Identification of subtypes of type I and II diabetes mellitus in the CHINESE population - men/women
Diagnosis of LADA-type diabetes mellitus
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Diagnosis of diabetes mellitus' subtypes
LADA - Latent Autoimmune Diabetes of Adults - It is the autoimmune diabetes that begins in adulthood and does not require insulin for glycemic control, at least for the first six months after diagnosis, due to the fact that the autoimmune process that destroys pancreatic β-cells evolves more slowly than in type 1 diabetes. It is sometimes also called diabetes 1.5. It has genetic, immunological and metabolic features common with both type 1 and type 2 diabetes mellitus with a progressively unfavorable course.
SAID - Severe Autoimmune Diabetes - is the classic type I, insulin-dependent and autoimmune diabetes, characterized by low insulin secretion and poor metabolic control. Increased risk of ketoacidosis at diagnosis, increased risk of retinopathy, and increased incidence of chronic kidney disease. Comprise 128 of 5,011 (2.6%), the patients showed the presence of GADA auto-antibodies and lower BMI.
SIDD - Severe Insulin Deficient Diabetes - This subgroup, comprising 999 out of 5011 subjects (19.9%) was characterized as having severe deficiency of insulin, poor control of HbA1c levels but normal levels of triglicerides and uric acid. More details
SIRD - Severe Insulin Resistant Diabetes - In this subgroup comprising 95 out of 5011 (1.9%), patients had insulin resistance, poor metabolic control with higher triglycerides and uric acid. It has severe lipid metabolic dysregulation accompanied by a substantial elevation of triglycerides, a significant reduction in high-density lipoprotein cholesterol and a major decrease in vitamin D. More details
MARD - Mild Age-Related Diabetes - In this subgroup, comprising 1,236 out of 5,011 (24.7%) patients were labeled as having senile-onset disease and mild disturbance in the levels of triglycerides. It has the lowest proportion of familiy history of diabetes.
MOD - Mild Obesity-Related Diabetes - In this subgroup with 859 out of 5,011 (17.1%), the patients showed obesity, early-onset disease and relatively poor control of HbA1c, elevated triglycerides and uric acid whereas they did not have insulin resistance. Has the highest proportion of alcohol drinking.
UARD - Uric Acid Related Diabetes - In this subgroup comprising 618 of 5,011 (12.3%) the patients had the highest level of uric acid, accompanied by mild insulin resistance and good control of HbA1c, higher residual β-cell function and older age-onset disease. It has higher systolic blood pressure, lower hemoglobin and albumin, and worse renal function, with higher levels of creatinine and proteinuria.
IRD - Inheritance-Related Diabetes - In this subgroup, comprising 1,076 of 5,011 (21.5%) patients the patients have the highest proportion of family history of diabetes, and moderate levels of triglycerides,uric acid, and insulin resistance compared with patients in other subgroups.
References - Xiao-fen Xiong, Yuan Yang, Ling Wei, Ying Xiao, Li Li, Lin Sun. Identification of two novel subgroups in patients with diabetes mellitus and their association with clinical outcomes: A two-step cluster analysis. J Diabetes Investig 2021; 12: 1346–1358. Available here.