Diabetes mellitus is a worldwide epidemic affecting the health of millions of people. While type 1 diabetes (T1D) is caused by autoimmune destruction of the insulin-producing beta cells of the pancreas, type 2 diabetes (T2D) results from a combination of insulin resistance and beta cell insulin secretory defect. Clear definition and diagnosis of these two types of diabetes has been increasing more and more difficult, leading to the inclusion of a new category, namely double or hybrid diabetes (DD) that demonstrates symptoms of both T1D and T2D via the accelerator hypothesis. In this review, we discuss the worldwide prevalence of DD, its main physiological characteristics, including beta-cell autoimmunity, insulin resistance, and cardiovascular disease, the main risk factors of developing DD, mainly genetics, obesity and lifestyle choices, as well as potential treatments, such as insulin titration, metformin and behavioural modifications. Increasing awareness of DD among the general population and primary care practitioners is necessary for successfully treating this complex, hybrid disease in the future.

中文翻译：

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双重或混合型糖尿病：对疾病患病率，特征和危险因素的系统评价。

糖尿病是一种影响数百万人健康的全球性流行病。虽然1型糖尿病（T1D）是由胰腺中产生胰岛素的β细胞的自身免疫破坏引起的，但2型糖尿病（T2D）是由胰岛素抵抗和β细胞胰岛素分泌缺陷共同导致的。对这两种类型的糖尿病的明确定义和诊断越来越困难，从而导致包括一个新的类别，即双重或混合型糖尿病（DD），该疾病通过加速器假说显示出T1D和​​T2D的症状。在这篇综述中，我们讨论了DD在全球的流行情况，其主要生理特征，包括β细胞自身免疫，胰岛素抵抗和心血管疾病，发展DD的主要危险因素，主要是遗传，肥胖和生活方式选择，以及潜在的治疗方法，例如胰岛素滴定，二甲双胍和行为改变。为了将来成功治疗这种复杂的杂种疾病，必须提高普通人群和基层医疗从业人员对DD的认识。