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New classification and diagnostic criteria for insulin resistance syndrome

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Abstract

This report of a working group established by the Japan Diabetes Society proposes a new classification and diagnostic criteria for insulin resistance syndrome. Insulin resistance syndrome is defined as a condition characterized by severe attenuation of insulin action due to functional impairment of the insulin receptor or its downstream signaling molecules. This syndrome is classified into two types: genetic insulin resistance syndrome, caused by gene abnormalities, and type B insulin resistance syndrome, caused by autoantibodies to the insulin receptor. Genetic insulin resistance syndrome includes type A insulin resistance as well as Donohue and Rabson-Mendenhall syndromes, all of which are caused by abnormalities of the insulin receptor gene; conditions such as SHORT syndrome caused by abnormalities of PIK3R1, which encodes a regulatory subunit of phosphatidylinositol 3-kinase; conditions caused by abnormalities of AKT2, TBC1D4, or PRKCE; and conditions in which a causative gene has not yet been identified. Type B insulin resistance syndrome is characterized by severe impairment of insulin action due to the presence of insulin receptor autoantibodies. Cases in which hypoglycemia alone is induced by autoantibodies that stimulate insulin receptor were not included in Type B insulin resistance syndrome.

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Author information

Authors and Affiliations

  1. Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Wataru Ogawa & Yushi Hirota

  2. Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honso, Chuo-ku, Kumamoto, 860-8556, Japan

    Eiichi Araki

  3. Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Iwate Medical University, 2-1-1 Idai Street, Shiwagun Yahabacho, Yahaba, 028-3695, Japan

    Yasushi Ishigaki

  4. Division of Diabetology, Endocrinology, and Nephrology, Department of Medicine, Shiga University of Medical Sciences, Setatsukinowacho, Otsu, 520-2192, Japan

    Hiroshi Maegawa

  5. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0003, Japan

    Toshimasa Yamauchi

  6. Division of Pediatric Endocrinology and Metabolism, Children’s Medical Center, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka, 534-0021, Japan

    Tohru Yorifuji

  7. Department of Metabolism and Diabetes, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aoba-ku, Sendai, 980-8575, Japan

    Hideki Katagiri

Authors
  1. Wataru Ogawa
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  2. Eiichi Araki
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  3. Yasushi Ishigaki
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  4. Yushi Hirota
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  6. Toshimasa Yamauchi
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Correspondence to Wataru Ogawa.

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Conflict of interest

Wataru Ogawa: Lecture fee (Sumitomo Dainippon Pharma Co., Ltd., Novartis Pharma K.K., Nippon Boehringer Ingelheim Co., Ltd., Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation, Abbott Japan), Total amount of research expenses (joint research, commissioned research, clinical trials, etc.) and grants (Noster, Nippon Boehringer Ingelheim Co., Ltd., Boehringer Ingelheim Pharma GmbH&Co.KG, Eli Lilly Japan K.K., Novo Nordisk Pharma LTD., Abbott Japan, Abbott Diabetes Care UK Ltd, Sumitomo Dainippon Pharma Co., Ltd.), Total amount of scholarships (incentives) (Kowa Company, Ltd., Novo Nordisk Pharma LTD., Astellas Pharma Inc., Sumitomo Dainippon Pharma Co., Ltd., ONO PHARMACEUTICAL CO., LTD., Takeda Pharmaceutical Co. Ltd., Abbott Japan, Novartis Pharma K.K., DAIICHI SANKYO CO., LTD., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Corporation, Nippon Boehringer Ingelheim Co., Ltd.), Eiichi Araki: Lecture fees (AstraZeneca, MSD, ONO PHARMACEUTICAL CO., LTD., Kowa Company, Ltd., Sanofi, DAIICHI SANKYO CO., LTD., Sumitomo Dainippon Pharma Co., Ltd., Novo Nordisk Pharma LTD.) Total amount of scholarships (incentives) (Astellas Pharma Inc., Kowa Company, Ltd., Sanofi, DAIICHI SANKYO CO., LTD., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation, Nippon Boehringer Ingelheim Co., Ltd., Eli Lilly Japan K.K., Novartis Pharma K.K., Novo Nordisk Pharma LTD. Bayer Yakuhin Ltd) Endowed chair (ONO PHARMACEUTICAL CO., LTD., Terumo Corporation), Yasushi Ishigaki: Lecture fees (MSD, Novartis Pharma K.K., Mitsubishi Tanabe Pharma Corporation, Sanofi, ONO PHARMACEUTICAL CO., LTD., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co. Ltd., Novo Nordisk Pharma LTD.) Total amount of research expenses (joint research, commissioned research, clinical trials, etc.) and grants (Novo Nordisk Pharma LTD., DAIICHI SANKYO CO., LTD.), Total amount of scholarships (incentives) donations (Novartis Pharma K.K., ONO PHARMACEUTICAL CO., LTD., Takeda Science Foundation), Yushi Hirota: Lecture fee (Eli Lilly Japan K.K. Sanofi), Hiroshi Maegawa: Lecture fees (Sanofi, Nippon Boehringer Ingelheim Co., Ltd., Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Pharma LTD., Sumitomo Dainippon Pharma Co., Ltd., MSD, Astellas Pharma Inc., DAIICHI SANKYO CO., LTD., AstraZeneca, Eli Lilly Japan K.K.) Total amount of research fees (joint research, commissioned research, clinical trials, etc.) and grants (Nippon Boehringer Ingelheim Co., Ltd., Sunstar, Mitsubishi Tanabe Pharma Corporation, Kyowa Kirin Co., Ltd. And Cimic Co., Ltd., Nissan Chemical Corporation, MIKI Corporation, Parexel), Total amount of scholarships (incentives) (Takeda Pharmaceutical Co. Ltd., Nippon Boehringer Ingelheim Co., Ltd., Mitsubishi Tanabe Pharma Corporation, DAIICHI SANKYO CO., LTD., Sumitomo Dainippon Pharma Co., Ltd., Kowa Company, Ltd., Sanwa Kagakukenkyusho Co, Ltd., Novo Nordisk Pharma LTD., Nipro Corporation, Astellas Pharma Inc., MSD, Taisho Pharma Co., Ltd., ONO PHARMACEUTICAL CO., LTD., Bayer Yakuhin Ltd, Novartis Pharma K.K.), Toshimasa Yamauchi: Lecture fees (Astellas Pharma Inc., AstraZeneca, ONO PHARMACEUTICAL CO., LTD., Sanofi, Takeda Pharmaceutical Co. Ltd., DAIICHI SANKYO CO., LTD., Novartis Pharma K.K., Novo Nordisk Pharma LTD.), Total amount of research expenses (joint research, commission research, clinical trials, etc.) and grants (Astra Zeneca, Kowa Company, Ltd., MSD, DAIICHI SANKYO CO.,LTD., Sanofi, Nippon Boehringer Ingelheim Co.,Ltd., Aero Switch Therapeutics, Inc., Sanwa Kagakukenkyusho Co, Ltd., Minophagen Pharmaceutical Co., LTD., Mitsubishi Corporation Life Sciences Limited, Nipro Corporation), Total amount of scholarships (incentives)(Kissei Pharmaceutical Co., Ltd., Taisho Pharma Co., Ltd., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Sanofi, Astellas Pharma Inc., Sumitomo Dainippon Pharma Co., Ltd., Novo Nordisk Pharma LTD., ONO PHARMACEUTICAL CO., LTD., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Co. Ltd., Sanwa Kagakukenkyosho Co, Ltd.), Endowed chair offered by companies, etc. (Takeda Pharmaceutical Co. Ltd., ONO PHARMACEUTICAL CO., LTD., Novo Nordisk Pharma LTD., Mitsubishi Tanabe Pharma Corporation, MSD, Nippon Boehringer Ingelheim Co.,Ltd., Kowa Company, Ltd., NTT Docomo Inc., Asahi Mutual Life Insurance Co), Tohru Yorifuji: Lecture fees (Novo Nordisk Pharma LTD.), Hideki Katagiri: Lecture fees (Mitsubishi Tanabe Pharma Corporation, Sanofi, Novo Nordisk Pharma LTD.), Total amount of research expenses (joint research, commission research, clinical trials, etc.) and grants (Otsuka Pharmaceutical Co., Ltd., Suntory Holdings Limited, Astellas Pharma Inc.), Total amount of scholarships (incentives) donations (Takeda Pharmaceutical Co. Ltd., DAIICHI SANKYO CO., LTD., Novartis Pharma K.K., Mitsubishi Tanabe Pharma Corporation, ONO PHARMACEUTICAL CO., LTD., Eli Lilly Japan K.K., MSD., Sanofi., Novo Nordisk Pharma LTD.)

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This article is the English version of the “New classification and diagnostic criteria for insulin resistance syndrome”, which was published in J Jpn Diab Soc. 2021;64(11):561-568 in Japanese (https://doi.org/10.11213/tonyobyo.64.561) and has been jointly published in Endocrine Journal (the official English journal of The Japan Endocrine Society: https://doi.org/10.1507/endocrj.EJ21-0725) and Diabetology International (the official English journal of the Japan Diabetes Society).

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Ogawa, W., Araki, E., Ishigaki, Y. et al. New classification and diagnostic criteria for insulin resistance syndrome. Diabetol Int 13, 337–343 (2022). https://doi.org/10.1007/s13340-022-00570-5

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