Nature Medicine: 25 years of research suggests that there are 6 subtypes in prediabetes!

Diabetes (DM) is considered one of the four noncommunicable diseases by the World Health Organization (WHO).
DM is a chronic disease caused by insufficient insulin secretion, sugar metabolism disorders and high blood sugar.
typical symptoms are commonly known as "three more than one less" - more urine, more drinking, more food and weight loss.
463 million DM patients worldwide today, according to the latest Global DM Map (9th edition) published on the official website of the International Diabetes Federation (IDF) in 2019.
1 in 11 adults (20-79 years old) has DM.
, China has the largest number of DM patients, with about 116 million patients.
projected to reach 578.4 million DM patients worldwide by 2030.
as one of the top 10 causes of death, 4.2 million people aged 20-79 died from DM or its complications in 2019 alone, equivalent to one death from DM every eight seconds, or about 11.3 percent of all deaths worldwide.
2019, global DM-related health spending will be about $760 billion.
know that before DM occurs, patients tend to go through a long period of prediabetes - impaired blood sugar on an empty stomach or abnormal glucose tolerance.
these two groups of people do not meet the diagnostic criteria for DM, but are already at high risk of type 2 diabetes (T2DM).
, however, there has been no established criteria for the pre-DM parting.
to this end, a team of experts from the Institute of Diabetes and Metabolic Diseases (IDM) and the German Diabetes Research Centre (DZD) at the University of Tubingen in Germany explored this work to predict future metabolic trajectories and better target DM-risk populations at an early stage.
study lasted 25 years and included 899 people diagnosed with prediabetes.
results were published in the latest issue of the journal Nature Medicine.
899 participants were from the TUEF/TULIP study, which measured metabolic data such as oral glucose tolerance tests, blood lipid levels, MRI measurements of body fat distribution, liver fat content and genetic risk over a 25-year period.
first of all, the above indicators were analyzed and six subgroups with characteristics were identified.
then validate variables identified in the queue using complex esopes in another study (WHITEHALL II).
results showed that MTNR1B rs10830963 bits were significantly associated with group specificity of diabetes-related genetic variation.
overall DM risk was lower in groups 1, 2, and 4 of the group, while the risk of DM and complications was significantly associated in the other three subgroups.
, group 5 had the highest incidence of DM, followed by group 3, and group 6 did not have a significant increase in DM risk during tuEF/TULIP study follow-up.
Further analysis showed that group 3 was generally at high risk because of low insulin secretion due to genetic factors;
It can be seen that, like DM, there are different esophoms in the early stages of DM, with different esopter subgroups of people with different blood sugar levels, insulin action and insulin secretion, body fat distribution, liver fat and genetic risk.
future, further forward-looking research is needed to explore the practicality of esothic classification methods.
, identifying and grouping the pre-DM population is beneficial to better prevent the occurrence of DM and its complications.
: Wagner, R., Heni, M., Tabák, A.G. et al. (2021). Pathophysiology-based subphenotyping of individuals at elevated risk for type 2 diabetes. Nat Med, DOI: MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized, may not be reproduced by any media, website or individual, and shall be reproduced with the words "Source: Mets Medicine".
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