More than just type 1 or type 2: DiMelli study points to different forms of diabetes

September 12, 2013

The DiMelli (Diabetes Mellitus Incidence Cohort Registry) study examines the frequency and characteristics of diabetes phenotypes in children and young adults below the age of 20. The study was commissioned to investigate the increasing incidence of diabetes mellitus, particularly in childhood and early adulthood.

The project is funded by the German Center for Diabetes Research (DZD). Bioprobe measurements were performed centrally by the Central Medical Laboratory (LMZ) at the Helmholtz Zentrum München (HMGU) so as to guarantee the high quality and comparability of laboratory parameters. The study is based on the DiMelli Bavarian Diabetes Register, the only register of its kind in Germany, which collects data on biological parameters in the blood of newly diagnosed diabetics as well as their phenotypic characteristics, i.e. their physical symptoms and features. A questionnaire is used to identify the characteristics of the form of the disease occurring in the patient in question such as body weight and weight changes as well as , residual and other biomarkers.

The team of scientists headed by Professor Anette-Gabriele Ziegler, Dr. Katharina Warncke and Dr. Andreas Beyerlein from the Institute of Diabetes Research (IDF) at the Helmholtz Zentrum München, the Diabetes Research Group at the Technical University of Munich (TUM), the Children's Hospital in Munich-Schwabing and the Department of Pediatrics at the Klinikum rechts der Isar, Technical University of Munich, have now evaluated the initial data from the DiMelli study.

Between April 2009 and June 2012, 630 people were included in the register. Of that number, 522 exhibited two or more diabetes-specific antibodies while 64 participants in the study displayed one antibody. In 44 of the participants no antibodies were found. The existence of antibodies characterizes autoimmune , whereas occurs without any specific immunological reaction. Although the participants with and without diabetes-specific autoantibodies displayed different characteristics in terms of body weight, weight loss and residual insulin production function, as expected, the phenotypic features could not be clearly assigned to specific disease types. This means that the formation of autoantibodies does not go hand-in-hand with a clearly separable combination of other blood values and clinical characteristics.

The authors thus conclude that the latest scientific findings no longer support such a rigid classification of diabetes. Rather there appears to be a continuum of forms and a mixture of diabetes . "In order to be able to introduce the right steps in treatment and to offer patients accurate information about their disease, it is essential to refine the criteria for differentiating and diagnosing the different forms of diabetes," Professor Ziegler explains. "Further studies are now required to shed light on the long-term development of the phenotypes, the distribution of different types of and the way in which their features present themselves in adult patients."

Explore further: New data on islet autoantibodies in young children defines early type 1 diabetes development

More information: Warncke, K. et al. (2013): Does Diabetes Appear in Distinct Phenotypes in Young People? Results of the Diabetes Mellitus Incidence Cohort Registry (DiMelli), PLOS ONE, DOI: 10.1371/journal.pone.0074339.s002

Related Stories

New data on islet autoantibodies in young children defines early type 1 diabetes development

June 19, 2013
A decade-long JDRF-funded study led by the Institute of Diabetes Research in Helmholtz Zentrum München, Germany, is providing a deeper understanding of the link between autoantibodies and the risk of developing type 1 diabetes ...

Markers of beta-cell dysfunction associated with high rate of progression to type 1 diabetes

June 18, 2013
The majority of children at risk of type 1 diabetes who developed 2 or more diabetes-related autoantibodies developed type 1 diabetes within 15 years, findings that highlight the need for research into finding interventions ...

Lap band surgery helps combat diabetes

September 2, 2013
(Medical Xpress)—A trial of gastric band surgery in overweight people with type 2 diabetes has found the surgery resulted in better outcomes for diabetes and weight loss than standard exercise and diet plans.

Severe hypoglycemia in diabetes tied to cardiac disease

August 16, 2013
(HealthDay)—For patients with type 1 and type 2 diabetes, severe hypoglycemia is associated with severe hypertension, hypokalemia, and QT prolongation, according to a study published online Aug. 12 in Diabetes Care.

Family history of diabetes increases the risk of prediabetes by 26 percent, with effect most evident in non-obese

August 21, 2013
A study involving more than 8,000 participants has shown that people with a family history of diabetes see their risk of prediabetes increase by 26%. The research is published in Diabetologia, the journal of the European ...

Posttraumatic stress disorder associated with type 2 diabetes

May 16, 2013
The presence of posttraumatic stress disorder is significantly associated with the development of type 2 diabetes. This is the finding of scientists from the Helmholtz Zentrum München and the University Hospital Gießen ...

Recommended for you

Scientists discover a new way to treat type 2 diabetes

July 21, 2017
Medication currently being used to treat obesity is also proving to have significant health benefits for patients with type 2 diabetes. A new study published today in Molecular Metabolism explains how this therapeutic benefit ...

Alzheimer's drug cuts hallmark inflammation related to metabolic syndrome by 25 percent

July 20, 2017
An existing Alzheimer's medication slashes inflammation and insulin resistance in patients with metabolic syndrome, a potential therapeutic intervention for a highly dangerous condition affecting 30 percent of adults in the ...

Diabetes or its precursor affects 100 million Americans

July 19, 2017
Almost one-third of the US population—100 million people—either has diabetes or its precursor condition, known as pre-diabetes, said a government report Tuesday.

One virus may protect against type 1 diabetes, others may increase risk

July 11, 2017
Doctors can't predict who will develop type 1 diabetes, a chronic autoimmune disease in which the immune system destroys the cells needed to control blood-sugar levels, requiring daily insulin injections and continual monitoring.

Diabetes complications are a risk factor for repeat hospitalizations, study shows

July 7, 2017
For patients with diabetes, one reason for hospitalization and unplanned hospital readmission is severe dysglycemia (uncontrolled hyperglycemia - high blood sugar, or hypoglycemia - low blood sugar), says new research published ...

Researchers identify promising target to protect bone in patients with diabetes

July 7, 2017
Utilizing metabolomics research techniques, NYU Dentistry researchers investigated the underlying biochemical activity and signaling within the bone marrow of hyperglycemic mice with hopes of reducing fracture risks of diabetics

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.