Researchers discovered that type 2 diabetes in young people isn’t one-size-fits-all. By studying 641 teenagers and young adults with newly diagnosed type 2 diabetes, scientists found three distinct subtypes with different characteristics. About half had obesity-related diabetes, while the other half split between two other types involving insulin problems. This discovery matters because it suggests doctors may need to treat young people with type 2 diabetes differently depending on which subtype they have, rather than using the same approach for everyone.

The Quick Take

  • What they studied: Whether young people with newly diagnosed type 2 diabetes fall into different groups based on their body measurements, blood sugar levels, and other health markers
  • Who participated: 641 young people aged 10-19 years old who had just been diagnosed with type 2 diabetes (within the last year). About 47% came from one research study and 53% from another. Just over half were female.
  • Key finding: Researchers identified three distinct subtypes: obesity-related diabetes (48.5% of participants), insulin-deficient diabetes (18.7%), and insulin-resistant diabetes (32.7%). Each subtype had different body measurements, blood sugar control, and other health characteristics.
  • What it means for you: If you or someone you know is a young person with type 2 diabetes, your specific subtype might matter for treatment decisions. However, this research is early-stage, and doctors still need more information before changing how they treat individual patients based on subtype.

The Research Details

This study looked at information already collected from two large research projects tracking young people with type 2 diabetes across the USA. The researchers took measurements and blood test results from 641 young people who had been diagnosed with type 2 diabetes within the past year. They used a computer method called cluster analysis, which is like sorting items into groups based on similar characteristics—imagine sorting a pile of mixed buttons by color, size, and number of holes. The researchers looked at information doctors routinely collect during regular checkups, like weight, height, blood pressure, and blood sugar levels.

Understanding that type 2 diabetes in young people comes in different forms is important because it suggests that one treatment approach might not work best for everyone. If doctors can identify which subtype a young person has, they might be able to choose treatments more likely to help that specific person. This is called ‘personalized medicine’ or ‘precision medicine.’

This study has several strengths: it included a large number of participants (641), came from two established research studies, and used standard medical measurements that doctors already use. However, because it’s a cross-sectional study (a snapshot in time rather than following people over months or years), we can’t be certain whether these subtypes stay the same or change over time. The study also only looked at newly diagnosed cases, so we don’t know if these subtypes apply to people who’ve had diabetes longer.

What the Results Show

The analysis revealed three distinct subtypes of youth-onset type 2 diabetes. The first subtype, obesity-related type 2 diabetes (yOD), included 48.5% of participants. These young people had high body mass index (BMI, a measure of weight relative to height) but surprisingly had lower blood sugar levels (measured by HbA1c, which shows average blood sugar over three months). The second subtype, insulin-deficient type 2 diabetes (yIDD), made up 18.7% of participants. These young people had low levels of C-peptide (a marker showing how much insulin their pancreas is making), high levels of HDL cholesterol (the ‘good’ cholesterol), and high blood sugar levels. The third subtype, insulin-resistant type 2 diabetes (yIRD), included 32.7% of participants. These young people had high BMI, high C-peptide levels (meaning their pancreas is working hard to make insulin), and high blood pressure.

An important secondary finding was that young people with the insulin-deficient and insulin-resistant subtypes had a higher rate of nerve damage (distal symmetric polyneuropathy) at the time of diagnosis compared to those with obesity-related diabetes. This type of nerve damage can cause numbness or tingling in the feet and hands. This suggests that some subtypes of youth-onset type 2 diabetes may be more aggressive or cause complications more quickly than others.

This research builds on earlier studies showing that type 2 diabetes in adults comes in different forms. However, most previous research focused on adults, and type 2 diabetes in young people may behave differently. This study is one of the first to systematically identify subtypes specifically in teenagers and young adults with newly diagnosed type 2 diabetes, making it a valuable addition to what we know about youth diabetes.

Several limitations should be considered. First, this study only looked at young people at the time of their diagnosis, so we don’t know if these subtypes remain stable over time or if people move between subtypes. Second, the study didn’t follow participants over time to see if different subtypes respond differently to treatment—that would require a longer study. Third, the study only included young people from the USA, so results might not apply to other countries with different populations. Finally, while the study identified three subtypes, it’s unclear whether these are truly distinct diseases or just different points on a spectrum of the same disease.

The Bottom Line

Based on this research, doctors may want to consider a young person’s specific characteristics (body weight, insulin levels, blood pressure, and blood sugar control) when planning treatment. However, this is still early research, and doctors should not yet change treatment decisions based solely on subtype classification. Young people with type 2 diabetes should continue following their doctor’s current treatment recommendations while this research develops further. (Confidence level: Moderate—this is promising research but needs follow-up studies.)

This research is most relevant to young people aged 10-19 who have recently been diagnosed with type 2 diabetes, their families, and their healthcare providers. It’s less immediately relevant to people with type 1 diabetes or adults with type 2 diabetes, though some concepts might eventually apply to them. People with type 2 diabetes diagnosed years ago might have different characteristics than newly diagnosed cases.

This research doesn’t directly tell us how quickly to expect benefits from treatment changes, since it’s a snapshot study rather than a treatment trial. However, if doctors do eventually tailor treatments based on subtype, benefits would likely develop over weeks to months, similar to current diabetes treatment timelines.

Want to Apply This Research?

  • Track weekly average blood sugar readings (HbA1c trends), blood pressure readings, and weight measurements. These are the key characteristics that define the different subtypes, so monitoring them helps show how your specific diabetes is responding to treatment.
  • Work with your doctor to understand which subtype characteristics apply to you. If you have high BMI, focus on gradual weight management. If you have high blood pressure, monitor salt intake and activity levels. If you have insulin-related issues, be extra consistent with medication timing and meals. Tailor your app reminders and goals to your specific subtype characteristics.
  • Set up monthly check-ins to review your key measurements (blood sugar, blood pressure, weight) with your healthcare team. Use the app to track trends over 3-6 months to see if your subtype characteristics are improving, staying the same, or worsening. Share these trends with your doctor to guide treatment adjustments.

This research identifies different subtypes of type 2 diabetes in young people but does not yet provide specific treatment recommendations for individual patients. If you or a young person in your care has been diagnosed with type 2 diabetes, continue following your doctor’s current treatment plan. Do not change medications or treatment based on this research alone. Discuss these findings with your healthcare provider to understand how they might apply to your specific situation. This article is for educational purposes and should not replace professional medical advice.