○ Diagnosis and disease management. A more specific diagnosis has the potential to reduce uncertainty and manage future expectations about disease course. This is clearly the case for some monogenic forms of diabetes, where diagnosis is nearly certain given its strong genetic indication and the specific treatment is coupled to the subcategory (genetic subtype) of disease. Emerging knowledge regarding subtypes of type 2 diabetes indicates that there is potential to classify individuals with diabetes at risk for progression to complications.

○ Misdiagnosis. Inaccurate classification of the type of diabetes, either from lack of precision or inadequate clinical attention to detail at the time of presentation, can have long-lasting adverse effects on mental health and quality of life. In the paediatric and younger adult population, the risk of misclassification is increasing as both ‘true’ type 1 diabetes and ‘true’ type 2 diabetes classifications are confused through the growing obesity epidemic in youth (type 2 diabetes) and older ages at onset (type 1 diabetes). In addition, monogenic variants of diabetes can be misdiagnosed as either type 1 or type 2 diabetes. A precision approach to diagnosis with appropriate standardised laboratory support and increased research to obtain novel biomarkers of disease has the potential to solve this problem.

○ Complications. Worry about complications is an issue for all people with diabetes. Currently, people having diabetes (either type 1 or type 2 diabetes) are given a label of being unequivocally at risk of reduced lifespan, amputation, kidney failure and blindness. A more precise diagnosis, prognosis, and strategy to predict and prevent complications has the potential to greatly reduce disease burden and distress and improve quality of life. Nevertheless, there is also a risk that more precise prognostification may cause distress if the options for successful intervention are limited or incompatible with the patient’s needs or desires.

○ Stigmatisation. A major burden for people with diabetes is that the disease is often considered the fault of the patient. This is particularly true for type 2 diabetes, as it is often labelled as ‘just’ a lifestyle disease. Clinical care of those with diabetes often results in a singular approach to treatment, regardless of their specific needs, life situation and other conditions. A clinical process that makes diagnosis more precise and includes the patient-oriented evaluation and response to needs has the potential to lessen stigma and reduce associated distress.