Centers for Disease Control and Prevention (CDC) considers prediabetes as serious condition. It is a state of intermediate hyperglycemia where sugar level is higher than normal, but not enough high to diagnose as type 2 diabetes. Recently, a research work published in Nature Medicine identifies six sub-phenotypes for prediabetes through a cohort study. The 25 years long study included 7,000 participants from Germany and UK. The study was led by Professor Hans-Urlich Haring. The study used partitioning of variables using glucose tolerance tests, MRI-measured body fat distribution, liver fat content and genetic risk. Six different clusters of sub-phenotypes were categorized as cluster 1 to 6. Three of these clusters i.e., 1,2 and 4 are suggested to be with low risk diabetes. Participants of clusters 1 and 2 were healthy while those from cluster 4 were having healthy metabolism. Remaining three clusters were 3,5 and 6 were considered on high risks for type 2 diabetes and associated diseases. Participants from cluster 3 were having low insulin secretion while those in cluster 5 were having pronounced fatty liver. Studies have shown the association of abnormal accumulation of fats in liver with insulin resistance. The subtype of cluster 6 was observed more dangerous as it was linked with kidney damage even before the diagnosis of type 2 diabetes. The mortality rate was observed higher under this subtype.
A screening is required to study the specific connection of every subtype concerned to genetic relationship. Various studies reveal the relationship of gene variants like palatin-like phospholipase domain-containing 3 (PNPLA3) and transmembrane 6 superfamily member 2 protein (TM6SF2) with type 2 diabetes. Various studies have shown the association of nucleus genomes and mitochondrial genomes with kidney and type 2 diabetes. Same way all other associated diseases have genetic links with type 2 diabetes. Better understanding of these phenotypes in relation to genes would be helpful in further researches.
