This review aims to describe the four metabolic subtypes or clusters of Type 2 DM. It summarises these different subtypes based on clinical and laboratory features—such as glutamic acid decarboxylase antibodies (GAD), age at onset, HbA1c, body mass index (BMI), and measures of insulin resistance and secretion—helping to characterise them. The main goal of identifying these clusters is to improve treatment personalisation and prevent complications that differ among these groups. The severe insulin-deficient group at diagnosis resembles Type 1 diabetes but lacks autoantibodies against beta cells and has different genetic markers. Microvascular complications like diabetic neuropathy and retinopathy are most common in this subtype, along with cardiovascular issues. Insulin therapy should be started early in this group. The insulin-resistant subtype is linked to the highest risk of diabetic nephropathy. Efforts to reduce insulin resistance and protect kidney function are essential for this cluster. The mild obesity-related and mild age-related subtypes usually have a lower risk of complications and respond well to lifestyle changes and weight loss. Recognising these subtypes of Type 2 DM allows for a personalised approach to disease management based on different metabolic profiles. For example, the insulin-deficient metabolic subtype carries the highest risk of microvascular complications, while the insulin-resistant subtype carries the greatest risk of diabetic kidney disease.
Author(s) Details
A. Manov
Internal Medicine and Transitional Year Residency Program, Mountain View
Hospital, Las Vegas, Nevada, USA.
S. Shehnaz
Sunrise Health GME Consortium, Las Vegas, Nevada, USA.
Please see the book here :- https://doi.org/10.9734/bpi/msraa/v11/6348
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