{"id":91879,"date":"2024-04-19T09:00:10","date_gmt":"2024-04-19T13:00:10","guid":{"rendered":"https:\/\/newsroom.carleton.ca\/?post_type=cu_story&p=91879"},"modified":"2025-08-19T09:37:02","modified_gmt":"2025-08-19T13:37:02","slug":"type-2-diabetes-subtypes-treatment","status":"publish","type":"cu_story","link":"https:\/\/carleton.ca\/news\/story\/type-2-diabetes-subtypes-treatment\/","title":{"rendered":"Type 2 Diabetes Is Not One-Size-Fits-All: Subtypes Affect Complications and Treatment Options"},"content":{"rendered":"\n
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\n Type 2 Diabetes Is Not One-Size-Fits-All: Subtypes Affect Complications and Treatment Options\n <\/h1>\n \n <\/header>\n <\/div>\n\n \n <\/path>\n <\/path>\n <\/svg>\n <\/div>\n\n \n\n <\/div>\n<\/section>\n\n

This article is republished<\/a> from The Conversation under a Creative Commons licence. All photos provided by The Conversation<\/a> from various sources.<\/p>\n\n\n\n

Lili Grieco-St-Pierre<\/a> is a PhD student of biochemistry at Carleton University, and Jennifer Bruin<\/a> is an associate professor in biology and in the university’s Institute of Biochemistry.<\/p>\n\n\n\n

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You may have heard of Ozempic, the “miracle drug” for weight loss, but did you know that it was actually designed as a new treatment to manage diabetes? In Canada, diabetes affects approximately 10 per cent of the general population<\/a>. Of those cases, 90 per cent have Type 2 diabetes.<\/p>\n\n\n\n

This metabolic disorder is characterized by persistent high blood sugar levels, which can be accompanied by secondary health challenges, including a higher risk of stroke and kidney disease<\/a>.<\/p>\n\n\n\n

Locks and keys<\/h2>\n\n\n\n

In Type 2 diabetes, the body struggles to maintain blood sugar levels<\/a> in an acceptable range. Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells. This equilibrium needs to be tightly controlled and is regulated by a lock and key system.<\/p>\n\n\n\n

In the body’s attempt to manage blood sugar levels and ensure that cells receive the right amount of energy, the pancreatic hormone, insulin, functions like a key<\/strong>. Cells cover themselves with locks<\/strong> that respond perfectly to insulin keys to facilitate the entry of sugar into cells.<\/p>\n\n\n\n

Unfortunately, this lock and key system doesn’t always perform as expected. The body can encounter difficulties producing an adequate number of insulin keys, and\/or the locks can become stubborn and unresponsive to insulin.<\/p>\n\n\n\n

All forms of diabetes share the challenge of high blood sugar levels; however, diabetes is not a singular condition; it exists as a spectrum. Although diabetes is broadly categorized into two main types, Type 1 and Type 2, each presents a diversity of subtypes, especially Type 2 diabetes.<\/p>\n\n\n\n

These subtypes carry their own characteristics and risks, and do not respond uniformly to the same treatments<\/a>.<\/p>\n\n\n\n

To better serve people living with Type 2 diabetes, and to move away from a “one size fits all” approach, it is beneficial to understand which subtype of Type 2 diabetes a person lives with. When someone needs a blood transfusion, the medical team needs to know the patient’s blood type. It should be the same for diabetes so a tailored and effective game plan can be implemented.<\/p>\n\n\n\n

This article explores four unique subtypes of Type 2 diabetes, shedding light on their causes, complications and some of their specific treatment avenues.<\/p>\n\n\n\n

Severe insulin-deficient diabetes: We’re missing keys!<\/h2>\n\n\n\n
\"Illustration<\/a>
In severe insulin-deficient diabetes, beta cells limit production of the keys that unlock cells to allow entry of sugar from the blood.<\/span>
\n(Lili Grieco-St-Pierre, Jennifer Bruin\/Created with BioRender.com)<\/span><\/span><\/figcaption><\/figure>\n\n\n\n

Insulin is produced by beta cells, which are found in the pancreas. In the severe insulin-deficient diabetes (SIDD) subtype, the key factories \u2014 the beta cells \u2014 are on strike. Ultimately, there are fewer keys in the body to unlock the cells and allow entry of sugar from the blood.<\/p>\n\n\n\n

SIDD primarily affects younger, leaner individuals, and unfortunately, increases the risk of eye disease and blindness<\/a>, among other complications. Why the beta cells go on strike remains largely unknown, but since there is an insulin deficiency, treatment often involves insulin injections.<\/p>\n\n\n\n

Severe insulin-resistant diabetes: But it’s always locked!<\/h2>\n\n\n\n
\"A<\/a>
In severe insulin-resistant diabetes, the locks start ignoring the keys, triggering the beta cells to produce even more keys to compensate.<\/span>
\n(Lili Grieco-St-Pierre, Jennifer Bruin\/Created with BioRender.com)<\/span><\/span><\/figcaption><\/figure>\n\n\n\n

In the severe insulin-resistant diabetes (SIRD) subtype, the locks are overstimulated and start ignoring the keys. As a result, the beta cells produce even more keys to compensate. This can be measured as high levels of insulin in the blood, also known as hyperinsulinemia.<\/p>\n\n\n\n

This resistance to insulin is particularly prominent in individuals with higher body weight. Patients with SIRD have an increased risk of complications such as fatty liver disease<\/a>. There are many treatment avenues for these patients but no consensus about the optimal approach<\/a>; patients often require high doses of insulin.<\/p>\n\n\n\n