Diabetic diseases have long been classified as either type 1 or type 2, but the new research conducted in Scandinavia now indicates that such classification is over-simplistic. Published in The Lancet Diabetes & Endocrinology, this study reveals five distinct subtypes of diabetes and opens doors for more nuanced and personalized treatment strategies.

Simply, diabetes is when the glucose present in the blood is too high because of impaired functioning of insulin- a hormone in charge of regulation of glucose in the body. Type 1 diabetes occurs after the immune system attacks cells which produce insulin inside the pancreas, leading to a complete inability to produce this essential hormone. It most often presents with symptoms at young age and needs continuous insulin therapy.

Type 2 diabetes, on the other hand, is characterized by insulin resistance, where the body produces insulin but does not use it effectively. This type is generally linked to obesity, sedentary lifestyles, and genetics and often manifests in adulthood. While these classifications have guided treatment for decades, the new research divides diabetes into five distinct clusters, each with unique characteristics, risks, and management needs.

5 Cluster of Diabetes

1. Severe Autoimmune Diabetes (SAID)

This form of diabetes is very similar to the original concept of type 1 diabetes. This subtype is due to an autoimmune attack that destroys beta cells responsible for insulin production, leaving the body incapable of producing insulin. It usually occurs in younger people and necessitates tight blood sugar control and insulin therapy.

2. Severe Insulin-Deficient Diabetes (SIDD)

The other extreme type, but not autoimmune, is SIDD. This condition generally affects younger, nonobese people whose bodies do not produce enough insulin because the beta cells are damaged. Individuals diagnosed with SIDD are at the highest risk for complications, including blindness. Generally, treatment consists of insulin therapy, possibly combined with other orally taken medication.

3. Severe Insulin-Resistant Diabetes (SIRD)

SIRD is characterized by a significant resistance to insulin, often linked to obesity. People with SIRD struggle to use the insulin their body produces, resulting in poor blood sugar control. This subtype is associated with a higher risk of kidney disease, and current treatment options are less effective, emphasizing the need for new approaches to manage this group.

4. Mild Obesity-Related Diabetes (MOD)

This presents as a milder form of diabetes associated with obesity. Although these patients have some degree of insulin resistance, this is not as marked as it is in SIRD. Lifestyle interventions including weight loss and physical activity are particularly important in managing MOD, combined with conventional medications for diabetes.

5. Mild Age-Related Diabetes (MARD)

The most prevalent subtype, typically occurring in the elderly. It is less severe than other forms of diabetes, with fewer major complications. Lifestyle changes and oral medications, such as metformin, often are used to keep blood glucose levels within normal limits.

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What This Means for Diabetes Management

These five subtypes show that diabetes is complex, and one treatment fits all may not be applicable. In type 2 diabetes, metformin is currently the first drug prescribed to the majority of patients, and then other drugs are added if required. It might not be appropriate for all people, particularly for subgroups such as SIRD, who require more intensive therapies on insulin resistance.

Identifying these subtypes will also enable clinicians to direct appropriate treatments based on the specific risk profiles. For example, those classified as SIDD should have an earlier screen and preventive interventions to avoid blindness. In turn, SIRD may require specific interventions for renal protection.

This study represents a step forward, but it also opens up new questions. Researchers are exploring whether factors such as genetic markers or blood pressure measurements could further refine these subtypes. Furthermore, it is unclear whether a patient's classification might change over time, and so treatment plans need to be flexible and adaptive.

Therefore, findings in this field do not herald a need to completely change the type 1 and type 2 diabetes scheme currently in practice; they rather work as a guideline to develop individualized, high-precision and successful treatment systems in the years to come for the millions dealing with diabetes in today's times.

Diabetes is no longer just about type 1 or type 2. Five distinct subtypes have been identified, and the chronic condition's complexity has now opened the door to a new era of personalized care.

Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. The Lancet Diabetes & Endocrinologyl. 2018

Scientists at the University of Pittsburgh School of Medicine are making significant progress toward developing a brain-computer interface (BCI) that could help people with tetraplegia (paralysis) restore their lost sense of touch. In the new study published in Nature Communications, participants explored digitally represented objects using an artificially created sense of touch. Through the interface, they described sensations as vivid as the warm fur of a purring cat, the smooth, rigid surface of a door key, and the cool roundness of an apple. This collaborative effort between the University of Pittsburgh and the University of Chicago represents a major step forward in neuroprosthetics.

Unlike earlier experiments—where artificial touch often felt like undifferentiated buzzing or tingling—this study introduced a novel feature: BCI users had control over the details of the electrical stimulation that generated their tactile sensations. By enabling participants to personalise their sensory input, scientists were able to help them recreate intuitive and meaningful experiences.

"Touch is an important part of nonverbal social communication; it is a sensation that is personal and that carries a lot of meaning," said lead author Ceci Verbaarschot, Ph.D., assistant professor of neurological surgery and biomedical engineering at the University of Texas-Southwestern and a former postdoctoral fellow at Pitt’s Rehab Neural Engineering Labs. "Designing their own sensations allows BCI users to make interactions with objects feel more realistic and meaningful, which gets us closer to creating a neuroprosthetic that feels pleasant and intuitive to use."

BCI converts Brain Activity Into Signals

A brain-computer interface converts brain activity into signals that can replace, restore, or enhance bodily functions normally controlled by the brain, such as movement. BCIs can also be used to restore lost sensations by directly stimulating the brain, essentially bypassing damaged neural pathways. Over the last decade, Pitt researchers have shown that a paralysed individual can feel sensation using a mind-controlled robotic arm. However, those sensations lacked nuance—touching a person’s hand felt no different than grasping a hard rock.

In this new study, researchers moved closer to creating a realistic, intuitive sense of touch. BCI users were able to "design" different tactile experiences for objects displayed on a screen and could identify objects based on sensation alone—though not perfectly. Participants, all of whom had lost hand sensation due to spinal cord injuries, were challenged to match stimulation settings with sensations like petting a cat or touching an apple, key, towel, or toast.

Sensations Were Subjective

Describing their sensations in rich and subjective detail, one participant noted a cat felt "warm and tappy," while another described it as "smooth and silky." Even when images were removed and participants had to rely solely on touch, they correctly identified the objects 35% of the time—better than chance. "We designed this study to shoot for the moon and made it into orbit," said senior author Robert Gaunt, Ph.D., associate professor of physical medicine and rehabilitation at Pitt. "Participants had a really hard task... and they were quite successful.

Vanellope Hope Wilkins made medical history in 2017 when she was born with her heart outside her body—a condition so rare it's described by experts as "one of a kind." Recently, she underwent a procedure wherein doctors split open her ribs to insert her heart back into her chest cavity. After the successful operation, they shared how they performed the seemingly impossible surgeries.

Born in the UK with a condition known as ectopia cordis, Vanellope underwent three major operations at Glenfield Hospital in Leicester to place her heart back inside her chest. The hospital says it knows of no other case in the UK where a baby with this condition has survived. Now seven years old, Vanellope has undergone groundbreaking surgery to reconstruct a protective cage around her heart—using her own ribs. Since then, she has worn a brace around her chest for protection.

She lives with complex medical needs and requires one-to-one care 24 hours a day. Vanellope is autistic and non-verbal, but according to her mother, Naomi Findlay, 39, from Clifton, Nottingham, she is "a happy little thing" who "brings a lot of joy and happiness." Speaking to the BBC, Naomi said she is extremely proud of the fact that her daughter has not only survived her rare medical condition but also achieved. "It makes me extremely proud to see how far she's come, what she's overcome, and what she's achieving. It's a real journey of strength and bravery... she's so brave," Naomi said, adding that saying goodbye at the theatre door before surgery is always emotional.

How Was It Done?

The surgical team carefully decided that the timing was right for this next step. Vanellope was placed on a bypass machine, which temporarily took over the function of her heart and lungs. This allowed her heart to deflate, making it easier to perform the “very tricky” procedure.

Surgeons first detached part of her heart—the right ventricular outflow tract—and the pulmonary artery from where it had fused to her skin. Then came the bilateral rib osteotomy, a procedure involving breaking her ribs on both sides. The ribs were then repositioned to create a protective cage around her heart.

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As you grow older, a lot of things change in your body. Your body grows and develops. While some of these changes could be smooth, other transitions could create a bit of turmoil. One such is wisdom tooth.

What Is A Wisdom Tooth?

As per the National Library of Medicine, wisdom teeth come in at the very back of our mouth, with one at the end of each row of teeth. They usually do not fully develop until ages 18 to 24. This is when they appear and are commonly known as "troublemakers". This is because often in our jaws, there is not enough space for these teeth, and so it can cause pain when it comes out.

Often the growth of wisdom tooth could lead to pain and inflammation and thus, removal would be necessary.

Historically, wisdom tooth date back to our distant ancestors who had larger jaws and thus had more teeth. However, as time wet by and with evolution and changing eating practices, the jaws have shrunken and are thus too small for some people to accommodate the "extra" teeth. However, this does not mean that it causes problems for everyone. For many, these teeth can easily settle in.

The percentage of wisdom teeth extracted in women is significantly higher than men, this is because women often consult more often consult more than men, as is also noted in a 2021 study published in Annals of Medicine & Surgery, titled: The wisdom behind the third molars removal: A prospective study of 106 cases.

Another study published in the Journal of Oral Rehabilitation from 1987 also notes that women have a smaller maximum jaw opening than men. This could also be the reason why women need to get their wisdom tooth extracted more often than men.

What Are The Signs That Tell You To Extract Your Wisdom Tooth?

If you have these signs, you may want to consider extracting your wisdom tooth

Wisdom Tooth Impaction

This is when the third molars grow without fully emerging through your gums. This happens when they grow at an odd angle and emerge crooked, and cause further damage to the other healthy neighboring teeth. The impacted wisdom tooth could often grow at 180 degrees in the wrong direction into the jaw, and thus cause oral infection, jawbone cysts, and gym disease.

Gum Inflammation

This happens when food, plaque, and bacteria get underneath your gum tissue. Swollen or inflamed gums are often the first signs of wisdom tooth impaction.

Stiff Jaw

If you witness your jaw being stiff, then this could be because your wisdom tooth is pressing against your other teeth.

Jaw Pain

This could also happen when your wisdom tooth is impacted and thus you face pain in your jaw, especially while you try to open your mouth.

Persistent Bad Breath or Taste In Your Mouth

Despite brushing and following all the oral hygiene routine, you still experience bad breath, it could be because wisdom tooth have caused decay to your adjacent teeth.

So, When Should You Remove It?

If you face any of these signs, it is best to see your dentist and consult with them before you go ahead with an extraction surgery. Furthermore, the American Dental Association notes that you may need to have your wisdom tooth taken out, if you have:

• Pain in or near your wisdom teeth.
• Repeated infection of soft tissue behind the lower last tooth.
• Fluid-filled sacs called cysts.
• Tumors.
• Damage to nearby teeth.
• Gum disease.
• Widespread tooth decay