The symptoms of diabetes were first described in an ancient Egyptian manuscript that dates back to about 1500 BC, when it described ‘too great emptying of the urine’. Around the same time, doctors in India also described the disease as ‘honey urine’ because of how it attracted ants. Around 250 BC, a Greek doctor by the name of Apollonius of Memphis coined the term diabetes which meant ‘to pass through’. Around 400-500 AD, a pair of doctors from India, Sushruta and Charaka, described the differences between what we know today as type 1 and type 2 diabetes. They differentiated the two as type 1 referring to children and type 2 related to obesity. Thomas Willis, a physician in the late 1600s was the first to use the term ‘mellitus’ which means ‘from honey’ as a way of differentiating it from diabetes insipidus.

Diabetes insipidus refers to the condition of passing out large amounts of urine on a daily basis – up to 20 liters per day – and a seemingly unquenchable thirst.

Diabetes mellitus refers to a group of conditions which include pre-diabetes, gestational diabetes and type 1 and type 2 diabetes.

Gestational diabetes is a condition that can be caused by being pregnant.

Type 1 diabetes is an autoimmune condition caused by a person’s antibodies attacking the pancreas and prevents it from producing insulin. This condition usually shows up in childhood and requires regular insulin injections.

I worked with a woman who had type 1 diabetes and she had to wear an insulin pump that helped her maintain her blood glucose levels.

Type 2 diabetes is also referred to as adult-onset diabetes which is generally caused by obesity. In some cases, a person can become diabetes free if they lose enough weight and watch their diet.

However, a new study, recently published in The Lancet, has suggested reclassifying diabetes into 5 categories or clusters. They discovered that those people they studied fell into 5 clusters, one of which included type 1 diabetes and the other 4 clusters were associated with type 2 diabetes.

The researchers are not suggesting a total changing of the terminology, but rather adding the 5 clusters to help define and treat diabetics.

According to a report, here are the 5 clusters:

• Cluster 1: Called “severe autoimmune diabetes,” this form is similar to type 1 diabetes. People in this cluster were relatively young when they were diagnosed, and they were not overweight. They had an immune system (autoimmune) disease that prevented them from producing inulin.
• Cluster 2: Called “severe insulin-deficient diabetes,” this form was similar to cluster 1 — people were relatively young at diagnosis and were not overweight. They were also not producing much insulin. But, crucially, their immune system was not the cause of their disease. People in this cluster “looked for all the world like [they had] type 1” diabetes, but they didn’t have “autoantibodies” that indicate type 1, Wyne said. Researchers aren’t sure why this happens, but people in this group may have a deficiency in the cells that produce insulin.
• Cluster 3: Called “severe insulin-resistant diabetes,” this form occurred in people who were overweight and had high insulin resistance, meaning their bodies were making insulin, but their cells were not responding to it.
• Cluster 4: Called “mild obesity-related diabetes,” this form occurred in people who had a milder form of the disease, without as many metabolic problems as those in cluster 3, and they tended to be obese.
• Cluster 5: Called “mild age-related diabetes,” this form was similar to cluster 4, but the people were older at their age of diagnosis. This was the most common form of diabetes, affecting about 40 percent of people in the study.

The researchers say that people in Cluster 2 have a greater risk of retinopathy (vision loss), the people in cluster 3 have a higher risk of kidney disease, both which are part of type 2 diabetes. The researchers suggest a more aggressive treatment to prevent these complications from occurring.

If you or someone in your family is diabetic, this study and new classification may help you or them and the doctor in treating the diabetic condition.