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Does 'type 2 diabetes' really exist?

A leading researcher believes that because ‘type 2 diabetes’ has various causes and treatments, the term is misleading.

Image: Diabetes via Shutterstock

THE TERM ‘TYPE 2 diabetes’ is leading medical researchers astray, and resulting in suboptimal treatment for patients.

That’s according to Professor Edwin Gale, of Southmead Hospital in the UK, who believes applying the term ‘type 2 diabetes’ to the complex and varied set of symptoms that us associated with the disease is wrong.

In a Viewpoint published in The Lancet, Professor Gale said, “If you give something a name, you imply that this thing actually exists. In practice, when somebody like myself talks about type 2 diabetes, I’m saying ‘a form of diabetes for which I can find no other cause’. In other words, it’s a diagnosis of exclusion…There are various conditions, spectrums, and severities of diseases, all wrapped into this one definition.”

Type 2 diabetes is diagnosed when a patient’s body can no longer produce enough insulin, or when the insulin that is produced does not work properly, which leads to problems maintaining a normal blood glucose level.

According to Diabetes UK, type 2 diabetes is estimated to affect around 2.6 million people in the UK.

However, Professor Gale argues that because the symptoms referred to by the term ‘type 2 diabetes’ have such widely varying causes and treatments, the term is misleading both researchers and patients.

Treating type 2 diabetes as a single disease has wasted the times of young investigators says Professor Gale, by the introduction of one-size-fits-all guidelines for disease management.

Although Professor Gale says an interim solution would be to replace ‘type 2 diabetes’ with the term ‘idiopathic hyperglycaemia’, which would encourage clinicians to stop thinking about the condition as a disease in its own right, but rather as an outcome of many interacting processes.

“When a century of scientific endeavour brings us round to the conclusion that we cannot define what we are talking about, it might be time to consider adjusting our minds. It is widely appreciated that type 2 diabetes is not a uniform disease entity with a definable cause, mechanism, and treatment, so why are these terms always used?” asks Professor Gale.

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About the author:

Amy Croffey

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