Cluster Classification of Diabetes Mellitus

Diabetes mellitus is a chronic disease representing a significant health, medicos-ocial and economic problem. The complex etiopathogenesis suggests its division into more than the hitherto known main types – diabetes mellitus type 1, diabetes mellitus type 2, gestational diabetes mellitus and symptomatic diabetes mellitus. The introduction of a new cluster classification, dividing patients into 5 specific groups, would help specialists to individualize their therapeutic approach and comprehensively define the presence of complications at the time of diagnosis. By evaluating the following 6 indicators – age, body mass index (BMI), HgA1c, presence of anti-GAD65 antibodies, assessment of beta-cell function (HOMA2-B) and insulin resistance (HOMA2-IR), diabetes mellitus can be classified into any of the following groups – severe autoimmune, severe insulin-deficient, severe insulin-resistant, mild obesity-related, and mild age-related diabetes mellitus. Pursuing a personalized approach would improve patient health, delay debilitating complications, and reduce healthcare costs by directing them toward disease-specific prevention and management. In the present review article, the specific characteristics of the different clusters, their frequency and association with a specific complication, based on data from different studies among populations around the world, showing their importance and necessity of use in daily practice, are discussed in particular.