Type 2 Diabetes in Morocco: Toward a Precision Diabetology, from Pathogenesis to Treatment

The traditional classification of diabetes into types 1 and 2 does not reflect its heterogeneity in presentation, progression, treatment response, and complications.

This study explores a new classification based on five distinct subgroups to enhance understanding and management. Its applicability was tested in 1002 newly diagnosed Moroccan type 2 diabetes patients and compared with the Indian "WellGen" and Swedish "ANDIS" cohorts.

Newly diagnosed Moroccan type 2 diabetics were mainly classified into four subgroups designated as: severe insulin deficiency diabetes (SIDD), severe insulin resistance diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). One thousand and two patients were included in our study with a sex ratio of 1. Patients were classified into the subgroups of MARD (42%), MOD (21%), and SIDD (19%), while SIRD was 14%. In our study, retinopathy and neuropathy were more prevalent in the SIDD subgroup, while nephropathy in the SIRD, while patients in the MARD group had a higher prevalence of cardiovascular complications.

Our results provide useful clues as to the pathophysiological mechanisms and susceptibility to complications of type 2 diabetes in the Moroccan population, and suggest a need to review management strategies. Our results confirm the new diabetic subgroups proposed by similar studies, suggesting a possible generalization of this diabetes classification to Africa and the MENA region.