Clusters of Type 2 Diabetes

 

Clusters of Type 2 Diabetes

Type 2 Diabetes is also known as adult-onset diabetes. People with Type 2 diabetes show insulin resistance. It is a condition in which body’s cells do not use blood sugar (glucose) efficiently to meet body’s need, and this also can be associated with poor quality diet and sedentary lifestyle.

Insulin is a hormone that helps the glucose to get into cells of the body for utilization. Insulin secreted by β cells (type of cells present in Islets of pancreas) into the blood stream to promote glycolysis (converts glucose to pyruvate and hydrogen ion) which lower glucose levels by increasing removal of glucose molecules from blood stream to most body cells.

According to the Indian-Scotland Partnership for Precision medicine in Diabetes (INSPIRED) study, has recently classified and categorized Type 2 Diabetes into four clusters.  

According to the Indian-Scotland Partnership for Precision medicine in Diabetes (INSPIRED) study, has recently classified and categorized Type 2 Diabetes into four clusters.

·        Severe Insulin Deficient Diabetes (SIDD)

·        Insulin Resistance Obese Diabetes (IROD)

·        Combined Insulin Resistant and Deficient Diabetes (CIRDD)

·        Mild Age Related Diabetes (MARD).

Of which, IROD and CIRDD are unique to Indians. 

A study of 19,084 individuals with type 2 diabetes (T2D) yielded four clusters of diabetes. The following categorized clusters of T2D help medical professionals to make selective/precised medicine, which allow Doctors to select specific and significant medication to prescribe diabetic patients.

Ø Cluster 1 (SIDD)

v Found in 26.2% - with lowest BMI and waist circumference, lowest C peptide (fasting and stimulated), low insulin resistance, high Hb A1c values.

v Categorized in younger age, poor metabolic control but no auto-antibodies.

v Prone to diabetic retinopathy.

Ø Cluster 2 (IROD)

v Found in 25.9% - highest BMI, waist circumference, highest insulin resistance, highest C-peptide levels.

v Intermediate metabolic control

v Prone to diabetic kidney disease.

Ø Cluster 3 (CIRDD)

v Found in 12.1% - BMI and waist circumference were intermediate to SIRD and IROD, lowest HDL cholesterol levels, highest triglyceride, insulin resistance values were intermediate.

v Prone to retinopathy and kidney disease.

Ø Cluster 4 (MARD)

v Found in 35.8%- Late onset, fairly preserved C-peptide values, highest HDL cholesterol.

v Best metabolic control

v Less prone to develop complications. 

                       

Dr. Colin Palmer from the Department of Pharmacogenomics, School of Medicine, University of Dundee, said “recognizing subtypes (clusters of Type 2 Diabetes) might help doctors more specifically choose medications for their patients instead of going with standard ones.”

By:

M. Mercy Paul

Pharm. D 5^th year                          

Intern at Clinosol Research Pvt. Ltd.