Researchers identify two biological forms of type 1 diabetes

A new international study suggests that type 1 diabetes may consist of two biologically distinct forms, ERR reports. Researchers from the United States and the United Kingdom reached the conclusion after examining the genetic material of more than 9,000 people with diabetes and nearly 14,000 healthy people.

The scientists divided the patients into two groups based on two common gene patterns known as HLA-DR3 and HLA-DR4. Both variants are associated with a high risk of diabetes, but the study found that they affect the immune system in different ways.

The genetic similarity between the two groups was unexpectedly limited. The researchers said the two forms of type 1 diabetes differ genetically by roughly as much as schizophrenia and bipolar disorder.

In patients with the DR4 gene pattern, T cells appear to play the leading role in the disease. These immune cells attack and destroy the insulin-producing beta cells in the pancreas after receiving an incorrect signal.

In people with the DR3 variant, mast cells appeared to be central to the mechanism. These cells are commonly associated with allergic reactions and inflammation.

Although patients in both groups ultimately require insulin injections, the pathways leading to the onset of the disease may differ. The researchers said the finding could be important for future treatments and prevention.

If doctors know a patient’s specific genetic pattern, they may be able to choose more targeted treatment, such as suppressing T cells in one group and targeting other immune cells in the other.

The researchers published their findings in the journal Diabetologia.