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Severe insulin-resistant diabetes (SIRD) is a subgroup of type 2 diabetes. While symptoms of SIRD are the same as other forms of type 2 diabetes, complications leading to severe kidney disease set it apart.
Keep reading to learn what makes SIRD different than other types of diabetes and how you can cope if you are diagnosed with this form of type 2 diabetes.
Elva Etienne / Getty Images
Insulin is a substance that allows glucose (sugar) to enter your cells to supply them with energy. Without insulin—or a healthy response to the insulin your body makes—glucose can build up in your bloodstream causing high blood sugar (hyperglycemia) and a range of complications.
Beyond these main types of diabetes, there are several subtypes of type 2 diabetes, including:

There is also a subtype called severe autoimmune diabetes (SAID), specific to type 1 diabetes.
Each subtype has specific criteria and may be associated strongly with particular complications.
Dividing diabetes into subgroups is a newer classification tool aimed at moving toward more precise medicine. Below is an estimation of how common each type 2 diabetes subtype is:
Symptoms of SIRD are similar to other forms of type 2 diabetes, but people who fall into this category are usually older—between the ages of 52 and 66—and have more diabetes-related kidney problems.
Other clinical signs and symptoms of SIRD can include:
Other common symptoms of type 2 diabetes may also be present and may include:
Like other forms of type 2 diabetes, SIRD is primarily caused by diet, lifestyle choices, and genetics. This type of diabetes usually develops later in life as a result of things like:
People with SIRD are more likely to experience severe diabetic kidney disease that can progress to end-stage renal disease.
Other complications known to occur more frequently in people who fall into the SIRD subgroup include the development of nonalcoholic fatty liver disease (NAFLD).
Some other complications noted in different subgroups of type 2 diabetes, like high blood pressure and cholesterol levels, are not as common in people with SIRD.
All the subtypes also share general complications associated with type 2 diabetes, including:
·      Foot problems
·      Heart attack
·      Stroke
·      Gum and mouth disease

SIRD and other type 2 diabetes subtypes are treated similarly. Diet and lifestyle changes, like carbohydrate control and regulated exercise, are vital to diabetes management. Treatment may also include oral antihyperglycemics, such as metformin or injected insulin.
Your healthcare provider may also recommend additional treatments, including:
Diabetes is a chronic condition for which there is no cure. You will have to manage diabetes for the rest of your life once diagnosed, but the disease is manageable with the proper lifestyle and diet changes and medications.
Sticking to a treatment plan you create with your healthcare provider can help you keep your diabetes in check and prevent the development of dangerous complications.
Living with diabetes can be challenging, and being in the SIRD subgroup means you have significantly higher chances of developing severe kidney disease.
The key to living with diabetes successfully is making a realistic plan with your healthcare provider, sticking to it, and asking for help when needed. Here are some tips to help you cope with and manage diabetes:
Diabetes is a serious condition no matter what subtype you have. It's important to find a way to be successful in managing your diabetes, especially if you have a subtype like SIRD that can increase your risk of serious complications like kidney failure.
Symptoms of SIRD are similar to type 2 diabetes symptoms, including increased thirst, frequent urination, blurry vision, and slow wound healing, among others. Causes are typically due to lifestyle and diet factors and genetics, including obesity, inactivity, and insulin resistance.
SIRD is treated similarly to type 2 diabetes—through lifestyle and diet changes and, sometimes, medication. Speak to your healthcare provider about a treatment plan that works for you.
Diabetes is a disease for which there is no cure and requires lifestyle and diet changes. SIRD is one subgroup of the disease that, if not managed well, could lead to serious complications with kidney function and overall health. Talk to your healthcare provider about the best way to manage your diabetes and—if you have SIRD—how to protect the health and function of your kidneys.

Some evidence suggests that artificial sweeteners can trick your body into releasing insulin and contribute to insulin resistance. Talk to your healthcare provider or a nutritionist about the best sweeteners to use if you have diabetes or are at risk of developing the condition.
Increasing exercise and improving your diet can help improve—and possibly even reverse—insulin resistance in the early stages (prediabetes). However, if you've already been diagnosed with diabetes, lifestyle and diet changes can help but are unlikely to reverse your insulin resistance completely.
Kidney and vascular problems are the issues most often linked to insulin resistance. High glucose levels in your bloodstream don't just keep energy from your cells; they can clog or slow other systems in your body.
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By Rachael Zimlich, BSN, RN
 Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.

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