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Diagnostic Criteria and Classification of Diabetes

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Abstract

Diabetes mellitus is a group of diverse metabolic disorders characterized by hyperglycemia and distinctive complications that include premature atherosclerotic cardiovascular disease and small vessel disease manifested as retinopathy with potential loss of vision; nephropathy leading to renal failure; and peripheral neuropathy with a high risk of foot ulcers and amputations. In the past, the classification of diabetes mellitus was based on clinical findings such as age of onset, so-called juvenile- or adult-onset diabetes, or treatment modalities, such as insulin-dependent versus non-insulin-dependent diabetes. In 1979 the National Diabetes Data Group (NDDG) in conjunction with World Health Organization (WHO) revised and published new and unified criteria for the classification and diagnosis of diabetes mellitus.

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References

  1. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979;28:1039–1057.

    Google Scholar 

  2. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2008;31(Suppl 1):S55–S60.

    Article  Google Scholar 

  3. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.

    Article  Google Scholar 

  4. Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–1350.

    Article  PubMed  CAS  Google Scholar 

  5. Berkowitz K, Peters R, Kjos SL, et al. Effect of troglitazone on insulin sensitivity and pancreatic beta-cell function in women at high risk for NIDDM. Diabetes. 1996;11:1572–1579.

    Article  Google Scholar 

  6. Scheen AJ, Ernest P. The xenical in the prevention of diabetes in obese subjects (XENDOS) trial. Diabetes Metab. 2002;28:437–445.

    PubMed  CAS  Google Scholar 

  7. DREAM (Diabetes Reduction Assessment with ramipril and rosiglitazone Medication) Trial Investigators. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomized controlled trial. Lancet. 2006;368:1096–1105.

    Article  Google Scholar 

  8. Atkinson MA, Maclaren NK. The pathogenesis of insulin dependent diabetes. N Engl J Med. 1994;331:1428–1436.

    Article  PubMed  CAS  Google Scholar 

  9. Kaufman D, Erlander M, Clare-Salzler M, Atkinson M, Maclaren N, Tobin A. Autoimmunity to two forms of glutamate decarboxylase in insulin-dependent mellitus. J Clin Invest. 1992;89:283–292.

    Article  PubMed  CAS  Google Scholar 

  10. Myers MA, Rabin DU, Rowley MJ. Pancreatic islet cell cytoplasmic antibody in diabetes is represented by antibodies to islet cell antigen 512 and glutamic acid decarboxylase. Diabetes. 1995;44:1290–1295.

    Article  PubMed  CAS  Google Scholar 

  11. Lan MS, Wasserfall C, Maclaren NK, Notkins AL. IA-2, a transmembrane protein of the protein tyrosine phosphatase family, is a major autoantigen in insulin-dependent diabetes mellitus. Proc Natl Acad Sci USA. 1996;93:6367–6370.

    Article  PubMed  CAS  Google Scholar 

  12. Lu J, Li Q, Xie H, et al. Identification of a second transmembrane protein tyrosine phosphatase, IA-2α, as an autoantigen in insulin-dependent diabetes mellitus: precursor of the 37-kDa tryptic fragment. Proc Natl Acad Sci USA. 1996;93:2307–2311.

    Article  PubMed  CAS  Google Scholar 

  13. Huang W, Connor E, DelaRosa T, et al. Although DR3-DQB1* may be associated with multiple component diseases of the autoimmune polyglandular syndromes, the human leukocyte antigen DR4-DQB1I0302 haplotype is implicated only in beta cell autoimmunity. J Clin Endocrinol Metab. 1996;81:1–5.

    Article  Google Scholar 

  14. Landon-Olson M. Latent autoimmune diabetes in adults. Ann NY Acad Sci. 2002;958:112–116.

    Article  Google Scholar 

  15. Palmer JP, Hampe CS, Chiu H, Goel A, Brooks-Worrell BM. Is latent autoimmune diabetes in adults distinct from type 1 diabetes or just type 1 diabetes at an older age?. Diabetes. 2005;54(Suppl 2):S62–S67.

    Article  PubMed  CAS  Google Scholar 

  16. Zimmet PZ, Tuomi T, Mackay R, et al. Latent autoimmune diabetes mellitus in adults (LADA): the role of antibodies to glutamic acid decarboxylase in diagnosis and prediction of insulin dependency. Diabetes Med. 1994;11:299–303.

    Article  CAS  Google Scholar 

  17. Banerji M, Lebovitz H. Insulin sensitive and insulin resistant variants in IDDM. Diabetes. 1989;38:784–792.

    Article  PubMed  CAS  Google Scholar 

  18. Fajans SS, Bell GI, Polonsky KS. Molecular mechanisms and clinical pathophysiology of maturity-onset diabetes of the young. N Engl J Med. 2001;345:971–980.

    Article  PubMed  CAS  Google Scholar 

  19. Hattersley AT, Ashcroft FM. Activating mutations in Kir6.2 and neonatal diabetes: new clinical syndromes, new scientific insights, and new therapy. Diabetes. 2005;54:2503–2513.

    Article  PubMed  CAS  Google Scholar 

  20. Flanagan SE, Edghill EL, Gloyn AL, Ellard S, Hattersley AT. Mutations in KCNJ11, which encodes Kir6.2, are a common cause of diabetes diagnosed in the first 6 months of life, with the phenotype determined by genotype. Diabetologia. 2006;49:1190–1197.

    Article  PubMed  CAS  Google Scholar 

  21. Gloyn AL, Pearson ER, Antcliff JF, et al. Activating mutations in the gene encoding the ATP-sensitive potassium-channel subunit Kir6.2 and permanent neonatal diabetes. N Engl J Med. 2004;350:1838–1849.

    Article  PubMed  CAS  Google Scholar 

  22. Pearson ER, Flechtner I, Njolstad PR, et al. Switching from insulin to oral sulfonylureas in patients with diabetes due to Kir6.2 mutations. N Engl J Med. 2006;355:467–477.

    Article  PubMed  CAS  Google Scholar 

  23. Kadowaki T, Kadowaki H, Mori Y, et al. A subtype of diabetes mellitus associated with a mutation of mitochondrial DNA. N Engl J Med. 1994;330:962–968.

    Article  PubMed  CAS  Google Scholar 

  24. Gruppuso PA, Gorden P, Kahn CR, Cornblath M, Zeller WP, Schwartz R. Familial hyperproinsulinemia due to a proposed defect in conversion of proinsulin to insulin. N Engl J Med. 1984;311:629–634.

    Article  PubMed  CAS  Google Scholar 

  25. Given BD, Mako ME, Tager HS, et al. Diabetes due to secretion of an abnormal insulin. N Engl J Med. 1980;302:129–135.

    Article  PubMed  CAS  Google Scholar 

  26. Taylor SI. Lilly lecture: molecular mechanisms of insulin resistance: lessons from patients with mutations in the insulin-receptor gene. Diabetes. 1992;41:1473–1490.

    Article  PubMed  CAS  Google Scholar 

  27. Kahn CR, Flier JS, Bar RS, et al. The syndromes of insulin resistance and acanthosis nigricans. N Engl J Med. 1976;294:739–745.

    Article  PubMed  CAS  Google Scholar 

  28. Dunaif A, Segal KR, Shelley DR, Green G, Dobrjansky A, Licholai T. Evidence for distinctive and intrinsic defects in insulin action in polycystic ovary syndrome. Diabetes. 1992;41:1257–1266.

    Article  PubMed  CAS  Google Scholar 

  29. Karjalainen J, Knip M, Hyoty H, et al. Relationship between serum insulin antibodies, islet cell antibodies and Coxsackie-B4 and mumps virus-specific antibodies at the clinical manifestation of type I (insulin-dependent) diabetes. Diabetologia. 1988;31:146–152.

    Article  PubMed  CAS  Google Scholar 

  30. Pak CY, Eun H, McArthur RG, Yoon J. Association of cytomegalovirus infection with autoimmune type 1 diabetes. Lancet. 1988;2:1–4.

    Article  PubMed  CAS  Google Scholar 

  31. Hui J, Sud A, Farrell GC, et al. Insulin resistance is associated with chronic hepatitis C and virus infection fibrosis progression. Gastroenterology. 2003;125:1695–1704.

    Article  PubMed  CAS  Google Scholar 

  32. Mehta S, Brancati F, Sulkowski M, Strathdee S, Szklo M, Thomas D. Prevalence of type 2 diabetes mellitus among persons with hepatitis C virus infection in the United States. Ann Intern Med. 2000;133:592–599.

    PubMed  CAS  Google Scholar 

  33. Engelgau MM, Herman WH, Smith PJ, German RR, Aubert RE. The epidemiology of diabetes and pregnancy in the U.S., 1988. Diabetes Care. 1995;18:1029–1033.

    Article  PubMed  CAS  Google Scholar 

  34. Magee MS, Walden CE, Benedetti TJ. Influence of diagnostic criteria on the incidence of gestational diabetes and perinatal morbidity. JAMA. 1993;269:609–615.

    Article  PubMed  CAS  Google Scholar 

  35. Langer O, Rodriguez DA, Xenakis EMJ, McFarland MB, Berkus MD, Arrendondo F. Intensified versus conventional management of gestational diabetes. Am J Obstet Gynecol. 1994;170:1036–1047.

    PubMed  CAS  Google Scholar 

  36. HAPO Study Cooperative Research Group. The hyperglycemia and adverse pregnancy outcome (HAPO) study. Int J Gynaecol Obstet. 2002;78:69–77.

    Article  Google Scholar 

  37. American Diabetes Association. Tests of glycemia in diabetes (Position Statement). Diabetes Care. 2001;24(Suppl 1):S80–S82.

    Article  Google Scholar 

  38. Engelgau MM, Thompson TJ, Herman WH, et al. Comparison of fasting and 2-hour glucose and HbA1c levels for diagnosing diabetes: diagnostic criteria and performance revisited. Diabetes Care. 1997;20:785–791.

    Article  PubMed  CAS  Google Scholar 

  39. McCance DR, Hanson RL, Charles MA, et al. Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes. Brit Med J. 1994;308:1323–1328.

    PubMed  CAS  Google Scholar 

  40. Consensus Committee. Consensus statement on the worldwide standardization of the HbA1c measurement. Diabetologia. 2007;50:2042–2043.

    Article  Google Scholar 

  41. Barrett-Connor E, Wingard DL. HbA1c levels predict mortality across population ranges. Brit Med J. 2001;322:5–6.

    Article  PubMed  CAS  Google Scholar 

  42. Harris MI, Hadden WC, Knowler WC, Bennett PH. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in the U.S. population aged 20–74 yr. Diabetes. 1987;36:523–534.

    Article  PubMed  CAS  Google Scholar 

  43. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20:1183–1197.

    Google Scholar 

  44. Tirosh A. Normal fasting glucose levels and type 2 diabetes in young men. N Engl J Med. 2005;353:1454.

    Article  PubMed  CAS  Google Scholar 

  45. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497.

    Article  Google Scholar 

  46. Klein R. Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care. 1995;18:258–268.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Joel Zonszein .

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Leu, J.P., Zonszein, J. (2010). Diagnostic Criteria and Classification of Diabetes. In: Poretsky, L. (eds) Principles of Diabetes Mellitus. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-09841-8_7

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  • DOI: https://doi.org/10.1007/978-0-387-09841-8_7

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