糖尿病分型新视野——基于临床表现向基于病因分子机制转变

doi:10.3969/j.issn.1006-5725.2024.16.001

Abstract

Abstract:

The classification of diabetes is undergoing a significant transformation. As advancements in medical technology and a deeper understanding of its etiology， traditional classification methods based on clinical characteristics and insulin dependency are increasingly revealing their limitations. In recent years， the integration of genomic， epigenetic， and metabolomic technologies， combined with the application of big data analytics and machine learning in disease classification， has propelled diabetes classification towards enhanced precision and personalization. These cutting-edge technologies elucidate the intricate pathophysiological mechanisms and extensive heterogeneity inherent in diabetes， offering novel methodologies for early diagnosis， individualized treatment， and prognostic evaluation. This paradigm shift not only deepens the comprehension of diabetes complexity but also holds the potential to provide more precise and efficacious therapeutic interventions for patients. Consequently， this marks a historic transition from simplistic， clinically-based classification systems to sophisticated， molecular mechanism-based paradigms in diabetes classification.

Key words: diabetes classification, etiological molecular mechanism, early diagnosis, precision medicine

CLC Number:

R587.1

Shuting YANG,Shuoming LUO,Zhiguang. ZHOU. A new vision of diabetes classification： A shift from clinical manifestation to etiological molecular mechanism[J]. The Journal of Practical Medicine, 2024, 40(16): 2199-2205.

Figures/Tables 2

References 72

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分型依据	亚型
自身免疫病因分型	自身免疫性1型糖尿病
自身免疫病因分型	特发性1型糖尿病
病情进展缓急分型	经典1型糖尿病
	暴发1型糖尿病
	缓发1型糖尿病（根据起病年龄是否超过18岁，分为LADY和LADA）

亚型名称	亚型特征
严重胰岛素缺乏型糖尿病（SIDD)	BMI相对较低，胰岛素分泌水平低，代谢控制差，容易发生糖尿病视网膜病变
严重胰岛素抵抗型糖尿病（SIRD)	高胰岛素抵抗和高BMI, 代谢控制较差，容易发生糖尿病肾病
轻度肥胖相关型糖尿病（MOD）	肥胖，不具有明显胰岛素抵抗，代谢状况较好，主要见于体重超重的人群
轻度年龄相关型糖尿病（MARD）	年龄相对较大，仅有轻度代谢紊乱

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A new vision of diabetes classification： A shift from clinical manifestation to etiological molecular mechanism

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