Limitations and Problems of Diabetes Classification from an Epidemiological Point of View
Classifications of disease are man-made devices to assist in the ordering of thought or the organization of action. It follows that they depend upon the current state of knowledge and that as knowledge increases so classification may change. It also follows that the nature of the classification will depend upon the type of action to be organized. Thus a classification appropriate to a clinician whose concern is with diagnosis and treatment may well be inappropriate to a basic scientist whose concern is research strategy and experimental design. The public health agent will require a classification which assists in provision of health care resources and the planning of preventive approaches. Epidemiological needs will also make special demands of a classification, the main requirement being for clear, unambiguous definitions. The classification formulated by the US National Diabetes Data Group (NDDG)1 and adopted in the Second Report of the World Health Organization Expert Committee on Diabetes Mellitus (WHO)2 (see abbreviated version, Table 1) goes a long way to meet the varying needs of these different user groups but falls short of perfection as is inevitable in any attempt to meet them all. It is the residual problems, mainly those for the epidemiologist, that are dealt with here.
KeywordsGestational Diabetes MELLITUS IKPAIRED Glucose Tolerance Islet Cell Antibody Term Type National Diabetes Data Group
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