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Review
. 2025 Mar 12;17(3):e80495.
doi: 10.7759/cureus.80495. eCollection 2025 Mar.

Double Diabetes: A Converging Metabolic and Autoimmune Disorder Redefining the Classification and Management of Diabetes

Raj K Chaudhary  1 , Obaid Ali  1 , Amrendra Kumar  1 , Abilesh Kumar  1 , Anjum Pervez  1
Affiliations
Review

Double Diabetes: A Converging Metabolic and Autoimmune Disorder Redefining the Classification and Management of Diabetes

Raj K Chaudhary et al. Cureus. .

Abstract

This review explores the pathophysiology, clinical implications, and management of double diabetes. The increasing prevalence of obesity, sedentary lifestyles, and genetic predisposition has blurred the difference between type 1 and type 2 diabetes, leading to diagnostic and therapeutic challenges. Double diabetes presents with overlapping symptoms from both diabetes types, making accurate diagnosis crucial. Biomarkers, such as C-peptide levels, autoantibody testing, and insulin resistance markers, help differentiate double diabetes from classic diabetes subtypes. Early intervention is necessary because of the condition's elevated risk of microvascular and macrovascular consequences, such as retinopathy, nephropathy, and cardiovascular disease. Effective management integrates pharmacological and lifestyle approaches. Metformin, sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and insulin therapy adjustments all boost glycemic control and metabolic results. Additionally, structured exercise, dietary modifications, and weight management are essential for reducing insulin resistance and preserving beta-cell activity. The potential of precision medicine, artificial intelligence (AI)-driven healthcare, and continuous glucose monitoring (CGM) offers promising advancements for personalized treatment strategies. Future research should focus on targeted immunotherapies, genetic profiling, and refined clinical guidelines to improve early detection and individualized treatment, with long-term outcomes. The review emphasizes the need for a multidisciplinary approach in managing double diabetes, ensuring early diagnosis, optimized treatment, and improved metabolic health to mitigate long-term complications.

Keywords: autoimmune dysfunction; beta-cell dysfunction; double diabetes; insulin resistance; metabolic syndrome; precision medicine.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Convergence of Type 1 and Type 2 Diabetes Leading to Double Diabetes
Image credit: The image has been created by the authors of this article
Figure 2
Figure 2. Key Factors Influencing Insulin Resistance in Type 1 Diabetes Management
Image credit: The image has been created by the authors of this article
Figure 3
Figure 3. Pharmacological Approaches in Double Diabetes Management
Image credit: The image has been created by the authors of this article SGLT2: Sodium-Glucose Cotransporter 2; GLP-1: Glucagon-Like Peptide-1; DPP-4: Dipeptidyl Peptidase-4
See this image and copyright information in PMC

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