The current classification of diabetes in different subtypes is based on the defect(s) that causes hyperglycemia, namely, aberrant or deficient insulin secretion or insufficient insulin action (1). Type 1 diabetes (T1D) originates from autoimmune-mediated destruction of the pancreatic P-cells that normally produce insulin, thus resulting in absolute insulin deficiency. Other types of pancreatic disease involving destruction of the P-cells, such as alcoholic pancreatitis, are classified otherwise. Previously, T1D was also known as juvenile-onset diabetes or insulin-dependent diabetes mellitus (IDDM). However, these expressions may result in misclassification and indistinct prognosis and therapeutic options. Criteria to diagnose T1D are shown in Table 1 (1). Note that diagnostic criteria do not include HbA1c levels, which are exclusively used to follow glycemic control, but not diagnosis.
Diagnostic criteria for diabetes mellitus (ADA)
Diabetes mellitus (overall)
Symptoms of polyuria, polydipsia, unexplained weight loss or
Random plasma glucose > 11.1 mmol/l (200 mg/dl) on 2 subsequent days or
Fasting (>8 h) plasma glucose > 7.0 mmol/l (126 mg/dl) on 2 subsequent days Type 1 diabetes mellitus
Autoantibody GAD positive and/or autoantibody tyrosine phosphatase IA-2/IA-2P
Presenting with ketoacidosis
Adapted from ADA Position Statement (23) and an interpretation of data from Service etal. (63).
Was this article helpful?