Type 2 diabetes is a complex metabolic disorder in which almost all of our organs and tissues stop feeling the hormone insulin. It makes cells absorb glucose, but if insulin signals are not received, then no one absorbs glucose. Its level in the blood rises greatly, and this leads to various grave consequences.
But diabetes doesn’t happen overnight. He has a preliminary stage – prediabetes. A person with prediabetes is not yet sick, the blood sugar level is steadily elevated, but remains within the normal range; the same can be said for other metabolic parameters. If you notice the beginning problems in time, then real diabetes can be avoided – for example, by changing the diet. However, prediabetes can “grow” into a real illness. And there may be different options. For example, someone very quickly has severe diabetic complications such as kidney failure. And for some, diabetes remains in a mild form, which is indicated only by the sugar level, slightly out of the normal range. And some people never get diabetes at all.
As it turned out, the severity of diabetes largely depends on what type of prediabetes the patient has. The types of pre-diabetes are discussed in Nature Medicine staff Diabetes Center Germany and the University of Tübingen. The researchers used medical data from several hundred people who, for 25 years, underwent tests in the laboratories of the University of Tübingen and passed various tests, from genetic ones to magnetic resonance imaging. The types of prediabetes were identified using statistical analysis of data on the level of glucose and lipids in the blood, the amount of fat in the liver, etc. – all this, of course, taking into account the genetic information about whether a particular person is predisposed to diabetes or not.
There were six types. Among them there are less dangerous and more dangerous. Three harmless prediabetes rarely develop into real diabetes: although the level of sugar in them is elevated, it almost never comes to pathology. Curiously, non-dangerous prediabetes can occur in both thin people and overweight people. The other three types of prediabetes usually spill over into real diabetes, with complications. One of the dangerous prediabetes is characterized by too low insulin levels. Another is a high fat content in the liver and a strong insensitivity to insulin, either a lot or a little: the tissues just barely perceive insulin signals and absorb glucose very poorly. Finally, with the third dangerous prediabetes, kidney failure begins very early – so early that it outstrips diabetes itself.
To verify the results, the authors used data from nearly 7,000 other patients who participated in a large-scale medical study in the UK. And these nearly seven thousand were found to have the same six types of prediabetes.
Obviously, the new data will be useful primarily in everyday medicine. The future of a patient who has something wrong in the metabolism must be assessed by a set of parameters – because, for example, being overweight alone does not mean that a person will necessarily develop diabetes. It is the set of parameters that indicate this or that type of prediabetes that will help to understand who should slightly adjust their lifestyle, and for whom the doctor should immediately take it seriously.
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