A SYSTEMATIC review examined the characteristics of a novel subgroup classification system for adult diabetes. The study, which analysed nearly 60,000 adult diabetes cases from 19 research papers, explored a new way of grouping diabetes that goes beyond the traditional distinction between type 1 and type 2.
Understanding the New Diabetes Subgroups
Researchers focused on seven novel diabetes subgroups: mild age-related diabetes (MARD), mild obesity-related diabetes (MOD), severe insulin-resistant diabetes (SIRD), severe insulin-deficient diabetes (SIDD), severe autoimmune diabetes (SAID), severe insulin-deficient and insulin-resistant diabetes (SIDRD), and severe obesity-related and insulin-resistant diabetes (SOIRD). These classifications were based on key metabolic features such as insulin resistance, beta-cell function, age, and body mass index (BMI).
Among the 59,915 patients reviewed, the MARD subgroup was the most common, accounting for about a third (32.5%) of cases. SIDD made up roughly 26%, MOD 22%, and SIRD 15%. The rarer subgroups, SAID, SIDRD, and SOIRD, represented smaller proportions but showed particularly severe metabolic disturbances.
The findings revealed striking differences in disease characteristics and complications across subgroups. Patients in the SIDD and SIDRD categories had higher blood glucose levels and significantly reduced beta-cell function, suggesting that they might require more aggressive glucose-lowering therapies. The SIRD and MARD subgroups showed lower kidney function, measured by reduced estimated glomerular filtration rate (eGFR), and a higher risk of diabetic nephropathy. Meanwhile, SIRD patients exhibited the most severe insulin resistance and pronounced lipid abnormalities, highlighting a potential need for targeted interventions to improve insulin sensitivity and lipid metabolism.
Toward More Personalised Diabetes Care
Overall, the study demonstrates that diabetes is not a single, uniform disease but a collection of related conditions with distinct biological and clinical profiles. The researchers argue that recognising and diagnosing the diabetes subgroups could transform its management by allowing clinicians to tailor treatments more precisely to each patient’s needs, moving the field closer to the goal of personalised diabetes care.
By adopting this refined classification, healthcare providers may improve disease outcomes, reduce complications, and enhance quality of life for millions living with diabetes worldwide.
Reference
Ao N et al. Clinical and laboratory characteristics of novel diabetes subgroups: a systematic review and meta-analysis. Sci Rep. 2025;15(1):38585.
