Autoimmune diabetes in adults and Type 2 diabetes subtypes-risk factors and prognosis- precision medicine in diabetes

Diabetes is a chronic disease affecting 1/5 swedes during their lifetime, associated with CVD and reduced life expectancy.

With a finer classification of diabetes, opportunities arise for better assessment of factors influencing onset and prognosis, which may lead to improved prevention.

This project involves subtypes within the broad categories T1D and T2D; LADA– a common form of autoimmune diabetes, newly proposed subtypes of T2D- including a severe insulin resistant and a severe insulin deficient type, and adult onset T1D.

We aim to provide new knowledge on the interplay environmental vs. genetic factors influences in the aetiology of these largely unexplored subtypes of diabetes.

To this aim, we are conducting the world´s largest study of LADA, the ESTRID-study, with incident cases of LADA and T2D subtypes and clinical, genetic and environmental information.

The Norwegian HUNT-study, European Epic-InterAct and UK biobank, which includes adult onset T1D, will be used for extensions and replication. We will use Mendelian Randomization design for causal inference.

ESTRID and HUNT are linked to national registers allowing us to follow patients from diagnosis and assess the prognostic role of clinical, genetic and lifestyle factors.

The aim is to identify factors increasing the risk of autoimmune diabetes in adults and different forms of T2D and factors contributing to poor prognosis. Such knowledge is central future efforts to prevent diabetes and its consequences.