A new classification of diabetes mellitus  – current approaches and challenges

Alicja  Szatko; Katarzyna  Mordarska; Joanna  Pokrzywa; Małgorzata  Godziejewska-Zawada

doi:10.36553/wm.65

Published: 2020-12-20

Vol. 2 No. 2 (2020)

A new classification of diabetes mellitus – current approaches and challenges

Alicja Szatko , Katarzyna Mordarska , Joanna Pokrzywa , Małgorzata Godziejewska-Zawada

Wiedza Medyczna

Section: Review papers

https://doi.org/10.36553/wm.65

Abstract

Diabetes is a chronic metabolic disorder with a rapidly growing incidence worldwide. It is currently classified into two main types, type 1 and type 2 diabetes, based on status of the autoantibodies directed at the β-cell. However, it does not reflect the complexity of diabetes and the broad spectrum of the clinical manifestations, particularly in type 2.

In this review we present the evolution of the World Health Organization (WHO) classification of diabetes, with a focus on newly introduced categories – hybrid forms of diabetes and unclassified diabetes. We compare the WHO diabetes subgroups with the American Diabetes Association (ADA) approach to this issue. Since the current classification systems do not reflect all the factors leading to hyperglycaemia in type 2 diabetes, we present novel approach to phenotyping diabetes in adults based on six variables (age at diagnosis, body mass index [BMI], C-peptide based homeostasis model assessments of β-cell function and insulin resistance, haemoglobin A1c and glutamic acid decarboxylase antibodies [GADA] status) which allowed to distinguish five replicable groups of patients in Swedish cohort with different clinical presentations.

The understanding heterogeneity of diabetes helps to classify the patients more adequately, but none of classifications is optimal. Including combination of genetic, metabolomic and clinical factors into classification schemas will pave the way towards personalized medicine in diabetes and will presumably result in more effective treatment of the patients.

Keywords:

classification of diabetes, hyperglycaemia, diabetes mellitus type 1, diabetes mellitus type 2, other types of diabetes

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Szatko, A. ., Mordarska, K. ., Pokrzywa, J. ., & Godziejewska-Zawada, M. . (2020). A new classification of diabetes mellitus – current approaches and challenges. Wiedza Medyczna, 2(2), 62–71. https://doi.org/10.36553/wm.65

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Alicja Szatko

Affiliation:

Department of Endocrinology, Bielański Hospital, Warsaw, Poland Poland

Katarzyna Mordarska

Affiliation:

Department of Endocrinology, Bielański Hospital, Warsaw, Poland Poland

Joanna Pokrzywa

Affiliation:

Department of Endocrinology, Bielański Hospital, Warsaw, Poland Poland

Małgorzata Godziejewska-Zawada

Affiliation:

Department of Endocrinology, Center of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland Poland

A new classification of diabetes mellitus – current approaches and challenges

Abstract

Keywords:

Alicja Szatko

Katarzyna Mordarska

Joanna Pokrzywa

Małgorzata Godziejewska-Zawada

A new classification of diabetes mellitus – current approaches and challenges