Diabetes isn’t only type I or type 2 as the latter can be further categorised into at least four subtypes in Indians, according to a recent study. These distinctions, scientists say, will help doctors cut down on medications for some patients and help them prescribe drugs to prevent complications such as blindness, kidney or nerve damage in some others.
The India-Scotland Partnership for Precision Medicine in Diabetes (INSPIRED) study, published in the BMJ Open Diabetes Research and Care recently, classified type 2 diabetes in Indians into four distinct clusters — SIDD (Severe Insulin Deficient Diabetes), IROD (Insulin Resistant Obese Diabetes), CIRDD (Combined Insulin Resistant and Deficient Diabetes) and MARD (Mild Age-Related Diabetes).
A team of scientists analysed nearly 20,000 case sheets of patients with Type 2 diabetes from Dr Mohan’s Diabetes Speciality Centre in association with the University of Dundee, School of Medicine, Scotland to categorise patients into four clusters, two of which were unique to Indians — IROD and CIRDD. The scientists then replicated the findings in a representative population-based ICMRINDIAB study in India done across 15 Indian states.
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“Until now, we have been treating all type 2 diabetes the same. The study shows different clusters of type 2 diabetes in Indians,” said diabetologist Dr R M Anjana, the first author of the study said.
This research helps doctors predict the risk of complications and focus on individuals with the highest risk of developing complications, said senior diabetologist Dr V Mohan.
Dr Colin Palmer from the Department of Pharmacogenomics, School of Medicine, University of Dundee, said “Recognizing subtypes might help doctors more specifically choose medication for their patients instead of going with the standard ones.”
While it still remains unknown if clusters of diabetes have different causes or whether people’s classification might change over time, scientists are already working to see if genetic markers play a vital role.
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