|
 |
|
|||||||
|
|||||||||
© 2006 by the American Diabetes Association
© 2006 by the American Diabetes Association, Inc.
POSITION STATEMENT |
Diagnosis and Classification of Diabetes Mellitus
American Diabetes Association
Abbreviations: FPG, fasting plasma glucose • GAD, glutamic acid decarboxylase • GCT, glucose challenge test • GDM, gestational diabetes mellitus • HNF, hepatocyte nuclear factor • IFG, impaired fasting glucose • IGT, impaired glucose tolerance • MODY, maturity-onset diabetes of the young • WHO, World Health Organization
| The first 300 words of the full text of this article appear below. |
 |
DEFINITION AND DESCRIPTION OF DIABETES MELLITUS |
|---|
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
Several pathogenic processes are involved in the development of diabetes. These range from autoimmune destruction of the ß-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues. Deficient insulin action results from inadequate insulin secretion and/or diminished tissue responses to insulin at one or more points in the complex pathways of hormone action. Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycemia.
Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision. Impairment of growth and susceptibility to certain infections may also accompany chronic hyperglycemia. Acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis or the nonketotic hyperosmolar syndrome.
Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers, amputations, and Charcot joints; and autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascular symptoms and sexual dysfunction. Patients with diabetes have an increased incidence of atherosclerotic cardiovascular, peripheral arterial, and cerebrovascular disease. Hypertension and abnormalities of lipoprotein metabolism are often found in people with diabetes.
The vast majority of cases of diabetes fall into two broad etiopathogenetic categories (discussed in greater detail below). In one category, type 1 diabetes, the cause is an absolute deficiency of
|
CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION |
|---|
Type 1 diabetes (ß-cell destruction, usually leading to absolute insulin deficiency)
Immune-mediated diabetes.
Idiopathic diabetes.
Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
Other specific types of diabetes
Genetic defects of the ß-cell.
Genetic defects in insulin action.
Diseases of the exocrine pancreas.
Endocrinopathies.
Drug- or chemical-induced diabetes.
Infections.
Uncommon forms of immune-mediated diabetes.
Other genetic syndromes sometimes associated with diabetes.
Gestational diabetes mellitus (GDM)
Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG)
|
DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS |
|---|
Diagnosis of GDM
Testing for gestational diabetes.
One-step approach.
Two-step approach.
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  T. A. Hillier, K. L. Pedula, K. K. Vesco, M. M. Schmidt, J. A. Mullen, E. S. LeBlanc, and D. J. Pettitt Excess Gestational Weight Gain: Modifying Fetal Macrosomia Risk Associated With Maternal Glucose Obstet. Gynecol., November 1, 2008; 112(5): 1007 - 1014. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D Deshpande, M. Harris-Hayes, and M. Schootman Epidemiology of Diabetes and Diabetes-Related Complications Physical Therapy, November 1, 2008; 88(11): 1254 - 1264. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Colao, C. Di Somma, T. Cascella, R. Pivonello, G. Vitale, L. F S Grasso, G. Lombardi, and S. Savastano Relationships between serum IGF1 levels, blood pressure, and glucose tolerance: an observational, exploratory study in 404 subjects Eur. J. Endocrinol., October 1, 2008; 159(4): 389 - 397. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Feng, G. Mao, X. Ren, H. Xing, G. Tang, Q. Li, X. Li, L. Sun, J. Yang, W. Ma, et al. Ser1369Ala Variant in Sulfonylurea Receptor Gene ABCC8 Is Associated With Antidiabetic Efficacy of Gliclazide in Chinese Type 2 Diabetic Patients Diabetes Care, October 1, 2008; 31(10): 1939 - 1944. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Sabio, M Zamora-Pasadas, J Jimenez-Jaimez, F Albadalejo, J Vargas-Hitos, M. Rodriguez del Aguila, C Hidalgo-Tenorio, M. Gonzalez-Gay, and J. Alonso Metabolic syndrome in patients with systemic lupus erythematosus from Southern Spain Lupus, September 1, 2008; 17(9): 849 - 859. [Abstract] [PDF]
|
|
|
|
 |
|
 K. S. Stote and D. J. Baer Tea Consumption May Improve Biomarkers of Insulin Sensitivity and Risk Factors for Diabetes J. Nutr., August 1, 2008; 138(8): 1584S - 1588S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Golden, M. Lazo, M. Carnethon, A. G. Bertoni, P. J. Schreiner, A. V. D. Roux, H. B. Lee, and C. Lyketsos Examining a Bidirectional Association Between Depressive Symptoms and Diabetes JAMA, June 18, 2008; 299(23): 2751 - 2759. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Balzer, T. Rassaf, C. Heiss, P. Kleinbongard, T. Lauer, M. Merx, N. Heussen, H. B. Gross, C. L. Keen, H. Schroeter, et al. Sustained benefits in vascular function through flavanol-containing cocoa in medicated diabetic patients a double-masked, randomized, controlled trial. J. Am. Coll. Cardiol., June 3, 2008; 51(22): 2141 - 2149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Manders, R. Koopman, M. Beelen, A. P. Gijsen, W. K. Wodzig, W. H. Saris, and L. J. van Loon The Muscle Protein Synthetic Response to Carbohydrate and Protein Ingestion Is Not Impaired in Men with Longstanding Type 2 Diabetes J. Nutr., June 1, 2008; 138(6): 1079 - 1085. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. B. Grammer, W. Marz, W. Renner, B. O. Bohm, and M. M. Hoffmann C-reactive protein genotypes associated with circulating C-reactive protein but not with angiographic coronary artery disease: the LURIC study Eur. Heart J., May 21, 2008; (2008) ehn191v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U.S. Preventive Services Task Force Screening for Gestational Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement Ann Intern Med, May 20, 2008; 148(10): 759 - 765. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Hillier, K. K. Vesco, K. L. Pedula, T. L. Beil, E. P. Whitlock, and D. J. Pettitt Screening for Gestational Diabetes Mellitus: A Systematic Review for the U.S. Preventive Services Task Force Ann Intern Med, May 20, 2008; 148(10): 766 - 775. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. Carr, K. M. Newton, K. M. Utzschneider, J. Tong, F. Gerchman, S. E. Kahn, and S. R. Heckbert Modestly Elevated Glucose Levels During Pregnancy Are Associated With a Higher Risk of Future Diabetes Among Women Without Gestational Diabetes Mellitus Diabetes Care, May 1, 2008; 31(5): 1037 - 1039. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Tiberti, C. Giordano, M. Locatelli, E. Bosi, G. F. Bottazzo, R. Buzzetti, D. Cucinotta, A. Galluzzo, A. Falorni, and F. Dotta Identification of Tyrosine Phosphatase 2(256-760) Construct as a New, Sensitive Marker for the Detection of Islet Autoimmunity in Type 2 Diabetic Patients: The Non-Insulin Requiring Autoimmune Diabetes (NIRAD) Study 2 Diabetes, May 1, 2008; 57(5): 1276 - 1283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Martinuzzi, G. Novelli, M. Scotto, P. Blancou, J.-M. Bach, L. Chaillous, G. Bruno, L. Chatenoud, P. van Endert, and R. Mallone The Frequency and Immunodominance of Islet-Specific CD8+ T-cell Responses Change after Type 1 Diabetes Diagnosis and Treatment Diabetes, May 1, 2008; 57(5): 1312 - 1320. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Golledge, M. Karan, C. S. Moran, J. Muller, P. Clancy, A. E. Dear, and P. E. Norman Reduced expansion rate of abdominal aortic aneurysms in patients with diabetes may be related to aberrant monocyte-matrix interactions Eur. Heart J., March 1, 2008; 29(5): 665 - 672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L Ronchi, E. Rizzo, A. G Lania, R. Pivonello, S. Grottoli, A. Colao, E. Ghigo, A. Spada, M. Arosio, and P. Beck-Peccoz Preliminary data on biochemical remission of acromegaly after somatostatin analogs withdrawal Eur. J. Endocrinol., January 1, 2008; 158(1): 19 - 25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Yeo, N. P. Hays, R. A. Dennis, P. M. Kortebein, D. H. Sullivan, W. J. Evans, and R. H. Coker Fat Distribution and Glucose Metabolism in Older, Obese Men and Women J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2007; 62(12): 1393 - 1401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, R. Pivonello, R. S Auriemma, M. Galdiero, S. Savastano, and G. Lombardi Beneficial effect of dose escalation of Octreotide-LAR as first-line therapy in patients with acromegaly Eur. J. Endocrinol., November 1, 2007; 157(5): 579 - 587. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. L. Rowe, S. Ram Kumar, H. Glass, D. B. Hood, and F. A. Weaver Race Independently Impacts Outcome of Infrapopliteal Bypass for Symptomatic Arterial Insufficiency Vascular and Endovascular Surgery, November 1, 2007; 41(5): 397 - 401. [Abstract] [PDF]
|
|
|
|
 |
|
 N. Brooks and R. R. Prevost Pharmacy Review: Reducing the Risks of Diabetes: The Pharmacist's Perspective American Journal of Lifestyle Medicine, October 1, 2007; 1(5): 356 - 357. [Abstract] [PDF]
|
|
|
|
 |
|
 N. Pannacciulli, A. D Salbe, E. Ortega, C. A Venti, C. Bogardus, and J. Krakoff The 24-h carbohydrate oxidation rate in a human respiratory chamber predicts ad libitum food intake Am. J. Clinical Nutrition, September 1, 2007; 86(3): 625 - 632. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Golden, H. B. Lee, P. J. Schreiner, A. D. Roux, A. L. Fitzpatrick, M. Szklo, and C. Lyketsos Depression and Type 2 Diabetes Mellitus: The Multiethnic Study of Atherosclerosis Psychosom Med, July 1, 2007; 69(6): 529 - 536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Vega-Lopez, L. M. Ausman, J. L. Griffith, and A. H. Lichtenstein Interindividual Variability and Intra-Individual Reproducibility of Glycemic Index Values for Commercial White Bread Diabetes Care, June 1, 2007; 30(6): 1412 - 1417. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Marz, B. Tiran, U. Seelhorst, B. Wellnitz, J. Bauersachs, B. R. Winkelmann, and B. O. Boehm N-Terminal Pro-B-Type Natriuretic Peptide Predicts Total and Cardiovascular Mortality in Individuals with or without Stable Coronary Artery Disease: The Ludwigshafen Risk and Cardiovascular Health Study Clin. Chem., June 1, 2007; 53(6): 1075 - 1083. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Hovi, S. Andersson, J. G. Eriksson, A.-L. Jarvenpaa, S. Strang-Karlsson, O. Makitie, and E. Kajantie Glucose Regulation in Young Adults with Very Low Birth Weight N. Engl. J. Med., May 17, 2007; 356(20): 2053 - 2063. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Dobratz, S. D. Sibley, T. R. Beckman, B. J. Valentine, T. A. Kellogg, S. Ikramuddin, and C. P. Earthman Predicting Energy Expenditure in Extremely Obese Women JPEN J Parenter Enteral Nutr, May 1, 2007; 31(3): 217 - 227. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. R. Chasens Obstructive Sleep Apnea, Daytime Sleepiness, and Type 2 Diabetes The Diabetes Educator, May 1, 2007; 33(3): 475 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Kong, R. L. Williams, M. Smith, A. L. Sussman, B. Skipper, A. C. Hsi, R. L. Rhyne, and On behalf of RIOS Net Clinicians Acanthosis Nigricans and Diabetes Risk Factors: Prevalence in Young Persons Seen in Southwestern US Primary Care Practices Ann. Fam. Med, May 1, 2007; 5(3): 202 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Golledge, S. Mangan, and P. Clancy Effects of Peroxisome Proliferator-Activated Receptor Ligands in Modulating Tissue Factor and Tissue Factor Pathway Inhibitor in Acutely Symptomatic Carotid Atheromas Stroke, May 1, 2007; 38(5): 1501 - 1508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Siminerio Educating Patients With Type 2 Diabetes on a New Class of Drug, Dipeptidyl Peptidase 4 Inhibitors The Diabetes Educator, May 1, 2007; 33(Supplement_5): 111S - 113S. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Harder, E. Rodekamp, K. Schellong, J. W. Dudenhausen, and A. Plagemann Birth Weight and Subsequent Risk of Type 2 Diabetes: A Meta-Analysis Am. J. Epidemiol., April 15, 2007; 165(8): 849 - 857. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. Larsen, M. Faulenbach, A. Vaag, A. Volund, J. A. Ehses, B. Seifert, T. Mandrup-Poulsen, and M. Y. Donath Interleukin-1-Receptor Antagonist in Type 2 Diabetes Mellitus N. Engl. J. Med., April 12, 2007; 356(15): 1517 - 1526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Keevil, M. W. Cullen, R. Gangnon, P. E. McBride, and J. H. Stein Implications of Cardiac Risk and Low-Density Lipoprotein Cholesterol Distributions in the United States for the Diagnosis and Treatment of Dyslipidemia: Data From National Health and Nutrition Examination Survey 1999 to 2002 Circulation, March 20, 2007; 115(11): 1363 - 1370. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Wilke, R. L. Berg, P. Peissig, T. Kitchner, B. Sijercic, C. A. McCarty, and D. J. McCarty Use of an Electronic Medical Record for the Identification of Research Subjects with Diabetes Mellitus Clin. Med. Res., March 1, 2007; 5(1): 1 - 7. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Ortega, N. Pannacciulli, C. Bogardus, and J. Krakoff Plasma concentrations of free triiodothyronine predict weight change in euthyroid persons Am. J. Clinical Nutrition, February 1, 2007; 85(2): 440 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. B. Panagiotakos, N. Tzima, C. Pitsavos, C. Chrysohoou, A. Zampelas, D. Toussoulis, and C. Stefanadis The Association between Adherence to the Mediterranean Diet and Fasting Indices of Glucose Homoeostasis: The ATTICA Study J. Am. Coll. Nutr., February 1, 2007; 26(1): 32 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Meinitzer, U. Seelhorst, B. Wellnitz, G. Halwachs-Baumann, B. O. Boehm, B. R. Winkelmann, and W. Marz Asymmetrical Dimethylarginine Independently Predicts Total and Cardiovascular Mortality in Individuals with Angiographic Coronary Artery Disease (The Ludwigshafen Risk and Cardiovascular Health Study) Clin. Chem., February 1, 2007; 53(2): 273 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Krishnan, C. K. Kwoh, H. R. Schumacher, and L. Kuller Hyperuricemia and Incidence of Hypertension Among Men Without Metabolic Syndrome Hypertension, February 1, 2007; 49(2): 298 - 303. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. P Weiss, J. Brandauer, O. Kulaputana, I. A Ghiu, C. R Wohn, D. A Phares, A. R Shuldiner, and J. M Hagberg FABP2 Ala54Thr genotype is associated with glucoregulatory function and lipid oxidation after a high-fat meal in sedentary nondiabetic men and women Am. J. Clinical Nutrition, January 1, 2007; 85(1): 102 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Miazgowski, S. Pynka, M. Noworyta-Zietara, B. Krzyzanowska-Swiniarska, and R. Pikul Bone mineral density and hip structural analysis in type 1 diabetic men Eur. J. Endocrinol., January 1, 2007; 156(1): 123 - 127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. McKennon and R. K. Campbell The Physiology of Incretin Hormones and the Basis for DPP-4 Inhibitors The Diabetes Educator, January 1, 2007; 33(1): 55 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R K. Campbell Rationale for Dipeptidyl Peptidase 4 Inhibitors: A New Class of Oral Agents for the Treatment of Type 2 Diabetes Mellitus Ann. Pharmacother., January 1, 2007; 41(1): 51 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Feldman, R. S. Streeper, R. V. Farese Jr., and K. R. Yamamoto Myostatin modulates adipogenesis to generate adipocytes with favorable metabolic effects PNAS, October 17, 2006; 103(42): 15675 - 15680. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Gambert and S. Pinkstaff Emerging Epidemic: Diabetes in Older Adults: Demography, Economic Impact, and Pathophysiology Diabetes Spectr, October 1, 2006; 19(4): 221 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. A. Perkins, J. Grewal, E. Ng, M. Ngo, and V. Bril Validation of a Novel Point-of-Care Nerve Conduction Device for the Detection of Diabetic Sensorimotor Polyneuropathy. Diabetes Care, September 1, 2006; 29(9): 2023 - 2027. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Y. Donath and J. A. Ehses Type 1, type 1.5, and type 2 diabetes: NOD the diabetes we thought it was PNAS, August 15, 2006; 103(33): 12217 - 12218. [Full Text] [PDF]
|
|
|
|
|
|
S. H. Kim, L. Chunawala, R. Linde, and G. M. Reaven Comparison of the 1997 and 2003 American Diabetes Association Classification of Impaired Fasting Glucose: Impact on Prevalence of Impaired Fasting Glucose, Coronary Heart Disease Risk Factors, and Coronary Heart Disease in a Community-Based Medical Practice J. Am. Coll. Cardiol., July 18, 2006; 48(2): 293 - 297. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |