Not everyone who has pre-diabetes with elevated blood glucose levels will go on to develop type 2 diabetes. Robert Wagner of the DZD partner Medical Clinic IV of Tübingen University Hospital has shown that there are six clearly definable subtypes that differ in the development of the disease, the risk of diabetes and the development of secondary diseases. For his findings, he was awarded the  Prevention Award 2021 by the German Foundation for Internal Medicine (DSIM) and the German Society for Internal Medicine (DGIM).  

In order to identify people at high risk of type 2 diabetes and secondary diseases at an early stage, Professor Robert Wagner, MD, examined the data of people at risk for diabetes but who had not yet developed the disease. The test persons (n=899) came from the Tübingen Family Study and the study of the Tübingen Lifestyle Program, who have repeatedly undergone intensive clinical, laboratory-chemical, magnetic resonance imaging and genetic examinations over the past 25 years. Using parameters such as the oral glucose tolerance test, magnetic resonance measurements of body and liver fat and genetic testing, his team identified six different clusters: In three prediabetes clusters, the probability of developing the disease was rather low, but the three other patient groups showed a high risk of developing type 2 diabetes, including more severe courses and secondary diseases. In one subtype, damage to the kidneys already occurred before a diabetes diagnosis. The mortality rate is also particularly high here. The cluster classification was confirmed in a British study with several thousand participants. 

"Professor Wagner's findings are of great value because in the future they could open up the possibility of better and earlier assessments of the individual risks and courses of type 2 diabetes," said Professor Stefan Frantz, MD, chairman of the German Foundation for Internal Medicine. "For example, they could make it possible to establish monitoring, prevention and therapy regimes specifically tailored to individual subtypes," said Professor Georg Ertl, MD, secretary general of the DGIM. "Because of this important work, we are honoring Professor Robert Wagner, MD, with this year's Prevention Award." 

"Prof. Wagner and the entire team have provided a novel approach to understanding prediabetes and the complications that already begin at this stage with a highly innovative combination of clinical research and computational science" explained Prof. Dr. Andreas Birkenfeld, Director of the Department of Diabetology, Endocrinology and Nephrology and the IDM at the University Hospital Tübingen and co-spokesperson of the DZD on the occasion of the award.  

The German Foundation for Internal Medicine, together with the German Society for Internal Medicine, conferres the Prevention Award for the best paper submitted from the German-speaking region in German or English in the field of primary and secondary prevention of internal diseases. The award is endowed with 10,000 euros.

 
Further information about Wagner's research