Adult-onset diabetes is a huge societal problem. In fact, problems with sugar metabolism are likely at the core of why most Americans develop heart disease and cancer. In addition, out-of-control sugar intake and insulin response can also seriously screw up your stem cells and shorten your life-span. Hence, when scientists discover a new type of diabetes, it’s a big deal.
Our pancreas houses beta cells that produce a glucose-regulating hormone called insulin. You’re probably most familiar with insulin as its relation to diabetes and the control of blood sugar. When we digest food, this increases our blood sugar. In response, healthy beta cells release the necessary amount of insulin to regulate our blood sugar. Basically, the insulin takes the sugar out of the bloodstream and forces it into the cells so that they can function. But what happens when our beta cells aren’t functioning properly and too much or not enough insulin is produced? The body can’t properly regulate the blood sugar and the cells eventually starve. In addition, all of this excess sugar in the blood wreaks havoc with the brain, heart, blood vessels, and other organ systems. Traditionally, once it gets to the point of not enough insulin, we know this as either type-1 or type-2 diabetes. Before we consider new types of diabetes, let me define these disease states.
Type-1 diabetes is an autoimmune disease in which the immune cells see the insulin-producing beta cells as foreign to the body and attack and destroy them. This usually happens in younger people, often in childhood or adolescence. No beta cells mean no insulin, which means the body is unable to control its own blood sugar. This is why type-1 diabetics must take insulin, and will always take insulin, to prompt the body to do what it can’t do for itself.
Type-2 diabetes is, by far, the most common. It is diagnosed when the cells can’t produce enough insulin to properly regulate the blood-sugar levels. In addition, insulin resistance can occur in type-2 diabetes when the previously normal levels of insulin are no longer able to effectively lower the blood sugar. So the beta cells are still doing the same job they’ve always done; it just isn’t enough. This most commonly happens in adults, so this is also known as adult-onset diabetes.
While type-1 diabetes is known to be a genetic and unpreventable disease, type-2 is associated with a variety of preventable environmental choices, such as poor diet, lack of exercise, metabolic syndrome (obesity, high blood pressure, etc.), and so on. In other words, while you can be genetically predisposed to obesity, if you have a healthy diet and exercise regularly, you will likely have a lower risk of metabolic syndrome and type-2 diabetes.
The new study was a cohort, meaning a combination two or more studies, that involved nearly 9,000 patients who’d been newly diagnosed with diabetes. Researchers considered variables such as age, BMI, and HbA1c levels (a long-term indicator of blood-sugar control) as well as complications, medications, genetic factors, and so on for each patient. Patients were placed into categories (termed clusters) based on the findings. The results? Interestingly, five distinct clusters, each with different diabetic characteristics and complications were determined.
Why is this significant? Diabetic patients in cluster 3, for example, carried increased risks for kidney disease. For those in cluster 2, retinopathy (eye disease) was more likely. Researchers hope with these findings, this is a first step toward diabetic treatments that can be more precisely focused on patients’ individual diabetic risks rather than the standard treatment approach to one of two types of diabetes. All of this means that there are likely subtypes of diabetics who have different risk factors for different serious disease.
In the meantime, as medical science strives to catch up to its newest diabetes findings, if you have type-2 diabetes or are borderline diabetic, there are some things you can do to work toward either controlling your diabetes or preventing it before it occurs:
The upshot? It always amazes me when we find out new things about the body and diseases that we thought we had dialed in. Expect many more of these discoveries in the age of big data analytics and artificial intelligence. As a result, I suspect that 50 years from now, physicians will look back at the quaint medicine that doctors embraced at the turn of 21st century, which to them will look as crazy as the medicine of our forebears in 1900 looks to us!
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About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…