Diabetes mellitus is much more complex and variable than the classification into type 1 and type 2 diabetes suggests. Researchers are therefore proposing a new classification of diabetes, i.e., the classification into five diabetes subtypes (see table).  These form the basis for more precise treatment and prevention of complications. Current studies show that patients in the individual subgroups have a different risk of complications. However, do the subtypes also have different levels of risk for depression symptoms, reduced quality of life, reduced well-being and diabetes-related distress?
 

Data from the German Diabetes Study (GDS) have been analyzed

In order to investigate the relationship between the diabetes subtypes and the self-reported health status (patient-reported outcomes) perceived by people with diabetes, researchers from the DZD partner German Diabetes Center analyzed the data of 1,391 participants in the German Diabetes Study (GDS). The GDS is a prospective, multicenter observational study investigating the course of diabetes in adults newly diagnosed with the disease (< 12 months). In addition to a variety of examinations, the GDS participants also complete validated questionnaires during the visits, including questionnaires on well-being, health-related quality of life, depression symptoms and diabetes-related distress (diabetes distress).

Recognizable differences between the diabetes subtypes

The study showed that, depending on the diabetes subtype, the participants differed in terms of depressive symptoms, health-related quality of life, well-being and diabetes-related distress as early as in the first year after diagnosis.

For example, at the time of study inclusion, people with severe insulin-resistant diabetes (SIRD) reported more severe symptoms of depression and a lower physical quality of life than people with other subtypes. People with severe autoimmune diabetes (SAID) reported more severe symptoms of depression and lower mental quality of life than people with mild age-related diabetes (MARD).

After five years, people with SIRD were almost three times or two times more likely to have clinically relevant symptoms of depression and a lower level of well-being than people with MARD. “Our results indicate that belonging to a diabetes subtype is related to the risk of future depressive symptoms,” explains DZD researcher Prof. Dr. Dr. Andrea Icks, Director of the Institute for Health Services Research and Health Economics at the DDZ.
 

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Treating Diabetes More Precisely

“With its research, the DDZ is making a significant contribution to the detailed characterization of the risk of complications in the diabetes subtypes. The aim of precision diabetology is to develop tailor-made therapy concepts for people with diabetes and thus, on the one hand, to positively influence the course of the disease and, on the other hand, to enable those affected to have the best possible quality of life,” emphasizes Prof. Dr. Michael Roden, Scientific Managing Director and Spokesman of the Board of the DDZ and Director of the Clinic for Endocrinology and Diabetology at the University Hospital Düsseldorf (UKD) and Spokesman of the German Center for Diabetes Research.

Original publication:
Sommer J, Borgmann SO, Gontscharuk V et al.:  Depression symptoms, wellbeing, health-related quality of life, and diabetes-related distress in novel subtypes of recent-onset diabetes in Germany: a 5-year observational follow-up study. Lancet Diabetes Endocrinol (2024).   DOI: 10.1016/S2213-8587(24)00234-1