she has left and bring her insulin down, but no dice. Meanwhile, my family says they’ll diet, eats trash, are fat, and have diabetes and act as if they and my wife have the same disease. Ultimately focusing all our attention on people engaging in self destructing behaviors lessens the amount of time spent helping people who actually have a disease
  - mft_ 9y ago
    A female (whose weight was already very much on the lower end of 'normal') was diagnosed as pre-diabetic a while ago, and was able to control/improve things with a fairly strict low-carb --verging on keto-- diet. Sounds similar, and a similar approach may be worth trying?
    - AstralStorm 9y ago
      These diets cause weight loss. The person is already mildly underweight so they are doubly risky. Not to say these shouldn't be tried, but only under careful monitoring.
      - mft_ 9y ago
        Sure - agree about the monitoring. No export, but from what I've read, while they (slow/low-carb diets) are usually used for weight-loss, your caloric intake is still important while following the diet. Thus it's possible to follow a s/low-carb diet and maintain, rather than lose, weight.
    - 9y ago
njarboe 9y ago
Too bad this is just five "clusters" of characteristics that people with not-type-I diabetes can be grouped into. No clear underlying mechanism for the cause of each of the groups diabetes. Maybe more in the journal paper? Or now focused studies can be done on each group to find out the root cause? I hope so.
Smaug123 9y ago
I was surprised to learn on reading this that the Type 1 classification always means "autoimmune disease". I was under the impression that the two type classifications were "1: unable to produce enough insulin", and "2: producing what ought to be normal amounts of insulin, but for some reason resistant to it"; naively, those seemed like much more natural classes for classifying a syndrome. Having a finer-grained analysis can't be a bad thing; for example, the paper identifies some increased risks for the individual clusters.
- carlmr 9y ago
  I had in my head that Type 1 was "unable to produce enough insulin, because of autoimmune problems with beta cells". I was surprised to read about Cluster 2 where they don't produce enough insulin and nobody knows why. I would have also intuitively put Cluster 2 under Type 1 diabetes though, because it's the same effect.
- manmal 9y ago
  AFAIK in type 1, most of the beta cells get destroyed, and it happens because of autoimmune processes. To me this means that immune-modulating medication or perhaps stem cell injections could help a great deal.
  - outworlder 9y ago
    Immune-modulating medication maybe, but unless this is identified very early, they won't help. Once the beta cell destruction is complete, you are left without any. Even if the immune system stops attacking, at some point it no longer helps.
    - mnw21cam 9y ago
      In fact, a long time ago some experimental treatment was tried, where active beta cells were transplanted into type 1 diabetes patients. They were very quickly destroyed by the patient's immune system.
  - ohtwenty 9y ago
eganist 9y ago
It seems a remarkable number of comments seem to think that people with Type II diabetes resulting from Obesity should be compelled not to eat and should be denied healthcare in the interim, such as this one [dead] comment: > Why spend money on a population who has a free, safe, and natural remedy (eating less) available to them? Please study food addictions¹²³⁴. Addiction is a disease⁵. Going cold turkey may work for some, but for many, this option is infeasible with drugs. With food, it's infeasible for everyone. Food addiction is especially difficult to combat without medical intervention⁶. Denying victims access to said care will only exacerbate the problem. ¹ https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/mental-health-food-addiction#1 https://www.webmd.com/mental-health/eating-disorders/binge-e... ² http://onlinelibrary.wiley.com/doi/10.1002/eat.20957/full http://onlinelibrary.wiley.com/doi/10.1002/eat.20957/full ³ https://www.sciencedirect.com/science/article/pii/S0195666311005617 https://www.sciencedirect.com/science/article/pii/S019566631... ⁴ https://www.sciencedirect.com/science/article/pii/S0195666316305050 https://www.sciencedirect.com/science/article/pii/S019566631... ⁵ https://scholar.google.com/scholar?hl=en&as_sdt=0%2C47&q=addiction+disease&btnG= https://scholar.google.com/scholar?hl=en&as_sdt=0%2C47&q=add... ⁶ https://www.sciencedirect.com/science/article/pii/S0195666312003844 https://www.sciencedirect.com/science/article/pii/S019566631...
- Mountain_Skies 9y ago
  What happens to people who refuse to submit to medical intervention?
  - eganist 9y ago
    That's up to them. I'm addressing the prospect of refusing medical intervention to people generally, especially to those who want it.
knbknb 9y ago
What about pregnancy-related diabetes? Some textbooks have it as a 3rd independent type of diabetes.
beagle3 9y ago
Alzheimer’s disease is informally referred to as Type 3 diabetes because of similarity; this informal name Is prevalent enough that when a different form of type I was discovered (which may or may not be cluster 2 in this article) it was called type 4
mnw21cam 9y ago
The quality of this article is rather poor. It's almost beyond belief that they didn't consult with Prof. Andrew Hattersley, who is regarded as one of the world leading experts in this. We have known for many many years about several other types of diabetes. It is what I research as my job. Type 1 is caused by the autoimmune destruction of the beta cells in the pancreas that generate insulin, and the patient becomes dependent on injected insulin. Type 2 is caused by a progression from the body becoming resistant to insulin due to being overweight, the beta cells generating more insulin to compensate, and then eventually the beta cells burning out. Along the way, treatment progresses from diet, to tablets such as metformin, and eventually to insulin injections. Many people think that you progress to type 1 when you become dependent on injected insulin, but that is not the case - it is still type 2. There is gestational diabetes, where the huge changes in the body caused by pregnancy can trigger temporary diabetes (although sometimes it persists for a while after pregnancy). For this reason, we tend to test the blood sugar level of pregnant women. Then we have MODY (Maturity Onset Diabetes of the Young), which is a form of monogenic diabetes. There are at least 10 types, caused by single gene defects in various genes. The treatment and prognosis depends on the gene which is defective. For instance, if you have one of your two copies of the GCK gene defective, then you get GCK MODY, which typically has few symptoms, but is usually detected when a woman is pregnant and has their blood sugar levels tested. The danger with GCK MODY is over-treatment - they do not need any treatment at all, but doctors may try to lower the blood sugar levels by giving insulin injections, which can be dangerous. Other forms of MODY do require insulin. There is also Neonatal Diabetes (NDM), which has two broad types, being permanent and transient, and there are several different sub-types depending on the gene defect. In this case, you are generally diagnosed with diabetes under the age of six months, and sometimes as young as hours after birth. If both of your copies of the GCK gene are defective, you will get permanent neonatal diabetes, and require insulin injections for life, from birth. However, if you have neonatal diabetes caused by defects in the ABCC8 or KCNJ11 genes, treatment with sulfonylurea tablets is highly effective. It is important to obtain a genetic diagnosis in order to get the correct treatment. There are other types of diabetes other than these. It is very weird for this article to be claiming the fact that there is more than just type 1 and type 2 to be news - it has been widely known for many years. A lot of the recent work has been on trying to distinguish the different types of diabetes. Neonatal diabetes is easy to distinguish, because it has a severe early onset. It is possible to determine the genetic cause in about 80% of patients that have this condition, and we are confident that further searches will reveal a large proportion of the remainder. MODY is however too similar to type 1 diabetes, so of patients sent for genetic testing for MODY, a proportion of them will have type 1 instead, so the genetic test success rate is lower, around 30%. Genetic risk scores for the autoimmune type 1 diabetes response are used to try and distinguish the two, in order to try and perform gene discovery research on as pure a MODY cohort as possible.
Ice_cream_suit 9y ago
"We did data-driven cluster analysis (k-means and hierarchical clustering) in patients with newly diagnosed diabetes (n=8980) from the Swedish All New Diabetics in Scania cohort. Clusters were based on six variables (glutamate decarboxylase antibodies, age at diagnosis, BMI, HbA1c, and homoeostatic model assessment 2 estimates of β-cell function and insulin resistance), and were related to prospective data from patient records on development of complications and prescription of medication. Replication was done in three independent cohorts: the Scania Diabetes Registry (n=1466), All New Diabetics in Uppsala (n=844), and Diabetes Registry Vaasa (n=3485). Cox regression and logistic regression were used to compare time to medication, time to reaching the treatment goal, and risk of diabetic complications and genetic associations" k-means and hierarchical clustering are notoriously prone to producing false positive clusters.
- CuriouslyC 9y ago
  k-means is just garbage, but hierarchical clustering can be good. The problem with hierarchical clustering is that you can produce whatever set of clusters you're biased towards by fiddling with the linkage function and the cut criterion.

133 points by sjcsjc 9y ago

I was diagnosed with diabetes seven years ago, and I started getting complications such as renal failure. Someone suggested that I purchase diabetes herbal formula from BEST HEALTH HERBAL CENTRE which i did. I only used the diabetes herbal formula for 5 weeks only. Is three months now, no more renal failure and I have been free of diabetes ..please visit their website for more details...ww w .besthealthherbalcentre. com

liragg 9y ago

DoreenMichele 9y ago

You can add a sixth class. I have been told that Cystic Fibrosis Related Diabetes (CFRD) is neither Type 1 nor Type 2.

Bitcoin_McPonzi 9y ago

There is certainly a need for a new category beyond "Type I" and "Type II". Estimates are that of Type II Diabetics who are overweight or obese, 85% of them would be asymptomatic if they simply reduced their weight to a healthy one, and didn't consume more calories than they burned each day. Obese people with "Type II" should be reclassified as "Type F Diabetes". This will help our healthcare system allocate funds and resources better. Why spend money on a population who has a free, safe, and natural remedy (eating less) available to them?

deleted 9y ago
[deleted]
Girlang 9y ago
Absolutely right. Here's a major disease that had a medically recognized free, safe, treatment which anyone can do.
glenra 9y ago
It would be lovely to live in a world in which telling obese people they should "just eat less" reliably allowed more than a tiny percentage of them to drop to a "normal" weight range and stay there for >5 years, but alas, that is not the world we do live in.
- jack9 9y ago
  > It would be lovely to live in a world in which telling obese people they should "just eat less" Why would it matter? Telling cigarette smokers to just smoke less didn't work either, but it's just as prescriptive. People rather fail than change, so there's really no reason to lump the funding (type I vs type II) together. I welcome the discerning scrutiny in research, described which should properly aim the funding.
  - glenra 9y ago
    > Telling cigarette smokers to just smoke less didn't work either, but it's just as prescriptive. Hang on - by what measurement are you claiming telling people to smoke less didn't work? People are smoking less, both as individuals and collectively. People who want to smoke less or to stop smoking entirely do manage to successfully do that with a decent success rate. Suggesting a smoker become a nonsmoker by smoking less isn't anywhere near so useless as telling an obese person to stop being obese by eating less. (This even shows up in population level stats: the percentage of Americans who smoke has dropped in half since the 1970s whereas the percentage of Americans who are obese has more than doubled since the 1970s. Stopping smoking actually works - there is advice that works and there are treatments that work and people can just do it on their own. Whereas regarding obesity we just don't know what the hell is going on; most of the advice given is useless at best and counterproductive at worst.)
    - jack9 9y ago
      > It would be lovely to live in a world in which telling obese people they should "just eat less" vs > Telling cigarette smokers to just smoke less didn't work either, but it's just as prescriptive. "Work" is a weasel word being used here to describe the initial axiomatic assumption about "fat people". The assumption is there is a measure of conversion not being met by medical advice. The warning about the dangers of cigarettes are the template for such advice, so it's reasonable to equate the two. If you don't think telling people to eat less "works", then telling people to smoke less didn't "work" either. No other lever was applied and people continued to suffer the consequences. I thought it was obvious, how I was making a correlation to highlight the absurdity of the initial axiomatic statement. I was not trying to revise history.
fludlight 9y ago
Obesity should be taxed, but indirectly. Taxing people with an eating disorder seems mean. Let's nudge them in the right direction by adding a massive federal healthcare tax to sugars at the wholesale level. Let's see how many Oreos you eat when they go from $2 to $20 per box. This is politically challenging because people hate taxes and farmers & processed food companies like money and they're organized. That said, we managed to tax cigarettes despite tens of millions of smokers and plenty of tobacco farmers and even RJR Nabisco.
- bufferoverflow 9y ago
  That will just create a black market. Prohibition doesn't work.
  - carlmr 9y ago
    Taxes aren't prohibition. Alcohol taxes work in most market, despite having a similar effect on price.
    - bufferoverflow 9y ago
      Insane taxes that increase the cost of the product 10 times is a form of prohibition. It doesn't even matter what you call it, you just created a black market with 900% margins. Alcohol taxes are quite low in most states: https://files.taxfoundation.org/legacy/docs/Spirits-Excise-Tax-Rates-2014%20%282%29.png https://files.taxfoundation.org/legacy/docs/Spirits-Excise-T... The comment above suggests a $18 tax on a tiny $2 pack, 14 Oz. That's very different from a few cents per bottle tax.
      - GordonS 9y ago
        > Alcohol taxes are quite low in most states The world is bigger than the USA! Look at Norway, for example, which has high alcohol taxes and even runs a state monopoly for alcohol over a certain strength (ftom memory, ~4%
tathougies 9y ago
You know,.. I actually agree with you. For whatever reason, my below average weight wife has persistently elevated insulin, but normal blood sugar. Still, it was high enough for her doctor to wonder whether she had pancreatic cancer (she doesn’t, thankfully). Shes athletic and active and doctors can’t say she her body simply produces more insulin. It’s really awful to be doing research and read over and over that those with high insulin should lose weight. If my wife loses 10 pounds she would actually be underweight. When she was pregnant last, she lost ten pounds and the doctors were starting to get worried. The shittiest part is that my fat diabetic family try to give her diet advice while simultaneously having no discipline. We’ve tried diets to lose what weight she has left and bring her insulin down, but no dice. Meanwhile, my family says they’ll diet, eats trash, are fat, and have diabetes and act as if they and my wife have the same disease. Ultimately focusing all our attention on people engaging in self destructing behaviors lessens the amount of time spent helping people who actually have a disease
- mft_ 9y ago
  A female (whose weight was already very much on the lower end of 'normal') was diagnosed as pre-diabetic a while ago, and was able to control/improve things with a fairly strict low-carb --verging on keto-- diet. Sounds similar, and a similar approach may be worth trying?
  - AstralStorm 9y ago
    These diets cause weight loss. The person is already mildly underweight so they are doubly risky. Not to say these shouldn't be tried, but only under careful monitoring.
    - mft_ 9y ago
      Sure - agree about the monitoring. No export, but from what I've read, while they (slow/low-carb diets) are usually used for weight-loss, your caloric intake is still important while following the diet. Thus it's possible to follow a s/low-carb diet and maintain, rather than lose, weight.
  - 9y ago

njarboe 9y ago

Too bad this is just five "clusters" of characteristics that people with not-type-I diabetes can be grouped into. No clear underlying mechanism for the cause of each of the groups diabetes. Maybe more in the journal paper? Or now focused studies can be done on each group to find out the root cause? I hope so.

Smaug123 9y ago

I was surprised to learn on reading this that the Type 1 classification always means "autoimmune disease". I was under the impression that the two type classifications were "1: unable to produce enough insulin", and "2: producing what ought to be normal amounts of insulin, but for some reason resistant to it"; naively, those seemed like much more natural classes for classifying a syndrome. Having a finer-grained analysis can't be a bad thing; for example, the paper identifies some increased risks for the individual clusters.

carlmr 9y ago
I had in my head that Type 1 was "unable to produce enough insulin, because of autoimmune problems with beta cells". I was surprised to read about Cluster 2 where they don't produce enough insulin and nobody knows why. I would have also intuitively put Cluster 2 under Type 1 diabetes though, because it's the same effect.
manmal 9y ago
AFAIK in type 1, most of the beta cells get destroyed, and it happens because of autoimmune processes. To me this means that immune-modulating medication or perhaps stem cell injections could help a great deal.
- outworlder 9y ago
  Immune-modulating medication maybe, but unless this is identified very early, they won't help. Once the beta cell destruction is complete, you are left without any. Even if the immune system stops attacking, at some point it no longer helps.
  - mnw21cam 9y ago
    In fact, a long time ago some experimental treatment was tried, where active beta cells were transplanted into type 1 diabetes patients. They were very quickly destroyed by the patient's immune system.
- ohtwenty 9y ago

eganist 9y ago

It seems a remarkable number of comments seem to think that people with Type II diabetes resulting from Obesity should be compelled not to eat and should be denied healthcare in the interim, such as this one [dead] comment: > Why spend money on a population who has a free, safe, and natural remedy (eating less) available to them? Please study food addictions¹²³⁴. Addiction is a disease⁵. Going cold turkey may work for some, but for many, this option is infeasible with drugs. With food, it's infeasible for everyone. Food addiction is especially difficult to combat without medical intervention⁶. Denying victims access to said care will only exacerbate the problem. ¹ https://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/mental-health-food-addiction#1 https://www.webmd.com/mental-health/eating-disorders/binge-e... ² http://onlinelibrary.wiley.com/doi/10.1002/eat.20957/full http://onlinelibrary.wiley.com/doi/10.1002/eat.20957/full ³ https://www.sciencedirect.com/science/article/pii/S0195666311005617 https://www.sciencedirect.com/science/article/pii/S019566631... ⁴ https://www.sciencedirect.com/science/article/pii/S0195666316305050 https://www.sciencedirect.com/science/article/pii/S019566631... ⁵ https://scholar.google.com/scholar?hl=en&as_sdt=0%2C47&q=addiction+disease&btnG= https://scholar.google.com/scholar?hl=en&as_sdt=0%2C47&q=add... ⁶ https://www.sciencedirect.com/science/article/pii/S0195666312003844 https://www.sciencedirect.com/science/article/pii/S019566631...

Mountain_Skies 9y ago
What happens to people who refuse to submit to medical intervention?
- eganist 9y ago
  That's up to them. I'm addressing the prospect of refusing medical intervention to people generally, especially to those who want it.

knbknb 9y ago

What about pregnancy-related diabetes? Some textbooks have it as a 3rd independent type of diabetes.

beagle3 9y ago

Alzheimer’s disease is informally referred to as Type 3 diabetes because of similarity; this informal name Is prevalent enough that when a different form of type I was discovered (which may or may not be cluster 2 in this article) it was called type 4

mnw21cam 9y ago

The quality of this article is rather poor. It's almost beyond belief that they didn't consult with Prof. Andrew Hattersley, who is regarded as one of the world leading experts in this. We have known for many many years about several other types of diabetes. It is what I research as my job. Type 1 is caused by the autoimmune destruction of the beta cells in the pancreas that generate insulin, and the patient becomes dependent on injected insulin. Type 2 is caused by a progression from the body becoming resistant to insulin due to being overweight, the beta cells generating more insulin to compensate, and then eventually the beta cells burning out. Along the way, treatment progresses from diet, to tablets such as metformin, and eventually to insulin injections. Many people think that you progress to type 1 when you become dependent on injected insulin, but that is not the case - it is still type 2. There is gestational diabetes, where the huge changes in the body caused by pregnancy can trigger temporary diabetes (although sometimes it persists for a while after pregnancy). For this reason, we tend to test the blood sugar level of pregnant women. Then we have MODY (Maturity Onset Diabetes of the Young), which is a form of monogenic diabetes. There are at least 10 types, caused by single gene defects in various genes. The treatment and prognosis depends on the gene which is defective. For instance, if you have one of your two copies of the GCK gene defective, then you get GCK MODY, which typically has few symptoms, but is usually detected when a woman is pregnant and has their blood sugar levels tested. The danger with GCK MODY is over-treatment - they do not need any treatment at all, but doctors may try to lower the blood sugar levels by giving insulin injections, which can be dangerous. Other forms of MODY do require insulin. There is also Neonatal Diabetes (NDM), which has two broad types, being permanent and transient, and there are several different sub-types depending on the gene defect. In this case, you are generally diagnosed with diabetes under the age of six months, and sometimes as young as hours after birth. If both of your copies of the GCK gene are defective, you will get permanent neonatal diabetes, and require insulin injections for life, from birth. However, if you have neonatal diabetes caused by defects in the ABCC8 or KCNJ11 genes, treatment with sulfonylurea tablets is highly effective. It is important to obtain a genetic diagnosis in order to get the correct treatment. There are other types of diabetes other than these. It is very weird for this article to be claiming the fact that there is more than just type 1 and type 2 to be news - it has been widely known for many years. A lot of the recent work has been on trying to distinguish the different types of diabetes. Neonatal diabetes is easy to distinguish, because it has a severe early onset. It is possible to determine the genetic cause in about 80% of patients that have this condition, and we are confident that further searches will reveal a large proportion of the remainder. MODY is however too similar to type 1 diabetes, so of patients sent for genetic testing for MODY, a proportion of them will have type 1 instead, so the genetic test success rate is lower, around 30%. Genetic risk scores for the autoimmune type 1 diabetes response are used to try and distinguish the two, in order to try and perform gene discovery research on as pure a MODY cohort as possible.

Ice_cream_suit 9y ago

"We did data-driven cluster analysis (k-means and hierarchical clustering) in patients with newly diagnosed diabetes (n=8980) from the Swedish All New Diabetics in Scania cohort. Clusters were based on six variables (glutamate decarboxylase antibodies, age at diagnosis, BMI, HbA1c, and homoeostatic model assessment 2 estimates of β-cell function and insulin resistance), and were related to prospective data from patient records on development of complications and prescription of medication. Replication was done in three independent cohorts: the Scania Diabetes Registry (n=1466), All New Diabetics in Uppsala (n=844), and Diabetes Registry Vaasa (n=3485). Cox regression and logistic regression were used to compare time to medication, time to reaching the treatment goal, and risk of diabetic complications and genetic associations" k-means and hierarchical clustering are notoriously prone to producing false positive clusters.

CuriouslyC 9y ago
k-means is just garbage, but hierarchical clustering can be good. The problem with hierarchical clustering is that you can produce whatever set of clusters you're biased towards by fiddling with the linkage function and the cut criterion.