Lund University, Medical Faculty

Uncertain diagnosis for every fifth diabetes patient

Published 2011-12-05

Despite of more advanced methods than in the routin care it will not be determined which kind of diabetes every fifth new diabetic patient is suffering from. In the ANDIS-project (All New Diabetics In Scania) the concepts will be sorted out. ANDIS also shows that one form of diabetes, LADA, which 15 years ago not even was described is twice as common today as type 1 diabetes.

- Diabetes is a more complexed disease than we have beleived, there are mixed forms and grey zones which we have to learn more about, says Mozhgan Dorkhan, diabetes physician and project leader for ANDIS. Every person in Skåne that gets ill in diabetes, from zero to one hundred years of age, can join ANDIS. A particiaption means a more detailed interview at the first visit and that more blood tests will be taken, among others known risk genes will be analyzed and if there are antibodies in the blood which shows if it is an autoimmune form of diabetes.

The diabetes diseases are more complex than believed.

Individualized treatment

ANDIS will look at the whole diabetes spectra in a whole population and this have never been done before.
The purpose is to identify sub groups and mixed groups and follow the disease in respective group. When this is done, the best treatment will be evaluated at individual level.
The mapping also aims to distinguish how different patient groups responds on different treatments and who has the most risk of developing complications.
- The goal is that the results from ANDIS will go from research to the everyday health care, says Mozhgan Dorkhan.

More than twice as common
One ANDIS finding is that the mix form LADA, which as type 1 is an autoimmune disease but as type 1 will have its debut later in life and has a milder course, is much more common than type 1 diabetes. Seven percent of the patients in  ANDIS have LADA diabetes, while three per cent have type 1 diabetes.
- Still we do not know which treatment is the best at LADA diabetes. The uncertainty will maybe contribute to that we maybe lose valuable time to prevent complications, says Mozhgan Dorkhan.

Origin for several surveys
In the research world is ANDIS appreciated. A follower has already been started in Uppsala and several is planned for at other locations of the country, among others in the Western Götaland region. Similar designs is in progress in Finland and in Denmark and many individual researchers will also see the advantages with ANDIS.
One example is ANDISec, the first large mapping for more than 20 years of eye complications in diabetes.
One other is ESTRID, the most ambitious study so far of LADA where the significance of both the environment and the risk genes will be investigated.
In a third, MEDIM, the existence of diabetes amongst people born in Iraq and living in Malmö is investigated. Preliminary results shows on a ticking health bomb. Every fifth in the nerighborhood Rosengård have either type 2 diabetes or a prestadium to the disease.
More studies will soon be ongoing within ANDIS.

Sharpen the diagnostics
Every hospital in Scania, more than one hundred health care centers and private caregivers is recruiting to ANDIS which today has more than 5000 participants.
- With help of ANDIS, we have the possibility to sharpen the diagnostics and get a clearer picture of the different diabetes forms which is provided for a more individualized treatment, says Mozhgan Dorkhan.

Text: Tord Ajanki/Ulrika Blom-Nilsson
Picture: Dreamstime

Last updated: December 6, 2011
Website contact: LUDC webteam

LUDC, CRC, SUS Malmö, Entrance 72, House 91:12. SE-205 02 Malmö. Telephone: +46 40 39 10 00