The many faces of diabetes: a disease with increasing heterogeneity

Tiinamaija Tuomi, Nicola Santoro, Sonia Caprio, Mengyin Cai, Jianping Weng, Leif Groop

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335 Citations (SciVal)


Diabetes is a much more heterogeneous disease than the present subdivision into types 1 and 2 assumes; type 1 and type 2 diabetes probably represent extremes on a range of diabetic disorders. Both type 1 and type 2 diabetes seem to result from a collision between genes and environment. Although genetic predisposition establishes susceptibility, rapid changes in the environment (ie, lifestyle factors) are the most probable explanation for the increase in incidence of both forms of diabetes. Many patients have genetic predispositions to both forms of diabetes, resulting in hybrid forms of diabetes (eg, latent autoimmune diabetes in adults). Obesity is a strong modifi er of diabetes risk, and can account for not only a large proportion of the epidemic of type 2 diabetes in Asia but also the ever-increasing number of adolescents with type 2 diabetes. With improved characterisation of patients with diabetes, the range of diabetic subgroups will become even more diverse in the future.
Original languageEnglish
Pages (from-to)1084-1094
JournalThe Lancet
Issue number9922
Publication statusPublished - 2014

Subject classification (UKÄ)

  • Endocrinology and Diabetes


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