Skip to main content

Main menu

  • Home
  • Content
    • Current Issue
    • Ahead of Print
    • Past Issues
    • Supplements
    • Article Type
    • Specialty
  • CME/MOC
    • Articles
    • Calendar
  • Info For
    • Manuscript Submission
      • 1-Minute Consult
      • Commentary
      • Current Drug Therapy
      • Editorial
      • Guidelines to Practice
      • Interpreting Key Trials
      • Letter to the Editor
      • Review
      • Smart Testing
      • Symptoms to Diagnosis
      • The Clinical Picture
    • Authors & Reviewers
    • Subscriptions
    • About CCJM
    • Contact Us
  • COVID-19
    • Curbside Consults Overview
    • Pulmonary/ICU
    • Patient Subsets & Specific Organ Involvement
    • Therapies
    • Imaging & Procedures
    • Patients with Underlying Disease
    • Virus Background & Testing
    • Healthcare System Practice
  • Conference Coverage
    • ASH Annual Meeting
    • AHA Sessions 2020
    • IDWeek 2020
    • CHEST 2020
    • ADA 2020
    • ACC 2020
  • Advertise
    • Media Kit
    • Contact
  • Other Publications
    • www.clevelandclinic.org

User menu

  • Register
  • Log in

Search

  • Advanced search
Cleveland Clinic Journal of Medicine
  • Other Publications
    • www.clevelandclinic.org
  • Register
  • Log in
Cleveland Clinic Journal of Medicine

Advanced Search

  • Home
  • Content
    • Current Issue
    • Ahead of Print
    • Past Issues
    • Supplements
    • Article Type
    • Specialty
  • CME/MOC
    • Articles
    • Calendar
  • Info For
    • Manuscript Submission
    • Authors & Reviewers
    • Subscriptions
    • About CCJM
    • Contact Us
  • COVID-19
    • Curbside Consults Overview
    • Pulmonary/ICU
    • Patient Subsets & Specific Organ Involvement
    • Therapies
    • Imaging & Procedures
    • Patients with Underlying Disease
    • Virus Background & Testing
    • Healthcare System Practice
  • Conference Coverage
    • ASH Annual Meeting
    • AHA Sessions 2020
    • IDWeek 2020
    • CHEST 2020
    • ADA 2020
    • ACC 2020
  • Advertise
    • Media Kit
    • Contact
Review

Type of diabetes mellitus: Does it matter to the clinician?

Byron J. Hoogwerf, MD, FACP, FACE
Cleveland Clinic Journal of Medicine February 2020, 87 (2) 100-108; DOI: https://doi.org/10.3949/ccjm.87a.19020
Byron J. Hoogwerf
Emeritus, Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic; Clinical Professor of Endocrinology, Medical Sciences Discipline, Central Michigan University College of Medicine, Mt. Pleasant
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: byronhoogwerf@gmail.com
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

CME/MOC

  • Release date: February 1, 2020
  • Expiration date: January 31, 2021
CME/MOC Accreditation Information.

ABSTRACT

The classification of diabetes mellitus in 2020 still starts with 2 major types, ie, type 1 and type 2, but each of these now includes a few uncommon variants. Understanding the many faces of the diabetes syndrome can make a difference in how clinicians select glucose-lowering therapy.

Footnotes

  • Dr. Hoogwerf has disclosed formerly being an employee of and currently owning stock in Eli Lilly and consulting for Mannkind Corp.

  • Copyright © 2020 The Cleveland Clinic Foundation. All Rights Reserved.
View Full Text

CME/MOC

Clicking the link below will connect you to begin the credit-claiming process for CME and MOC. After clicking on the link, scroll to the bottom of the page and click on “Complete the CME/MOC Process.” You will need your myCME login information to access this.

Click here to complete the CME/MOC process.

REFERENCES

  1. ↵
    1. Anonymous
    . Insulin and diabetes: the types for which cure is in sight. Hosp Health Rev 1923; 2(16):78–79. pmid:29418321
    OpenUrl
  2. ↵
    1. Bliss M
    . The Discovery of Insulin. Chicago, IL: University of Chicago Press; 1963.
  3. ↵
    1. Zhang H,
    2. Pollin TI
    . Epigenetics variation and pathogenesis in diabetes. Curr Diab Rep 2018; 18(11):121. doi:10.1007/s11892-018-1091-4
    OpenUrlCrossRef
    1. Sircana A,
    2. Framarin L,
    3. Leone N, et al
    . Altered gut microbiota in type 2 diabetes: just a coincidence? Curr Diab Rep 2018; 18(10):98. doi:10.1007/s11892-018-1057-6
    OpenUrlCrossRef
    1. Chen X,
    2. Devaraj S
    . Gut microbiome in obesity, metabolic syndrome, and diabetes. Curr Diab Rep 2018; 18(12):129. doi:10.1007/s11892-018-1104-3
    OpenUrlCrossRef
  4. ↵
    1. Ahlqvist E,
    2. Storm P,
    3. Karajamaki A, et al
    . Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. Lancet Diabetes Endocrinol 2018; 6(5):361–369. doi:10.1016/S2213-8587(18)30051–2
    OpenUrlCrossRef
    1. Dorajoo R,
    2. Liu J,
    3. Boehm BO
    . Genetics of type 2 diabetes and clinical utility. Genes (Basel) 2015; 6(2):372–384. doi:10.3390/genes6020372
    OpenUrlCrossRef
  5. ↵
    1. Raz I,
    2. Riddle MC,
    3. Rosenstock J, et al
    . Personalized management of hyperglycemia in type 2 diabetes: reflections from a Diabetes Care Editors’ Expert Forum. Diabetes Care 2013; 36(6):1779–1788. doi:10.2337/dc13-0512
    OpenUrlAbstract/FREE Full Text
  6. ↵
    1. Stancakova A,
    2. Laakso M
    . Genetics of type 2 diabetes. Endocr Dev 2016; 31:203–220. doi:10.1159/000439418
    OpenUrlCrossRefPubMed
  7. ↵
    1. Hanson MA,
    2. Godfrey KM
    . Genetics: epigenetic mechanisms underlying type 2 diabetes mellitus. Nat Rev Endocrinol 2015; 11(5):261–262. doi:10.1038/nrendo.2015.31
    OpenUrlCrossRef
  8. ↵
    1. American Diabetes Association
    . 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2019. Diabetes Care 2019; 42(suppl 1):S13–S28. doi:10.2337/dc19-S002
    OpenUrlAbstract/FREE Full Text
  9. ↵
    1. Lawrence RD
    . Types of human diabetes. Br Med J 1951; 1(4703):373–375. doi:10.1136/bmj.1.4703.373
    OpenUrlFREE Full Text
  10. ↵
    1. Himsworth HP
    . Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types. Diabet Med 2011; 28(12):1440–1444. doi:10.1111/j.1464-5491.2011.3508.x
    OpenUrlCrossRefPubMed
  11. ↵
    1. Kota SK,
    2. Meher LK,
    3. Jammula S,
    4. Kota SK,
    5. Modi KD
    . Genetics of type 2 diabetes mellitus and other specific types of diabetes; its role in treatment modalities. Diabetes Metab Syndr 2012; 6(1):54–58. doi:10.1016/j.dsx.2012.05.014
    OpenUrlCrossRefPubMed
  12. ↵
    1. Malecki MT,
    2. Mlynarski W
    . Monogenic diabetes: implications for therapy of rare types of disease. Diabetes Obes Metab 2008; 10(8):607–616. doi:10.1111/j.1463-1326.2007.00736.x
    OpenUrlCrossRefPubMed
  13. ↵
    1. Mihai B,
    2. Mihai C,
    3. Cijevschi-Prelipcean C,
    4. Lacatusu C
    . Rare types of diabetes mellitus. Rev Med Chir Soc Med Nat Iasi 2012; 116(3):700–707. pmid:23272513
    OpenUrl
  14. ↵
    1. Shields BM,
    2. Shepherd M,
    3. Hudson M, et al. UNITED study team
    . Population-based assessment of a biomarker-based screening pathway to aid diagnosis of monogenic diabetes in young-onset patients. Diabetes Care 2017; 40(8):1017–1025. doi:10.2337/dc17-0224
    OpenUrlAbstract/FREE Full Text
  15. ↵
    1. Todd JN,
    2. Srinivasan S,
    3. Pollin TI
    . Advances in the genetics of youth-onset type 2 diabetes. Curr Diab Rep 2018; 18(8):57. doi:10.1007/s11892-018-1025-1
    OpenUrlCrossRef
  16. ↵
    1. Klupa T,
    2. Skupien J,
    3. Malecki MT
    . Monogenic models: what have the single gene disorders taught us? Curr Diab Rep 2012; 12(6):659–666. doi:10.1007/s11892-012-0325-0
    OpenUrlCrossRefPubMed
  17. ↵
    1. Pearson ER,
    2. Flechtner I,
    3. Njolstad PR, et al. Neonatal Diabetes International Collaborative Group
    . Switching from insulin to oral sulfonylureas in patients with diabetes due to Kir6.2 mutations. N Engl J Med 2006; 355(5):467–477. doi:10.1056/NEJMoa061759
    OpenUrlCrossRefPubMed
    1. Anik A,
    2. Catli G,
    3. Abaci A,
    4. Bober E
    . Maturity-onset diabetes of the young (MODY): an update. J Pediatr Endocrinol Metab 2015; 28(3–4):251–263. doi:10.1515/jpem-2014-0384
    OpenUrlCrossRefPubMed
  18. ↵
    1. Bacon S,
    2. Kyithar MP,
    3. Rizvi SR, et al
    . Successful maintenance on sulphonylurea therapy and low diabetes complication rates in a HNF1A-MODY cohort. Diabet Med 2016; 33(7):976–984. doi:10.1111/dme.12992
    OpenUrlCrossRefPubMed
  19. ↵
    1. Bishay RH,
    2. Greenfield JR
    . A review of maturity onset diabetes of the young (MODY) and challenges in the management of glucokinase-MODY. Med J Aust 2016; 205(10):480–485. doi:10.5694/mja16.00458
    OpenUrlCrossRef
  20. ↵
    1. Steck AK,
    2. Winter WE
    . Review on monogenic diabetes. Curr Opin Endocrinol Diabetes Obes 2011; 18(4):252–258. doi:10.1097/MED.0b013e3283488275
    OpenUrlCrossRefPubMed
  21. ↵
    1. Urakami T
    . Maturity-onset diabetes of the young (MODY): current perspectives on diagnosis and treatment. Diabetes Metab Syndr Obes 2019 Jul 8; 12:1047–1056. doi:10.2147/DMSO.S179793
    OpenUrlCrossRef
  22. ↵
    1. Banerji MA
    . Impaired beta-cell and alpha-cell function in African-American children with type 2 diabetes mellitus—”Flatbush diabetes”. J Pediatr Endocrinol Metab 2002; 15(suppl 1):493–501. pmid:12017222
    OpenUrl
  23. ↵
    1. Banerji MA,
    2. Chaiken RL,
    3. Huey H, et al
    . GAD antibody negative NIDDM in adult black subjects with diabetic ketoacidosis and increased frequency of human leukocyte antigen DR3 and DR4. Flatbush diabetes. Diabetes 1994; 43(6):741–745. doi:10.2337/diab.43.6.741
    OpenUrlCrossRef
  24. ↵
    1. Lebovitz HE,
    2. Banerji MA
    . Ketosis-prone diabetes (Flatbush diabetes): an emerging worldwide clinically important entity. Curr Diab Rep 2018; 18(11):120. doi:10.1007/s11892-018-1075-4
    OpenUrlCrossRef
  25. ↵
    1. Andersen MK,
    2. Hansen T
    . Genetic aspects of latent autoimmune diabetes in adults: a mini-review. Curr Diabetes Rev 2019; 15(3):194–198. doi:10.2174/1573399814666180730123226
    OpenUrlCrossRef
    1. Beyan H,
    2. Ola T,
    3. David R,
    4. Leslie G
    . Progression of autoimmune diabetes: slowly progressive insulin-dependent diabetes mellitus or latent autoimmune diabetes of adult. Ann N Y Acad Sci 2006; 1079(1):81–89. doi:10.1196/annals.1375.011
    OpenUrlCrossRefPubMed
    1. Cousminer DL,
    2. Ahlqvist E,
    3. Mishra R, et al
    . First genome-wide association study of latent autoimmune diabetes in adults reveals novel insights linking immune and metabolic diabetes. Diabetes Care 2018; 41(11):2396–2403. doi:10.2337/dc18-1032
    OpenUrlAbstract/FREE Full Text
    1. Grill V
    . LADA: a type of diabetes in its own right? Curr Diabetes Rev 2019; 15(3):174–177. doi:10.2174/1573399814666180716150905
    OpenUrlCrossRef
    1. Landin-Olsson M
    . Latent autoimmune diabetes in adults. Ann N Y Acad Sci 2002; 958(1):112–116. doi:10.1111/j.1749-6632.2002.tb02953.x
    OpenUrlCrossRefPubMed
  26. ↵
    1. Nabhan F,
    2. Emanuele MA,
    3. Emanuele N
    . Latent autoimmune diabetes of adulthood. Unique features that distinguish it from types 1 and 2. Postgrad Med 2005; 117(3):7–12. doi:10.3810/pgm.2005.03.1597
    OpenUrlCrossRefPubMed
  27. ↵
    1. Collins FS,
    2. Mansoura MK
    . The Human Genome Project. Revealing the shared inheritance of all humankind. Cancer 2001; 91(suppl 1):221–225. doi:10.1002/1097-0142(20010101)91:1+<221::aid-cncr8>3.3.co;2-0
    OpenUrlCrossRefPubMed
  28. ↵
    1. Dunston GM,
    2. Akinsete O,
    3. Collins FS
    . Diabetes project. Science 1997; 276(5315):1013. doi:10.1126/science.276.5315.1013b
    OpenUrlCrossRef
  29. ↵
    1. Kwak SH,
    2. Park KS
    . Genetics of type 2 diabetes and potential clinical implications. Arch Pharm Res 2013; 36(2):167–177. doi:10.1007/s12272-013-0021-x
    OpenUrlCrossRefPubMed
  30. ↵
    1. Sun X,
    2. Yu W,
    3. Hu C
    . Genetics of type 2 diabetes: insights into the pathogenesis and its clinical application. Biomed Res Int 2014; 2014:926713. doi:10.1155/2014/926713
    OpenUrlCrossRefPubMed
  31. ↵
    1. Handelsman Y,
    2. Oral EA,
    3. Bloomgarden ZT, et al. American Association of Clinical Endocrinologists
    . The clinical approach to the detection of lipodystrophy—an AACE consensus statement. Endocr Pract 2013; 19(1):107–116. pmid:23435042
    OpenUrlCrossRefPubMed
  32. ↵
    1. Araujo-Vilar D,
    2. Santini F
    . Diagnosis and treatment of lipodystrophy: a step-by-step approach. J Endocrinol Invest 2019; 42(1):61–73. doi:10.1007/s40618-018-0887-z
    OpenUrlCrossRef
  33. ↵
    1. Akinci B,
    2. Meral R,
    3. Oral EA
    . Update on therapeutic options in lipodystrophy. Curr Diab Rep 2018; 18(12):139. doi:10.1007/s11892-018-1100-7
    OpenUrlCrossRef
  34. ↵
    1. Motulsky AG,
    2. Beutler E
    . Population screening in hereditary hemochromatosis. Annu Rev Public Health 2000; 21:65–79. doi:10.1146/annurev.publhealth.21.1.65
    OpenUrlCrossRefPubMed
  35. ↵
    1. Waalen J,
    2. Beutler E
    . Hereditary hemochromatosis: screening and management. Curr Hematol Rep 2006; 5(1):34–40. pmid:16537044
    OpenUrlPubMed
  36. ↵
    1. DeFronzo RA
    . Banting lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009; 58(4):773–795. doi:10.2337/db09-9028
    OpenUrlFREE Full Text
  37. ↵
    1. American Diabetes Association
    . 9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes-2019. Diabetes Care 2019; 42(suppl 1):S90–S102. doi:10.2337/dc19-S009
    OpenUrlAbstract/FREE Full Text
  38. ↵
    1. Garber AJ,
    2. Abrahamson MJ,
    3. Barzilay JI, et al. American Association of Clinical Endocrinologists (AACE); American College of Endocrinology (ACE)
    . Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm—2016 executive summary. Endocr Pract 2016; 22(1):84–113. doi:10.4158/EP151126.CS
    OpenUrlCrossRefPubMed
    1. American Diabetes Association
    . 4. Comprehensive medical evaluation and assessment of comorbidities: standards of medical care in diabetes—2019. Diabetes Care 2019; 42(suppl 1):S34–S45. doi:10.2337/dc19-S004
    OpenUrlAbstract/FREE Full Text
    1. Marso SP,
    2. Daniels GH,
    3. Brown-Frandsen K, et al. LEADER Trial Investigators
    . Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375(4):311–322. doi:10.1056/NEJMoa1603827
    OpenUrlCrossRefPubMed
    1. Gerstein HC,
    2. Colhoun HM,
    3. Dagenais GR, et al. REWIND Investigators
    . Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet 2019; 394(10193):121–130. doi:10.1016/S0140-6736(19)31149–3
    OpenUrlCrossRefPubMed
    1. Husain M,
    2. Bain SC,
    3. Jeppesen OK, et al
    . Semaglutide (SUSTAIN and PIONEER) reduces cardiovascular events in type 2 diabetes across varying cardiovascular risk. Diabetes Obes Metab 2020 Jan 5 [Epub ahead of print]. doi:10.1111/dom.13955
    OpenUrlCrossRef
    1. Pfeffer MA,
    2. Claggett B,
    3. Diaz R, et al. ELIXA Investigators
    . Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med 2015; 373(23):2247–2257. doi:10.1056/NEJMoa1509225
    OpenUrlCrossRefPubMed
  39. ↵
    1. Holman RR,
    2. Bethel MA,
    3. Mentz RJ, et al. EXSCEL Study Group
    . Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med 2017; 377(13):1228–1239. doi:10.1056/NEJ-Moa1612917
    OpenUrlCrossRefPubMed
  40. ↵
    1. Fajans SS,
    2. Floyd JC,
    3. Tattersall RB,
    4. Williamson JR,
    5. Pek S,
    6. Taylor CI
    . The various faces of diabetes in the young: changing concepts. Arch Intern Med 1976; 136(2):194–202. pmid:1247351
    OpenUrlCrossRefPubMed
  41. ↵
    1. Tattersall R
    . Maturity-onset diabetes of the young: a clinical history. Diabet Med 1998; 15(1):11–14. doi:10.1002/(SICI)1096-9136(199801)15:1<11::AID-DIA561>3.0.CO;2-0
    OpenUrlCrossRefPubMed
  42. ↵
    1. Hoogwerf BJ,
    2. Rich SS,
    3. Barbosa JJ
    . Meal-stimulated C-peptide and insulin antibodies in type I diabetic subjects and their nondiabetic siblings characterized by HLA-DR antigens. Diabetes 1985; 34(5):440–445. doi:10.2337/diab.34.5.440
    OpenUrlAbstract/FREE Full Text
  43. ↵
    1. Madsbad S,
    2. Faber OK,
    3. Binder C,
    4. McNair P,
    5. Christiansen C,
    6. Transbol I
    . Prevalence of residual beta-cell function in insulin-dependent diabetics in relation to age at onset and duration of diabetes. Diabetes 1978; 27(suppl 1):262–264. doi:10.2337/diab.27.1.s262
    OpenUrlAbstract/FREE Full Text
  44. ↵
    1. Chiquette E,
    2. Oral EA,
    3. Garg A,
    4. Araujo-Vilar D,
    5. Dhankhar P
    . Estimating the prevalence of generalized and partial lipodystrophy: findings and challenges. Diabetes Metab Syndr Obes 2017; 10:375–383. doi:10.2147/DMSO.S130810
    OpenUrlCrossRef

This article requires you to have a ccjm.org account to view the full text. If you already have an account, you may log in below to view this article along with all other CCJM content. If you do not have an account, register here. It’s free!

Log in using your username and password

Forgot your user name or password?
PreviousNext
Back to top

Registration is Now Required for Free Access to CCJM Content

Register once and log in for full access to articles and content. Click “Register” in the upper right corner and follow the simple instructions to create a new account.

If you are using a mobile device, click on the settings icon to access the Register link.

In this issue

Cleveland Clinic Journal of Medicine: 87 (2)
Cleveland Clinic Journal of Medicine
Vol. 87, Issue 2
1 Feb 2020
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
  • Complete Issue (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Cleveland Clinic Journal of Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Type of diabetes mellitus: Does it matter to the clinician?
(Your Name) has sent you a message from Cleveland Clinic Journal of Medicine
(Your Name) thought you would like to see the Cleveland Clinic Journal of Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
2 + 1 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Type of diabetes mellitus: Does it matter to the clinician?
Byron J. Hoogwerf
Cleveland Clinic Journal of Medicine Feb 2020, 87 (2) 100-108; DOI: 10.3949/ccjm.87a.19020

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Type of diabetes mellitus: Does it matter to the clinician?
Byron J. Hoogwerf
Cleveland Clinic Journal of Medicine Feb 2020, 87 (2) 100-108; DOI: 10.3949/ccjm.87a.19020
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Linkedin Share Button

Jump to section

  • Article
    • ABSTRACT
    • TYPES AND BIOMARKERS OF DIABETES
    • TYPE 2 DIABETES MELLITUS
    • TYPE 1 DIABETES MELLITUS
    • OTHER HYPERGLYCEMIC STATES
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

  • The search for precision
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Oral immunotherapy: The answer to peanut allergy?
  • Cardiac surveillance for anti-HER2 chemotherapy
  • Precision treatment for metastatic non–small cell lung cancer: A conceptual overview
Show more Review

Similar Articles

Navigate

  • Current Issue
  • Past Issues
  • Supplements
  • Article Type
  • Specialty
  • CME/MOC Articles
  • CME/MOC Calendar
  • Media Kit
  • Advertise Contact

Authors & Reviewers

  • Manuscript Submission
  • Authors & Reviewers
  • Subscriptions
  • Advertisers
  • About CCJM
  • Contact Us
  • Cleveland Clinic Center for Continuing Education
  • Consult QD

Share your suggestions!

Copyright © 2021 The Cleveland Clinic Foundation. All rights reserved. The information provided is for educational purposes only. Use of this website is subject to the website terms of use and privacy policy. 

Powered by HighWire