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Classification and Laboratory Diagnosis of Diabetes Mellitus

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Endocrinology and Diabetes

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Abstract

Diabetes mellitus (DM) is a growing problem worldwide, resulting in enormous economic burdens for many countries. Over the years, there had been several changes in the classification of DM, due to its heterogeneous clinical and genetic nature. Though DM is traditionally diagnosed by oral glucose tolerance test (OGTT), there is a growing practice of utilization of glycated hemoglobin (HbA1c) as the diagnostic tool in the recent years. This chapter aims to cover the clinical stages, classification and types, as well as the laboratory diagnosis of DM.

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References

  1. Aroda VR, Ratner R. Approach to the patient with prediabetes. J Clin Endocrinol Metab. 2008;93: 3259–65.

    Article  PubMed  CAS  Google Scholar 

  2. Himsworth HP. Diabetes mellitus: its differentiation into insulin-sensitive and insulin-insensitive types. Lancet. 1936;1:117.

    Google Scholar 

  3. Bornstein J, Lawrence RD. Plasma insulin in human diabetes mellitus. Br Med J. 1951;2:1541–4.

    Article  PubMed  CAS  Google Scholar 

  4. Berson SA, Yalow RS. Immunoassay of endogenous plasma insulin in man. J Clin Invest. 1960;39: 1157–75.

    Article  PubMed  Google Scholar 

  5. World Health Organization. Second report of the WHO expert committee on diabetes mellitus. Technical report series no. 646. Geneva, Switzerland; 1980.

    Google Scholar 

  6. Definition, diagnosis and classification of diabetes mellitus and its complications—report of a WHO consultation 1999 (WHO/NCD/NCS 99.2).

    Google Scholar 

  7. American Diabetes Association Expert Committee. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 1997;20:1183–97.

    Google Scholar 

  8. Kaprio J, Tuomilehto J, Koskenuo M, Romanov K, Reunanen A, Eriksson J, et al. Concordance for type 1 (insulin-dependent) and type 2 (insulin-independent) diabetes mellitus in a population-based cohort of twins in Finland. Diabetologia. 1992;35:1060–7.

    Article  PubMed  CAS  Google Scholar 

  9. UKPDS. Overview of six years’ therapy of type 2 diabetes—a progressive disease. Diabetes. 1995;44: 1248–58.

    Article  Google Scholar 

  10. Leslie RD, Williams R, Pozzilli P. Clinical review: type 1 diabetes and latent autoimmune diabetes in adults: one end of the rainbow. J Clin Endocrinol Metab. 2006;91:1654–9.

    Article  PubMed  Google Scholar 

  11. Stenstrom G, Gottsater A, Bakhtadz E, Berger B, Sundkvist G. Latent autoimmune diabetes in adults. Diabetes. 2005;54:S68–72.

    Article  PubMed  Google Scholar 

  12. Pozzilli P, Di Mario U. Autoimmune diabetes not requiring insulin at diagnosis (latent autoimmune diabetes of the adult): definition, characterization, and potential prevention. Diabetes Care. 2001;24:1460–7.

    Article  PubMed  CAS  Google Scholar 

  13. Umpierrez GE, Smiley D, Kitabchi AE. Narrative review: ketosis-prone type 2 diabetes mellitus. Ann Intern Med. 2006;144:350–7.

    Article  PubMed  Google Scholar 

  14. Mauvais-Jarvis F, Sobngwi E, Porcher R, Riveline J-P, Kevorkian J-P, Vaisse C, et al. Ketosis-prone type 2 diabetes in patients of sub-Saharan African origin: clinical pathophysiology and natural history of β-cell dysfunction and insulin resistance. Diabetes. 2004;53: 645–53.

    Article  PubMed  CAS  Google Scholar 

  15. Umpierrez GE, Casals MM, Gebhart SP, Mixon PS, Clark WS, Phillips LS. Diabetes ketoacidosis in obese African-Americans. Diabetes. 1995;44:790–5.

    Article  PubMed  CAS  Google Scholar 

  16. Banerji MA, Chaiken RL, Lebovitz HE. Long-term normoglycemic remission in black newly diagnosed NIDDM subjects. Diabetes. 1996;45:337–41.

    Article  PubMed  CAS  Google Scholar 

  17. Umpierrez GE, Clark WS, Steen MT. Sulphonylurea treatment prevents recurrence of hyperglycemia in obese African-American patients with a history of hyperglycemic crises. Diabetes Care. 1997;20:479–83.

    Article  PubMed  CAS  Google Scholar 

  18. Jones A, Hattersley AT. Monogenic causes of diabetes. Textbook of diabetes. 4th ed. UK: Wiley-Blackwell. p. 2010;245–64.

    Google Scholar 

  19. Ellard S, Colclough K. Mutations in the genes encoding the transcription factors HNF1α and 4α in maturity onset diabetes of the young. Hum Mutat. 2006;27:854–69.

    Article  PubMed  CAS  Google Scholar 

  20. Gloyn AL. Glucokinase mutations in hyper and hypoglycemia: maturity onset diabetes of the young, permanent neonatal diabetes, and hyperinsulinemia of infancy. Hum Mutat. 2003;22:353–62.

    Article  PubMed  CAS  Google Scholar 

  21. Ellard A, Thomas K, Edghill EL, Owens M, Ambye L, Cropper J, et al. Partial and whole gene deletion mutations of the GCK and HNF1α genes in maturity onset diabetes of the young. Diabetologia. 2007;50:2313–7.

    Article  PubMed  CAS  Google Scholar 

  22. http://www.diabetesgenes.org/content/gck-gene-analysis-maturity-onset-diabetes-young-gck-mody. Accessed 21 Aug 2012.

  23. http://www.diabetesgenes.org/content/hepatocyte-nuclear-factor-1-alpha-hnf1a-hepatocyte-nuclear-factor-4-alpha-hnf4a-gene-analysi. Accessed 21 Aug 2012.

  24. American Diabetes Association. Diagnosis and classification of diabetes mellitus (position statement). Diabetes Care. 2009;32(Supp 1):S62–7.

    Article  Google Scholar 

  25. National Center for Health Statistics, National Diabetes Fact Sheet. Centers for Disease Control and Prevention. 2011. http://www.cdc.gov/diabetes/pubs/estimates11.htm. Accessed 21 Aug 2012.

  26. Omori Y, Jovanovic L. Proposal for the reconsideration of the definition of gestational diabetes. Diabetes Care. 2005;28:2592–3.

    Article  PubMed  Google Scholar 

  27. Schaefer UM, Songster G, Xiang A, Berkowitz K, Buchanan TA, Kjos SL. Congenital malformations in the offspring of women with hyperglycemia first detected during pregnancy. Am J Obstet Gynecol. 1997;177:1165–71.

    Article  PubMed  CAS  Google Scholar 

  28. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 3: 676–82.

    Google Scholar 

  29. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:1991–2002.

    Article  Google Scholar 

  30. Centers for Disease Control and Prevention: National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2011.

    Google Scholar 

  31. American Diabetes Association. Diagnosis and classification of diabetes mellitus (position statement). Diabetes Care. 2012;35(Supp 1):S64–71.

    Article  Google Scholar 

  32. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Report of a WHO/IDF consultation. 2006; 1–47.

    Google Scholar 

  33. International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009; 32: 1327–34.

    Google Scholar 

  34. Use of glycated hemoglobin (HbA1c) in the diagnosis of diabetes mellitus—abbreviated report of a WHO consultation. 2011. p. 1–25.

    Google Scholar 

  35. Mikesh LM, Bruns DE. Stabilization of glucose in blood specimens: mechanism of delay in fluoride inhibition of glycolysis. Clin Chem. 2008;54:930–2.

    Article  PubMed  CAS  Google Scholar 

  36. Bruns DE, Knowler WC. Stabilization of glucose in blood samples: why it matters. Clin Chem. 2009;55: 850–2.

    Article  PubMed  CAS  Google Scholar 

  37. Tahara Y, Shima K. The response of glycated hemoglobin to stepwise plasma glucose change over time in diabetic patients. Diabetes Care. 1993;16:1313–4.

    PubMed  CAS  Google Scholar 

  38. Little RR, Rohlfing CL, Wiedmeyer HM, Myers GL, Sacks DB, Goldstein DE. The national glycohemoglobin standardization program: a five-year progress report. Clin Chem. 2001;47:1985–92.

    PubMed  CAS  Google Scholar 

  39. Hoelzel W, Weykamp C, Jeppsson JO, Miedema K, Barr JR, Goodall I, et al. IFCC reference system for measurement of hemoglobin A1c in human blood and the national standardization schemes in the United States, Japan, and Sweden: a method-comparison study. Clin Chem. 2004;50:166–74.

    Article  PubMed  CAS  Google Scholar 

  40. Bonora E, Tuomilehto J. The pros and cons of diagnosing diabetes with A1c. Diabetes Care. 2011;34 Suppl 2:S184–90.

    Article  PubMed  CAS  Google Scholar 

  41. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ. Translating the AIC assay into estimated average glucose values. Diabetes Care. 2008;31(8): 1473–8.

    Article  PubMed  CAS  Google Scholar 

  42. http://www.aacc.org/publications/cln/2008/october/Pages/cover1_1008.aspx. Accessed 21 Aug 2012.

  43. Sacks DB. AIC versus glucose testing: a comparison. Diabetes Care. 2011;34:518–23.

    Article  PubMed  Google Scholar 

  44. Inzucchi SE. Diagnosis of diabetes. N Engl J Med. 2012;367:542–50.

    Article  PubMed  CAS  Google Scholar 

  45. Herman WH, Cohen RM. Racial and ethnic differences in the relationship between HbA1c and blood glucose: implications for the diagnosis of diabetes. J Clin Endocrinol Metab. 2012;97(4):1067–72.

    Article  PubMed  CAS  Google Scholar 

  46. Casparie AF, Miedema K. Glycosylated hemoglobin in diabetes and renal failure. Lancet. 1977;2(8041): 758–9.

    Article  PubMed  CAS  Google Scholar 

  47. De Boer MJ, Miedema K, Casparie AF. Glycosylated hemoglobin in renal failure. Diabetologia. 1980;18(6): 437–40.

    Article  PubMed  Google Scholar 

  48. Eschbach Jr JW, Funk D, Adamson J, Kuhn I, Scribner BH, Finch CA. Erythropoiesis in patients with renal failure undergoing chronic dialysis. N Engl J Med. 1967;276:653–8.

    Article  PubMed  Google Scholar 

  49. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.

    Article  Google Scholar 

  50. Weinstock RS, Zygmont SV. Endotext diabetes and carbohydrate metabolism chapter 5: pancreatic islet function tests. 2010. Accessed 21 Aug 2012.

    Google Scholar 

  51. Delli AJ, Larsson HE, Ivarsson SA, Lernmark AK, Kong APS, Chan JCN. Type 1 diabetes. Textbook of diabetes. 4th ed. UK: Wiley-Blackwell. p. 141–52.

    Google Scholar 

  52. Lee YS, Ng WY, Thai AC, Lui KF, Loke KY. Prevalence of ICA and GAD antibodies at initial presentation of type 1 diabetes mellitus in Singapore children. J Pediatr Endocrinol Metab. 2001;14:767–72.

    PubMed  CAS  Google Scholar 

  53. Sanjeev CB, Hagopian WA, Landin-Olsson M, Kockum I, Woo W, Palmer JP, et al. Association between autoantibody markers and subtypes of DR4 and DR4-DQ in Swedish children with insulin-dependent diabetes reveals closer association of tyrosine pyrophosphatase autoimmunity with DR4 than DQ8. Tissue Antigens. 1998;51:281–6.

    Article  Google Scholar 

  54. Vardi P, Ziegler AG, Mathews JH, Dib S, Kller RJ, Ricker AT, et al. Concentration of insulin autoantibodies at onset of type 1 diabetes: inverse log-linear correlation with age. Diabetes Care. 1998;11:736–9.

    Google Scholar 

  55. Graham J, Hagopian WA, Kockum I, Li LS, Sanjeevi CB, Lowe RM, et al. Genetic effects on age-dependent onset and islet cell autoantibody markers in type 1 diabetes. Diabetes. 2002;51:1346–55.

    Article  PubMed  CAS  Google Scholar 

  56. Barker JM, Barriga KJ, Yu LP, Miao DM, Erlich HA, Norris JM, et al. Prediction of autoantibody positivity and progression to type 1 diabetes: Diabetes Autoimmunity Study in the Young (DAISY). J Clin Endocrinol Metab. 2004;89:3896–902.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology and Diabetes, The Alfred, 55 Commercial Road, Melbourne, VIC, Australia

    Shui Boon Soh M.B.B.S. & Duncan Topliss M.B.B.S., M.D.

Authors
  1. Shui Boon Soh M.B.B.S.
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  2. Duncan Topliss M.B.B.S., M.D.
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Corresponding author

Correspondence to Shui Boon Soh M.B.B.S. .

Editor information

Editors and Affiliations

  1. Professor Associado e Livre-Docente, Disciplina de Endocrinologia da Faculdade de Ciências Medicas da Universidade de Pernambuco, Chefe da Divisão de Endocrinologia e Diabetes do Hospital Agamenon, Magalhães-MS/UPE, Recife, Brazil

    Francisco Bandeira

  2. American Thyroid Association Past President, American Association of Clinical Endocrinologists, Professor of Medicine, Mayo Clinic College of Medicine President-Elect, Rochester, Minnesota, USA

    Hossein Gharib

  3. Federal Foundation and School of Medical Sciences, Porto Alegre, Brazil

    Airton Golbert

  4. Department of Medicine, University of Pernambuco School of Medicine, Recife, Brazil

    Luiz Griz

  5. Department of Medicine, University of Maranhao School of Medicine, Sao Luis, Brazil

    Manuel Faria

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Soh, S.B., Topliss, D. (2014). Classification and Laboratory Diagnosis of Diabetes Mellitus. In: Bandeira, F., Gharib, H., Golbert, A., Griz, L., Faria, M. (eds) Endocrinology and Diabetes. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8684-8_27

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  • DOI: https://doi.org/10.1007/978-1-4614-8684-8_27

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