Type 2 diabetes is five different conditions

Development of a new diagnostic tool for individualised diabetes treatment

Type 2 diabetes is five different conditions

“We have developed an analysis method that separates the different groups from each other. Hopefully, they can identify pre-diabetic people in order to provide prevention and early treatment.”

85–90 per cent of those with diabetes have type 2

“For 100 years we have only measured glucose. We add a number of extra variables, including C-peptide, which gives us a measurement of insulin secretion and insulin sensitivity, and HbA1c, a long-term measurement of glucose. Using this approach, we gain a lot more information from a single blood sample”, says Leif Groop.

Large differences

Leif Groop and his team have created cluster analyses by studying blood from tens of thousands of diabetics. There are considerable differences between the five groups concerning how the disease expresses itself. They are to be treated differently and it is important to find people in two of these groups at an early stage.

  • Group 1, under 10 per cent, overlaps with type 1 diabetes and have antibodies against their own insulin-producing cells.
  • Group 2, approx. 20 per cent, is a large group.

“These patients, whose lack of insulin is almost as severe as group 1, are treated incorrectly at present. They are to have insulin from the start, not metformin or other medication”, says Leif Groop.

  • Group 3, approx. 15 per cent, have severe insulin-resistance and a high risk of kidney and liver diseases.
  • Groups 4 and 5 have obesity and age-related diabetes respectively.

“These people actually only need lifestyle guidance and metformin. They are at risk of developing complications, but are considerably overrepresented in the studies”, points out Leif Groop.

New approach and treatment

The project is now developing a web portal where healthcare professionals can check which group a patient belongs to. In addition, they want to develop two apps, one for healthcare professionals and one for patients.

“It’s particularly important to start working with groups 2 and 3. This is a totally new way of looking at diabetes – group 2 patients are to have insulin from the start. We are working to find specific gene panels for group 3, so that we can identify the patients in advance. Many of those who receive their diagnosis have already started to develop kidney diseases.”

Seeking technical partners

Leif Groop estimates that within three to five years beta-versions of the apps will be tested and on the market and that methods will have been developed to identify pre-diabetic people in the various groups.

“We will also conduct a study in China and probably India as well. The relations between the different groups will be different there.”

After Swelife’s funding and important assistance with making contacts, subsequent investments have been received via Pfizer and Astra Zeneca.

“What we really need now are partners on the technical and marketing sides”, says Leif Groop.

Updated: 6 November 2017

Text: Jörgen Olsson