Until recently, type 2 diabetes (T2D) was considered a single disease. We believed that the risks of poor health were similar for anyone who develops T2D. Now, it appears that T2D can be divided into different groups of people based on their genes, medical history, and risk for future complications. We know that excess weight and high blood sugar levels may be common factors for individuals with T2D. However, this research shows that the long-term health outcomes may be different between individuals. This impacts how people choose the best treatment options for them.
The 4 kinds of type 2 diabetes
Researchers looked at over 5,000 participants aged 45-76 years with T2D. Participants were offered intensive lifestyle treatment (such as reducing calorie intake in the diet and increasing physical activity). For comparison, they also had a control group who received usual care without lifestyle changes. The study lasted 10 years. Researchers were interested in what happened to the participants’ weight, waist size and diabetes control once they made the lifestyle changes. They found that the effects of the lifestyle changes were different in four groups of people. The four groups included: older age at time of diabetes diagnosis (42% effective), people with severe obesity (24% effective), those developing diabetes at a younger age (20% effective), and those with poor blood sugar control (14% effective). This shows that lifestyle intervention was consistently less effective in the group with poor blood sugar control compared to the other three groups of people (including older age at diabetes diagnosis, severe obesity, and younger age at diabetes diagnosis).
The future is personal
Going forward, this new research shows that when it comes to treating T2D, we need to move away from “one size fits all.” There is a need to offer people living with diabetes a more personalized approach.