Not all instances of prediabetes are created equal.

A new study from Germany is shedding light on six different kinds of prediabetes and how treatments could potentially be tailored to reflect these differences.

The broad definition of the condition remains the same across its different types. People who are prediabetic typically exhibit persistently high blood sugar. Eventually, their body’s cells become resistant to insulin, which regulates blood sugar levels. According to the Centers for Disease Control and Prevention, most people with prediabetes — 84%, in fact — do not know they are prediabetic.

Understanding the different types of prediabetes may help providers distinguish between their different prognoses and better select corresponding interventions based on appropriateness.

The six types of prediabetes originate from several core metabolic features: the amount of fat in the liver, blood glucose levels, overall fat distribution, levels of blood lipids, and genetic history of diabetes.

Each of the six types possessed its own metabolic characteristics and relative risk profiles. For example, Types 1, 2 and 4 had low mortality and a low risk of their prediabetes evolving into diabetes compared with the other groups. Those with Type 4 prediabetes were overweight, but possessed a healthy metabolism. Others, like Type 3, had a moderate risk of mortality but produced too little insulin and had genetic risk factors for diabetes and cardiovascular complications.

Researchers hope this information will help identify those whose risk is especially high and make prevention strategies more effective.