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Diagnostic criteria for acute-onset type 1 diabetes mellitus (2012)

Report of the Committee of Japan Diabetes Society on the Research of Fulminant and Acute-onset Type 1 Diabetes Mellitus

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Abstract

Type 1 diabetes is a disease characterized by destruction of pancreatic β cells, which leads to absolute deficiency of insulin secretion. Depending on the manner of onset and progression, it is classified as fulminant, acute-onset, or slowly progressive type 1 diabetes. Here, we propose the diagnostic criteria for acute-onset type 1 diabetes mellitus. Among the patients who developed diabetic ketosis or ketoacidosis within 3 months after the onset of hyperglycemic symptoms and need insulin treatment continuously after the diagnosis of diabetes, patients with anti-islet autoantibodies are diagnosed with “acute-onset type 1 diabetes mellitus (autoimmune)”. On the other hand, those whose endogenous insulin secretion is exhausted [fasting serum C peptide immunoreactivity (CPR) < 0.6 ng/ml] without verifiable anti-islet autoantibodies are diagnosed simply with “acute-onset type 1 diabetes mellitus”. Patients should be reevaluated after certain periods in case their statuses of anti-islet autoantibodies and/or endogenous insulin secretory capacity is unknown.

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Acknowledgments

The authors thank Drs. M. Okubo (Toranomon Hospital), Y. Kajio and K. Yasuda (National Center for Global Health and Medicine), K. Kamoi (Nagaoka Red Cross Hospital), J. Satoh (Iwate Medical University), S. Tanaka (University of Yamanashi), K. Nakanishi (Okinaka Memorial Institute for Medical Research), S. Fujii (Ishikawa Prefectural Central Hospital), J. Miura (Tokyo Women’s Medical University School of Medicine) and S. Murao (KKR Takamatsu Hospital) as collaborators in the subcommittee on Fulminant and Acute-onset Type 1 diabetes, Committee on Type 1 diabetes, Japan Diabetes Society. The authors also thank Drs. T. Urakami (Nihon University School of Medicine), S. Amemiya (Saitama Medical University), and S. Sugihara (Tokyo Women’s Medical University Medical Center East) for giving us valuable suggestions. The authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Metabolism/Diabetes and Clinical Nutrition, Nagasaki University Hospital, Nagasaki, Japan

    Eiji Kawasaki

  2. Department of Internal Medicine, Saitama Social Insurance Hospital, Saitama, Japan

    Taro Maruyama

  3. Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan

    Akihisa Imagawa

  4. Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan

    Takuya Awata

  5. Department of Endocrinology, Metabolism and Diabetes, Kinki University School of Medicine, Osaka, Japan

    Hiroshi Ikegami & Yumiko Kawabata

  6. Diabetes Center, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan

    Yasuko Uchigata

  7. Department of Laboratory Medicine, Ehime University School of Medicine, Ehime, Japan

    Haruhiko Osawa

  8. Third Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan

    Tetsuro Kobayashi

  9. Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan

    Akira Shimada

  10. Department of Internal Medicine, The Sakakibara Heart Institute of Okayama, Okayama, Japan

    Ikki Shimizu

  11. Department of Diabetes and Metabolism, Iwate Medical University, Iwate, Japan

    Kazuma Takahashi

  12. Department of Internal Medicine, Kakogawa West City Hospital, Hyogo, Japan

    Masao Nagata

  13. Diabetes Center, Shiraishi Hospital, Ehime, Japan

    Hideichi Makino

  14. Department of Internal Medicine (I), Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan

    Toshiaki Hanafusa

Authors
  1. Eiji Kawasaki
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  2. Taro Maruyama
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  3. Akihisa Imagawa
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  4. Takuya Awata
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  5. Hiroshi Ikegami
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  6. Yasuko Uchigata
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  7. Haruhiko Osawa
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  8. Yumiko Kawabata
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  9. Tetsuro Kobayashi
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  10. Akira Shimada
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  11. Ikki Shimizu
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  12. Kazuma Takahashi
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  13. Masao Nagata
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  14. Hideichi Makino
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  15. Toshiaki Hanafusa
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Corresponding author

Correspondence to Toshiaki Hanafusa.

Additional information

In 2012, the Japan Diabetes Society established the Committee of the Japan Diabetes Society on the Research of Fulminant and Acute-onset Type 1 Diabetes Mellitus, which published a committee report in J Japan Diab Soc 2013; 56: 584–589 (in Japanese). This is the English version of that report. Chairman: T. Hanafusa.

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Kawasaki, E., Maruyama, T., Imagawa, A. et al. Diagnostic criteria for acute-onset type 1 diabetes mellitus (2012). Diabetol Int 4, 221–225 (2013). https://doi.org/10.1007/s13340-013-0122-2

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  • DOI: https://doi.org/10.1007/s13340-013-0122-2

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