Review

Diabetologia

, Volume 40, Issue 3, pp 247-255

Diagnosing diabetes mellitus – do we need new criteria?

  • D. R. McCanceAffiliated withSir George E. Clark Metabolic Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK
  • , R. L. HansonAffiliated withDiabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
  • , D. J. PettittAffiliated withDiabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
  • , P. H. BennettAffiliated withDiabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
  • , D. R. HaddenAffiliated withSir George E. Clark Metabolic Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK
  • , W. C. KnowlerAffiliated withDiabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA

Summary

The current classification and diagnostic criteria for diabetes mellitus were introduced by the United States National Data Group in 1979 and endorsed by the World Health Organization in 1980, with modifications in 1985 and 1994. The criteria, chosen to reflect the risk of complications, were the synthesis of considerable thought and expertise and represented a consensus which, it was hoped, would prove helpful to all those involved with diabetes – practising clinician, research scientist and epidemiologist alike. The inconvenience, variability and nonphysiological nature of the oral glucose tolerance test (OGTT) are well-recognised. In spite of these limitations the 2-h post-load plasma glucose has remained the standard against which all other tests have been evaluated. This article reviews the original justification for the OGTT, and in the light of more recent epidemiological research seeks to place the current diagnostic criteria for diabetes into a pathophysiological, diagnostic and prognostic perspective. [Diabetologia (1997) 40: 247–255]

Keywords Diabetes mellitus diagnosis oral glucose tolerance test fasting plasma glucose 2-h plasma glucose haemoglobin A1c retinopathy nephropathy complications.