Definition, diagnosis and classification of diabetes mellitus and its complications

Author(s): Alberti KG, Zimmet PZ


The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has been changed since that time. There is however considerable new knowledge regarding the aetiology of different forms of diabetes as well as more information on the predictive value of different blood glucose values for the complications of diabetes. A WHO Consultation has therefore taken place in parallel with a report by an American Diabetes Association Expert Committee to re-examine diagnostic criteria and classification. The present document includes the conclusions of the former and is intended for wide distribution and discussion before final proposals are submitted to WHO for approval. The main changes proposed are as follows. The diagnostic fasting plasma (blood) glucose value has been lowered to > or =7.0 mmol l(-1) (6.1 mmol l(-1)). Impaired Glucose Tolerance (IGT) is changed to allow for the new fasting level. A new category of Impaired Fasting Glycaemia (IFG) is proposed to encompass values which are above normal but below the diagnostic cut-off for diabetes (plasma > or =6.1 to <7.0 mmol l(-1); whole blood > or =5.6 to <6.1 mmol l(-1)). Gestational Diabetes Mellitus (GDM) now includes gestational impaired glucose tolerance as well as the previous GDM. The classification defines both process and stage of the disease. The processes include Type 1, autoimmune and non-autoimmune, with beta-cell destruction; Type 2 with varying degrees of insulin resistance and insulin hyposecretion; Gestational Diabetes Mellitus; and Other Types where the cause is known (e.g. MODY, endocrinopathies). It is anticipated that this group will expand as causes of Type 2 become known. Stages range from normoglycaemia to insulin required for survival. It is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements.

Similar Articles

Targeting postprandial hyperglycemia: a comparative study of insulinotropic agents in type 2 diabetes

Author(s): Carroll MF, Gutierrez A, Castro M, Tsewang D, Schade DS

Inhibitors of the rate of carbohydrate and lipid absorption by the intestine

Author(s): Puls W, Krause HP, Müller L, Schutt H, Sitt R, et al.

Trans-chalcone: a novel small molecule inhibitor of mammalian alpha-amylase

Author(s): Najafian M, Ebrahim-Habibi A, Hezareh N, Yaghmaei P, Parivar K, et al.

Plant alpha-amylase inhibitors and their interaction with insect alpha-amylases

Author(s): Franco OL, Rigden DJ, Melo FR, Grossi-De-Sá MF

Analgesic and Anti-Inflammatory Activity of PinusroxburghiiSarg

Author(s): Kaushik D, Kumar A, Kaushik P, Rana AC

Anticonvulsant activity of alcoholic extract of bark of PinusroxburghiiSarg

Author(s): Kaushik D, Kumar A, Kaushik P, Rana AC

GC-MS Analysis and Antimicrobial Activity of Essential Oil of PinusroxburghiiSarg

Author(s): Kaushik D, Kaushik P, Kumar A, Rana AC, Sharma C, et al.

Evaluation of Anticancer Activity of PinusroxburghiiSarg

Author(s): Kaushik P, Khokra S, Rana A, Kaushik D

The phenols and prodelphinidins of white clover flowers

Author(s): Foo LY, Lu Y, Molan AL, Woodfield DR, McNabb WC

13C CP/MAS NMR studies of flavonoids

Author(s): Wawer I, Zielinska A