Classification of diabetes: a new view on the problem

Diabetes mellitus is one of the main problems of modern medicine, which is primarily due to the high risk of developing cardiovascular complications in patients, as well as their early disability and mortality. The progressive increase in the number of patients with diabetes mellitus and high mortality among them dictate the need for further study of the causes and mechanisms of the development of the disease. Despite the availability of modern diagnostic methods, as well as the development of new therapeutic and preventive measures, the number of cases of early disability and mortality continues to increase among people with diabetes mellitus of working age. The main reason for such outcomes is the development of chronic cardiovascular complications. Evaluation of modern aspects of the etiology and pathogenesis of carbohydrate metabolism disorders will allow developing more effective methods for diagnosing, treating and preventing the development of complications in patients with diabetes mellitus. Despite more than a century of history of the study of diabetes mellitus, our knowledge of the pathogenesis of the disease is constantly supplemented by new links. The pathogenesis of diabetes mellitus is a multifaceted process. The modern classification of diabetes mellitus is based on some links of pathogenesis and determines its therapy. A number of authors have presented a cluster approach of types of diabetes mellitus, reflecting not only the links of pathogenesis, but also the risk of developing chronic complications. There are 5 clusters of the disease in total: SAID, SIDD, SARD, MOD, MARD. We studied 1120 case histories of patients with diabetes mellitus, determined the frequency of occurrence of its clusters and estimated the prognosis of chronic complications. At the same time, it was found that diabetic retinopathy was most common in the clusters SAID, SIDD, MOD. Along with this, diabetic nephropathy was characteristic of SAID, SIDD, SIRD, and distal polyneuropathy was characteristic of SIDD. Individuals with the MARD cluster were more likely to develop macroangiopathy of the lower extremities. The identification and study of clusters of diabetes mellitus contributes to the optimization of therapeutic and preventive measures.

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